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研究生:吳秀琴
研究生(外文):Shiou-Chin Wu
論文名稱:英國社工員在社區照顧團隊中的角色之研究
論文名稱(外文):A Study on the Roles of A Social Worker in the Communiy Care Team in UK
指導教授:黃源協黃源協引用關係
指導教授(外文):Yuan-Shie Hwang
學位類別:碩士
校院名稱:國立暨南國際大學
系所名稱:社會政策與社會工作學系
學門:社會服務學門
學類:社會工作學類
論文種類:學術論文
論文出版年:2002
畢業學年度:90
語文別:中文
論文頁數:152
中文關鍵詞:社工員社區照顧團隊照顧管理個案管理
外文關鍵詞:social workercommunity careteamcare managementcase management
相關次數:
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  本研究的主要目的在探討英國社區照顧的實施、團隊的運作、社工員的角色和社工員在不同時期的角色之轉變,並根據研究結果提出有益的實施建議。為讓研究能更聚焦於某一案主團體,本研究以老人社區照顧的實施為研究對象。研究範圍則包含英國社區照顧實驗期的Gateshead社會照顧計畫、Gateshead健康暨社會照顧計畫、EPIC計畫,以及1990年代國民保健服務及社區照顧法案通過後的社區照顧改革期的實施。
  研究結果發現 : 首先,在社區照顧實驗期,起初僅有社工員投入社區照顧團隊,後來為滿足案主的複雜需求,健康照顧專業(如醫師、護士、物理治療師、職能治療師等)亦共同投入服務的供給。從單一專業至多科際專業的投入,社工員所面臨的角色轉變為:1.照顧管理經費籌措壓力降低。2.個案發掘與轉介來源增加。3.照顧包裹與計畫更周延。4.照顧包裹的監督更周延。5.知識與技巧提昇。另外,在社區照顧改革期方面,由於1990年代國民保健服務及社區照顧法案的通過,加上照顧混合經濟的實施、購買者/供給者的分離,社工員面臨了角色的重新界定。社工員遠離了傳統的個案工作,供給者不再是社工員任務的重心,取而代之的是評估者、購買者、協調者等照顧管理的角色。
  另外,研究發現,社工員若要在社區照顧中擔任照顧管理者的角色,必須朝以下幾方面努力:1.加強資源網絡的運用能力,以回應資源的限制。2.取得專業與管理主義之間的平衡。3.維護案主的自抉與選擇。4.強調多科際專業的照顧供給。5.爭取與其它專業人員的認同6.保有彈性的心態。7.加強照顧管理的才能。
  最後,因為我國老年人口的增加,帶來各種照顧的問題,為因應高齡化社會的挑戰,照顧管理的運用已逐漸受到我國的重視。本研究亦從政策面、實施面、教育面三個面向提出台灣實施照顧管理之建議。在政策面上:1.中央與地方應建立一套照顧管理的政策,並劃分清楚權責。2.建立整合的社政與衛政體系。3.推動照顧管理實驗性方案,並逐步地擴大和全面推動。在實務面:1.建立一套本土化的照顧管理的模式。2.確立社工員的角色。3.訂定合理的個案負荷量。4.強化專業間的合作、互信與互重。5.充份運用、開發及整合資源。6.倡導案主的選擇、參與的環境與能力。7.鼓勵社工員創新及保有彈性心態。在教育面:1.社工相關科系開設照顧管理課程,以儲備人才。2.加強現有社工從業人員的照顧管理在職訓練,以增強其能力。
The major purposes of this essay were to study the community care practice in UK , the operation of community care teams , the roles of a social worker and their changes in different period . Besides , according to the research findings ,some useful suggestions were presented .In order to focus on one client group,the study was targeted at elderly community care practice.The extent of this study included some experimental schemes , like the Gateshead social care scheme , Gateshead health and social care scheme in 1980s and EPIC project in early 1990s.Community care practice reforms after the passing of NHSCCA in 1990 was also included.
The conclusions drawn were as follows:First of all,in the community care experimental period,there were only several social workers involved at first.In order to satisfy complex needs of clients,health care professionals such as doctors, nurses , occupational therapists , physical therapists were also involved in the provision of care.From single profession to multi-professions involved,the roles of a social worker suffered some changes : 1.The funding pressure about care management fell.2.The source of the case-finding and refferal was more diverse. 3.The care package and plans were more inclusive. 4.The monitoring of care package was more thorough. 5. The social worker possessed more knowledge and skills . Furthermore,in the reform period following the passing of the 1990 NHSCCA and the coming of mixed economy of care,seperation of purchaser/provider , the social worker redefined her/his roles . The social worker was more far from traditional casework,and moved towards a care manager,such as evaluator, purchaser , coordinator et al. Provision was not a core task of a social worker any more.
