隨著高齡社會的來臨、85歲以上之「老老人」人數增長，具有長期照護需求者亦隨之增加；在眾多長期照顧資源中，目前以小型養護機構的所提供的服務量最為多，可見此種機構類型在長期照顧領域中的重要性。由於長期照顧機構間競爭激烈及評鑑期待等因素，使得服務品質成為目前小型養護機構發展的目標；社工員專業功能的發揮對於機構服務品質提升多有助益，但社工員的任用或許因為法源不足、成本考量、機構人員認識不足等因素沒有受到同等的重視，亦形成社工員高流動率與聘僱不易等問題。目前對於此研究對象的相關研究甚少，無法對於此種現象進行瞭解，且不能解答筆者過去一年多兼職工作經驗中所產生的疑慮，因而本研究以小型養護機構社工員為研究對象，探討其專業角色的發展歷程。本研究之目的如下：（1）試圖了解小型養護機構社工員在機構內的工作職責；（2）這些角色如何學習、建構與發展之歷程；（3）社工員的角色認知與其它工作人員角色期待磨合的過程；（4）此段過程中的各式影響因素；（5）期待本研究能使政策制定者、社工教育的學者及實務工作者關注社工員在小型養護機構內奮鬥的辛酸，並提出改善社工員所處情境之建議。
本研究因為過去相關研究甚少、據探索性研究特質、以生命經驗作為探索焦點及重視研究參與者觀點等因素採用質性研究典範，使用深度訪談方式蒐集資料，並以樣版式方法進行分析，在研究過程中亦有處裡研究倫理及信、效度等議題。本研究之研究結果為：（1）社工員於小型養護機構內的工作職責為「與個案一起工作」、「與家屬一起工作」及「與機構一起工作」；（2）專業角色發展歷程大致可歸納為兩主軸，其一為「角色不明確->學習」，初入機構時，多數社工員會感到角色不明確，而出現不知所措、挫折感、壓力、沒有成就感與緊張害怕等情緒，其運用正式教育訓練與非正式觀察模範、蒐集資訊、反思學習等方式進行社工員角色扮演、認識角色組成員、病理知識、組織運作資訊等相關學習，但由於機構內正式訓練不足、非正式學習並無相同專業之指導者，所以社工員紛紛表達需求督導支持；（3）專業角色發展歷程的第二主軸為「角色衝突->因應」，社工員對自己專業角色有所認知，進入機構後，部份機構主管因為對社工員專業角色認識不清、人力聘用不足、較不熟悉電腦操作等因素，對社工員有較高的行政角色期待，而引發角色衝突困境，令社工員感到抗拒、排斥、不滿、專業角色不被重視、想要離職、掙扎或對主管的角色期待產生疑惑等負面情緒，若干社工員以工時不足為由與機構主管溝通協調捍衛自己對於專業角色的認知，但多數仍不敵機構主管的期待而妥協接受機構主管角色期待，成為機構內的行政人員或社工兼任行政人員，在同時扮演兩種角色或捨棄原有專業角色轉而扮演自己不熟悉的角色之情況下，社工員會出現角色負荷過度的問題，並對自己專業成長沒有信心、付出收益不等值及引發自責等負面情緒。但仍有些社工員能運用說服的技巧、堅定拒絕的態度、事先避免等策略來堅持自己所認知的專業角色；（4）在上述的兩個主軸的影響因素中，社工員個人的人力資本、社會支持與自我認同會使得社工員較能堅持專業角色，同樣地組織內機構主管的學習經驗、接觸社工員的經驗也會讓機構主管較為清楚了解社工員的工作角色；但社工員重視人際合諧、畏懼權威等個人特質，會讓社工員妥協接受機構主管的角色期待，而機構內學習資源不足、社工員兼職工作身分等因素會阻礙社工員資訊之取得，機構內無行政專責人員、機構專業分工不清之文化，則會令機構主管對於社工員產生角色期待；除了個人與組織層次之助、阻力之外，社會環境層次中，規範小型養護機構的法規及評鑑項目等亦對於社工員專業角色發展有所影響；（5）學習是小型養護機構社工員專業角色發展歷程之核心機制，貫穿了「角色不明確->學習」主軸，也與角色衝突、因應策略息息相關，更是左右此歷程發展之重要因素。最後，研究者亦有針對上述研究結果之相關議題進行深入討論，並提出數點建議期待研究成果有較為實質的貢獻。 / With the approach of aged society and the growing number of senior citizens over 85, people with the needs of long-term care is also on the increase. Currently, among all the long-term care resources, the amount of service provided by small-scale nursing home is the largest. Therefore, we can realize the significance of such type of facilities in the field of long-term care. However, due to factors like the keen competition and the expectations of evaluation among long-term care facilities, the quality of service has become the goal of small-scale nursing home. The realization of social workers’ professional roles is beneficial to the enhancement of the service quality of facilities. Nevertheless, probably because of reasons such as the insufficient laws, the consideration of cost, and the insufficient knowledge of staff, the employment of social workers is not equally emphasized, and thus causes problems like the high mobility of social workers and the difficulty in hiring social workers. Since there are few related studies on social workers, I could not understand such phenomena and there is no answer to the problems raised from my part-time experience. Hence, studying social workers, this study aims to explore the developing process of the roles. The purposes of this study are as follows: first, understanding the duties of social workers in small-scale nursing home; second, the way social workers learn and construct roles as well as their developmental process; third, the role identification of social workers and the process they conciliate with the role expectations from other staff; fourth, the various influencing variables during the process; fifth, the hope that this study could make policy-makers, scholars in social worker education field and practician concern the hardship and struggle that social workers encounter in small-scale nursing home, and provide suggestions for improving the conditions of social workers in these workplaces.
