居家服務的照顧關係：以澎湖為例

Abstract

本研究在探討澎湖的居家服務員在照顧工作中所建立的互動關係，研究試圖從工作者的生活與工作經驗出發，理解在地工作者如何詮釋居家服務與照顧關係，並描繪出照顧工作的意義如何鑲嵌在他們身處的在地脈絡以及文化特性。 研究透過深度訪談以及田野觀察作為資料蒐集方法，主要是以8位居家服務員的個人經驗分享作為資料分析來源，同時也加入研究者在研究場域中與其他一線工作者的互動經驗與觀察，並採用主題分析法作為分析途徑。 研究結果與發現： 一、「照顧關係」是潛藏在居家服務中的隱形勞動工作，雖然是被忽略的工作細節，但對工作者而言，照顧關係的建立才能達成個別化照顧的目的；照顧裡的互動關係也是服務的一環，工作者在互動過程便能夠回應與支持服務對象在心理與社會層面的照顧需求，以完成全人觀點下的照顧。 二、在以關係為基礎的居家服務中，工作者與服務對象之間會形塑多元的角色關係，不論是以家人、朋友般的樣態存在，或出現跨越專業關係的互動，都反應了一線的照顧工作者所建立的照顧關係，除了遵循專業倫理守則之外，也會依據在地的文化脈絡或特性，因此，在社會網絡較為緊密的澎湖地區，在地居家服務工作者，同時也扮演了社區中的鄰里照顧角色。 三、多元角色關係裡的工作者會面臨正式與非正式關係界線的議題，以及需要承擔更多的照顧責任，特別是服務在地社區的居家服務員，面對到缺少家庭支持的服務對象，也被期待要提供額外的照顧與協助，最後，這樣的照顧工作特性與澎湖的生活脈絡，也潛藏了對於工作者的剝削與負擔。

This study aims to explore the issue about relationship between home-care workers and their clients in Penghu. Based on materials collected by in-depth interviews and participant observations, this study analyzes the life and working experience of care workers. The focus is on care workers’ interpretation and meaning of care relationship. The cultural context embedded in the relationship is emphasized. The results of the research are as follows： 1. The process of “relationship building” in home-care service is invisible. It is often overlooked. However, it’s an important element that helps care-workers to do personalized caring. It’s also important for meeting service recipients’ emotional and mental demands. 2. Caregivers and service recipients often describe their relationships as kin-like or friends. In addition, cultural context in Penghu plays an important role in shaping their interaction. To some extent, the relationship is like neighborhood social network. The workers who have private connection with service user would become more than formal caregivers. 3. The fact that care workers and service recipients have multiple or dual roles results in the blurring of the boundaries of formal and informal relationship. As a consequence, caregivers have to take more responsibility to do extra favors, especially for isolated clients. This special relationship has made homecare workers overburdened in Penghu.