Moreover,the author suggested that if a social worker wanted to resume a care manager in the community care , she/he had to devote her/his effort to :1.Enforcing the ability of mobilizing resource to respend toe the limits of resources. 2.Balancing professionism with managerialism. 3.Maintaining the self-determination and choice of clients. 4. Emphasizing multi-professionals''s care provision. 5.Winning the identity of other professionals. 6.Keeping flexible attitude. 7.Strengthening the competence of care management.
Finallay,due to the growing numbers of elderly people in Taiwan,various care problems emerged.In order to deal with the challenge that our aging society faced, the author presented some suggestions for the practice of care management in Taiwan from the perspectives of policy , practice and education dimensions.In the way of policy:1.The central and local government should work out a policy of care management , and
had clear divison.2.An integrated social and health care policy should be built.3.Experimental care management programs should be pushed and extended increasingly and wholly.In respect of practice:1.A localized care management model should be built . 2.The roles of a social worker should be identified.3.Sutiable case workloads should be defined.4.Cooperation,mutual trust and respect should be strengthened among professionals.5.Resources should be used,developed and integrated sufficiently. 6.The ability and atmosphere of choice and participation of clients should be advocated.7.A social worker should be encouraged to be innovative and flexible.So fas as education be concerned : 1.Social work related departments should set up care management courses to have workers prepared.2.Social workers should have more on-the-job-training in care management to strengthen her/his competence.
目 次
                           頁次
第一章 研究動機與目的---------------------------------1
  第一節 研究動機-----------------------------------1
  第二節 研究目的------------------------- ---------4
  第三節 研究方法------------------------- ---------5
第二章 英國的社區照顧、照顧管理與團隊-----------------7
  第一節 社區照顧的發展與內涵-----------------------7
  第二節 照顧管理的緣起與內涵-----------------------14
  第三節 社區照顧團隊與照顧管理---------------------25
  第四節 社會工作的發展與概況-----------------------33
  第五節 社會工作、社區照顧與照顧管理---------------44
第三章 社區照顧實驗計畫期之社工員角色分析-------------51
  第一節 Gateshead實驗計畫--------------------------51
  第二節 蘇格蘭EPIC計畫-----------------------------70
  第三節 社區照顧團隊之運作-------------------------82
  第四節 社工員角色之分析---------------------------91
第四章 1990年代社區照顧改革期之社工員角色分析---------95
  第一節 1990年代社區照顧的實施---------------------95
  第二節 1990年代社區照顧團隊之運作----------------108
  第三節 社工員角色之分析--------------------------116
第五章 社工員在社區照顧團隊中角色之探討--------------125
  第一節 社工員在社區照顧團隊中角色之轉變----------125
  第二節 社工員何去何從----------------------------131
第六章 結論------------------------------------------119
  第一節 研究結論----------------------------------119
  第二節 研究建議與限制----------------------------123
圖 目 次
                           頁次
圖2.1 照顧管理的發展軌跡------------------------------15
圖2.2 團隊的類型--------------------------------------31
圖2.3 社會服務部門的傳統組織--------------------------42
圖2.4 社會工作之三種社區照顧角色----------------------45
圖2.5 社會工作、社區照顧團隊、照顧管理與社區照顧之關係--
------------------------------------------------49
圖3.1 Gateshead的地理位置-----------------------------53
圖3.2 Stirling的地理位置------------------------------71
圖3.3 在健康暨社會體系的責信--------------------------87
表 目 次
                           頁次
表2.1 個案工作、主要工作者、照顧管理之差異------------22
表2.2 團隊類型之比較----------------------------------30
表2.3 社會工作的轉變----------------------------------39
表3.1 Gateshead社會照顧計畫中個案管理者的活動---------82
表3.2 Gateshead社會照顧計畫中個案管理者所使用的資源---83
表3.3 Gateshead健康暨社會照顧計畫中個案管理者的活動---84
表3.4 Gateshead健康暨社會照顧計畫中個案管理者與正式機構的
接觸--------------------------------------------85
表3.5 Gateshead健康暨社會照顧計畫中個案管理者所使用的資源
    ------------------------------------------------85
表3.6 Gateshead、EPIC計畫執行之摘要及社工員角色之分析-91
表4.1 福利部門及老人社區照顧供給---------------------110
表5.1 社工員在社區照顧內的角色轉變-------------------126
表6.1 研究結果摘要-----------------------------------138
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三、網站資料:
travel.lycos.com/destinations/Europe/Scotland/Stirling
www.doh.gov.uk/publications/wgpaper.html.
www.dss.gov.uk/ha/bfi/gateshead/appb.htm.
www.geordiepride.demon.co.uk/gateshead.guide.htm
www.geo.ed.ac.uk/home/scotland/county3.html
www.geo.ed.ac.uk/home/scotland/localgov.html
www.heartofscotland.scotland.org.uk/html/tourism.html
www.heartofscotland.org.uk/html/living.html
www.heartofscotland.org.uk/html/population.html
www.lenymede.demon.co.uk/stirling.html/tourism.html
www.oldpeople.org.tw/resource/resourceorg.htm
vol.moi.gov.tw/sowf3w/04/07/07/htm
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