臺北地區遠距健康照護服務之現況與展望及社工的角色內涵

Abstract

遠距健康照護服務橫跨醫療衛生、社會福利、資訊通訊等多元領域，屬於長期照護中的創新服務，在當今人口高齡化及科技進步的趨勢下，發展空間大。 本研究運用深度訪談法，訪問臺北地區六位實際從事遠距健康照護服務的社工、四位管理者以及一位社工督導，欲瞭解臺北地區遠距健康照護服務體系的現況，以及之中社工的角色內涵。 研究首先將臺北地區遠距健康照護服務的發展歷程分為四個階段，分述其運作現況，發現無論社政體系主導的緊急救援系統，或是衛政主事的遠距健康照護計畫，皆高度受到政府政策影響。 該服務模式內的社工擔負著直接服務、行政工作、社區經營及政策倡導等角色。然而，目前遠距健康照護服務仍以醫療取向為主，重視生理量測功能，參與的社工人數少，角色也顯模糊。 研究建議推動全人觀點的整合性遠距健康照護服務，符合使用者全人的需求，亦使得資源配置更為公平與普及。其次，建議政府應著手修改相關法規，以利該服務的發展。至於社工投入方面，本研究建議社工運用社區工作方法，由社區切入遠距健康照護領域，開拓新的實務契機。同時應在學校教育、在職教育、角色楷模、研究發展及組織支持等層面，增進社工的裝備與教育訓練。 期待更多社工投入本領域，在跨專業團隊中發揮社工專業，讓使用者獲得更完善的服務。在衛生福利部甫成立的環境氛圍中，本研究也希望促成社會工作及衛生醫療兩種專業的互動與合作。

Telehealthcare service, extending from health service, social welfare, to information communication, is innovative among long-term care service. It will have a broader development space owing to the population aging and technological advancement today. The research, adopting in-depth interview with six social workers who are actually conducting telehealthcare, four executives and one supervisor on social workers, aims to specify the situation of telehealthcare service system in metropolitan Taipei and the role connotation of social workers within it. In the research, the development process of telehealthcare service in metropolitan Taipei is divided into four phases firstly, and then their operations are described respectively. It’s found out that whether emergency rescue system led by social welfare administration or telehealthcare plans ministered by health administration, are highly influenced by governmental policies. Social workers within the service mode play roles in direct service, administrative work, community management, policy advocacy, etc. However, at present, telehealthcare service still focuses on medical service, valuing physiological measurement, with few participated social workers whose roles are also obscure. The research proposes that integrated telehealthcare service with the perspective of whole person should be promoted, which caters to the user’s demands as a whole person and makes the allocation of resources fairer and more widespread. Next, the government should start to amend relevant laws in order to promote the development of the service. As to the involvement of social workers, it’s suggested that social workers adopt community work approach, participate in telehealthcare service from communities and explore more practical opportunities. In the meanwhile, social workers’ equipment and educational training should be strengthened through schooling, in-service education, role modeling, research and organizational support. It is expected that more social workers devote themselves into this field and bring out their best in the trans-disciplinary team so as to provide better service for the users. As Department of Health and Human Services was newly established, the research also expects to promote the interaction and cooperation between social work and health service.