As a result of elements like few related studies, studies with exploratory features focusing on life experience and on the viewpoints of participants, this study adopts the qualitative paradigm, collects data with in-depth interviewing, and explains with the template analysis style. The study also deals with certain issues like ethics, reliability, and validity during the process. There are 5 findings in this study. First, the duties of social workers in small-scale nursing home include “working with the client,” “working with the family,” and “working with the facility.” Second, the developmental process of professional roles can generally be divided into 2 categorizes. One is “from uncertain role to learning.” At the beginning, most social workers feel uncertainty about the role and emotions like loss, frustration pressure, lack of achievement, nervousness and fear occur. With formal educational training, informal observing model, collecting data, and reflective learning, they learn through the role play of the social workers, knowing group members, pathological knowledge, and information about the running of organizations. Nevertheless, owing to insufficient formal training in the facility and no advisor with the same expertise for informal learning, social workers turn to supervisors for help one after another. Third, the other category is “from role conflicts to solutions.” After social workers realize their professional roles and work in facilities, due to facts like insufficient understanding of the professional roles of social workers, insufficient staff, and unfamiliarity of using computers, part of managers in facilities hold higher expectations of administrative roles on social workers, and thus causes social workers the dilemma of role conflicts and negative emotions like resistance, refusal, disaffection, despise of professional roles, resignation, struggle, or doubts about the role expectations from managers. Several social workers negotiate with the managers for the reason of insufficient working time to defend their recognition on professional roles. However, most of them still compromise and accept such role expectations. They become the administrative staff or social worker and part-time administrative staff. Under the circumstances of playing 2 roles at the same time or giving up the previous professional roles and turning into a less familiar role, social workers suffer from overload, become not confident in their professional development, feel inequality between devotion and reward, and have negative emotions like reproving themselves. Yet, some workers employ strategies like techniques in persuasion, firm refusing attitude, and prevention in advance to insist on the professional role in their mind. Fourth, among the variables in the 2 categories, the personal human capital of social workers, social support, and self-identification enable social workers to persist in their professional roles. By the same token, the learning experience of institute managers and their experience of contacting social workers also make managers understand the role of social workers better. Nonetheless, characteristics like emphasis on interpersonal harmony and fear of authority lead social workers to compromise and accept the role expectations of facility managers, while factors like lack of learning resources in the facility and the part-time role of social workers prevent social workers from access to information. The lack of full-time administrative staff and the culture of vague division of work in the facility cause facility managers to hold role expectations on social workers. In addition to the encouragement and obstruction from the personal and organizational level, in terms of social environmental level, the laws and evaluation items that regulate small-scale nursing home also affect the social workers professional role development. Fifth, learning is the core mechanism of the process of social workers’ professional role development in small-scale nursing home. It not only penetrates the category of “from uncertain role to learning,” but also is closely related to role conflicts and responding strategies. Moreover, it is the important element that affects the development of this process. At last, the researcher also has a deep discussion in terms of related issues about the results and proposes several suggestions in the hope that the results could have practical contributions.
| Identifer | oai:union.ndltd.org:CHENGCHI/G0093254018 |
| Creators | 林易沁 |
| Publisher | 國立政治大學 |
| Source Sets | National Chengchi University Libraries |
| Language | 中文 |
| Detected Language | English |
| Type | text |
| Rights | Copyright © nccu library on behalf of the copyright holders |
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