小型老人長照養護型機構專職社會工作人員的工作現況與因應之道

Abstract

本文旨在探討社工受聘於小型老人養護型機構後所面臨的工作生態情境，及其在實踐社會工作專業時所遭遇之困境因素，與面對困境的因應之道。透過半結構式訪談現職於臺北市核准立案之小型老人養護機構聘任之專職社工，本研究發現：（一）社工與機構所產生的衝突，是因機構以營利為主的取向，與社工對自身、服務對象與組織的專業想望有所衝突而造成。（二）專業倫理與機構結構上的衝突、社會政策對實務工作的要求、機構對社工的期待及看待照顧的態度、勞雇關係中的權力控制及社工缺乏心理支持，均是影響社工發揮專業角色的因素。（三）社工所面的困境區分為「機構量能的限制」、「互動上困境」、「溝通上的困境」、「一人社工的困境」等類型，並按此發展出不同的因應之道。本研究依上述研究結果，針對社會工作者、小型老人養護型機構、社會政策、社工專業組織團體提出建議。

The purpose of this paper is to explore the work situation faced by social workers who are employed in small long term care facilities for the elderly, the difficulties they encounter in practicing the social work profession, and corresponding coping strategies they adopt. Through semi-structured interviews conducted with full-time social workers who are currently employed in approved small senior care facilities in Taipei, this study found that:\n(1) The conflict between social workers and senior care facilities primarily results from the contradiction between the profit-oriented objective of facilities and the professional expectations that social workers have for themselves, their service targets, and the facilities.\n(2) Factors that affect how social workers perform in their professional role include conflicts between professional ethics and institutional structure, social policy requirements for practical work, facilities’ expectations of social workers and their attitude towards caregiving services, power control in employer-employee relationships, and a lack of psychological support for social workers.\n(3) The difficulties confronted by social workers are classified into the following categories: “institutional capacity limitations”, “interaction difficulties”, “communication difficulties”, and “difficulties of one-person social workers”; different coping strategies have been developed accordingly.\nBased on the above findings, this study proposes recommendations for social workers, small senior care facilities, social policies, and social work professional organizations, respectively.