台灣印尼籍居家看護新冠疫情前後心理健康的質性研究

Abstract

隨著臺灣進入「高齡社會」階段，對外籍看護工的需求大幅增加，主要是擔任居家照護長輩的印尼女性。在 COVID-19 疫情期間，由於與長輩者密切接觸，這些看護工面臨更高的健康風險。本研究探討在臺灣疫情控制成效顯著的背景下，疫情對居家印尼看護工心理健康的影響。現有研究鮮少採取縱向視角，未能比較疫情前後看護工的心理健康經驗。本研究旨在從看護工的觀點出發，定義心理健康的意涵，追蹤其心理狀態隨時間的變化，並辨識影響心理健康的關鍵因素。

研究參與者透過社交媒體、社區公告與口耳相傳的滾雪球抽樣方式於臺北招募。研究進行了八場半結構式訪談，訪談語言為印尼語，並由翻譯協助。訪談內容經轉錄與翻譯為英文後，採用詮釋現象學分析法進行分析。

研究結果歸納出四個主要主題與七個次主題：與雇主的關係位置（疏遠、中距離與親近關係）、來自家鄉的推力與拉力（家庭連結與生產結構）、信仰作為立足點，以及在海外的社交網絡（傾聽的耳朵與學習/充實）。受訪者將心理健康理解為情緒穩定，極易受到外在因素影響，尤其是與雇主的關係。疫情對於與雇主關係不佳者造成負面影響，但對於關係良好者則促進了情感連結與心理福祉。由於臺灣疫情控制得當，多數雇主得以繼續工作，有助於緩解看護工的經濟不穩定。所有受訪者皆展現出韌性，並對在疫情期間展現同理心與關懷的雇主表達感謝。

為了在面對高齡化挑戰時維持競爭力，臺灣應在薪資之外，提供安全、高品質的工作條件與有意義的成長機會，吸引與留住外籍看護工。雇主可透過建立健康且開放的關係，以及善用長照 2.0 所提供的專業服務，來提升外籍看護工的能力並支持其心理健康。

As Taiwan enters an “aged society” phase, the demand for migrant caregivers - primarily Indonesian women in in-home eldercare roles - has increased significantly. During the COVID-19 pandemic, these caregivers faced heightened health risks due to their close contact with older adults. This study investigates the mental health impacts of the pandemic on in-home Indonesian caregivers within the context of Taiwan’s highly effective pandemic response. Existing research has rarely adopted a longitudinal perspective, failing to compare caregivers’ mental health experiences before and after the pandemic. This study aims to define mental health from caregivers’ perspectives, trace changes in their mental health status over time, and identify key influencing factors.

Participants were recruited in Taipei using snowball sampling through social media, community postings, and word of mouth. Eight semi-structured interviews were conducted in Indonesian with the assistance of a translator. The interviews were transcribed, translated into English, and analyzed using interpretive phenomenological analysis.

Four major themes and seven subthemes emerged: Position Relative to Employers (distant, mid-distance, and close relationships), Push and Pull from the Homeland (family ties and productive structures), Grounding Faith, and Social Networking Abroad (listening ears and learning/enrichment). Caregivers conceptualized mental health as emotional stability, highly susceptible to external influences, particularly their relationships with employers. The pandemic negatively impacted those with unsupportive employers, while it strengthened bonds and emotional well-being for those with positive relationships. Taiwan’s successful pandemic control allowed employers to continue working, helping alleviate caregivers’ financial instability. All participants demonstrated resilience and gratitude toward employers who showed empathy and commitment to their well-being during this period.

To remain competitive with other aging societies, Taiwan must complement its wage offerings with safe, high-quality employment conditions and meaningful enrichment opportunities for migrant caregivers. Employers can achieve this by fostering a healthy and open relationship with their caregiver, as well as using the services offered by LTC 2.0 healthcare professionals to enhance foreign caregivers’ competence and support their mental health.