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研究生:李金美
研究生(外文):Ching-Mei Lee
論文名稱:長期照顧人力需求之跨域治理解析—以高雄市照顧服務員為例
論文名稱(外文):A Cross-Domain Governance Analysis for Manpower Needs in Long-Term Care-The Case of Nurse Aides in Kaohsiung
指導教授:汪明生汪明生引用關係
指導教授(外文):Ming-Shen,Wang
學位類別:博士
校院名稱:國立中山大學
系所名稱:公共事務管理研究所
學門:社會及行為科學學門
學類:公共行政學類
論文種類:學術論文
論文出版年:2018
畢業學年度:106
語文別:中文
論文頁數:179
中文關鍵詞:互動管理社會判斷理論跨域治理照顧服務員長期照顧
外文關鍵詞:Cross-Domain GovernanceSocial Judgment TheoryInteractive ManagementNurse AidesLong-Term Care
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高雄市人口老化指數偏高,已有高齡人口傾斜的現象,但卻有照護人力短缺的問題,因此長期照顧成為重要的課題。穩健長照人力需求,特別是第一線照顧服務員的人力若能永續成長,將有助於社會福利資源分配的有效利用與規劃。然而,高雄市長照服務人力缺乏,特別是高雄市的財政困難下,有入不敷出、現金緊迫、債務償還等問題下,如何維持長照人力需求的穩定,是一個值得深究的課題。
  本研究以公共事務管理整合參考架構(PAM)為理論架構,輔以跨域治理應用研究架構,結合判斷與決策方法論探討個體認知、以及個體與群體行為,主要以長期照護人力需求為研究案例,並分別於個體認知權重以社會判斷理論(SJT)、群體互動結構以互動管理(IM)為研究方法。
在SJT結果發現,在各群組之社會支持與政府效能的相對權重值分別為(1).應屆畢業生群組:45%、55%;(2).一般民眾群組:53%、47%;(3).公務人員群組: 58%、42%;(4).照顧服務員群組:66%、34%。就互動會議之群體互動結果,認為政府制定健全政策與法源應為首要著重策略目標,中程目標則為確立照顧服務員之專業形象,並改善其社會地位,並提供培訓管道與就業獎勵,才能更增加青年就業之磁吸效應,遠程目標係於政策與載體條件皆具備後,再啟動經濟關鍵-「擴大就業機會」。因此研究建議,對於提昇高雄在地青年投入照顧服務員行列課題,提出以下四個政策建議:1. 提高社會支持力以創造長照人力永續、2.建立長期照顧服務員之產學媒介平臺以啟動經濟關鍵、3. 從小紮根長期照顧價值以啟動教育關鍵、4. 以政策學習觀點檢視多回合判斷決策分析。本文之研究方法與成果可提供長期照顧政策之主導單位釐清多元複雜治理結構認知分析與舉辦公民會議相關作法之參考。
There’s high aging index in Kaohsiung city, and it appears the phenomenon of population aging, on the other hand, results the shortage of nursing aides, therefore, long-term care will become an important public policy in society. Steady and long-term care manpower needs, especially sustainable growth of the frontline nursing aides, it will contribute to the effective usage and planning of social welfare resources allocation. However, the workforce’s shortage of long-term care especially under the financial difficulties of Kaohsiung City with the situation of unable to make ends meet, tight cash flow and debt payment, how to maintain the demand stability of long-term care manpower is the subject that worthy of further study.
This study uses the public affairs management (PAM) as the main theoretical framework, secondly, using the cross-domain governance application research framework that combines the judgment and decision-making methodology to explore individual cognition and group behavior, mainly with the long-term care workforces demand as the case study. The study also utilizes the research method of society judgment theory (SJT) to work on the individual cognition weight and interactive management (IM) to work on the group interaction frame work.
According to the SJT results, in the new graduates group, the relative weights of social support are 45%, the relative weights of government efficiency are 55% ; in the general public group, the relative weights of social support are 53%, the relative weights of government efficiency are 47% ; in the public servants group, the relative weights of social support are 58%, the relative weights of government efficiency are 42% ; in the nursing aids group, the relative weights of social support are 66%, the relative weights of government efficiency are 34%.
As the results of IM, it suggests the government should establish a complete policy and sources of law as the primary strategic goal. The medium-term goal is to establish the professional image of the nursing aids, to improve their social status, and to provide training channels and employment rewards, otherwise, it will increase the magnetic effect of youth employment. The long-term goal can restart the economic key of “expanding employment opportunities” after to meet the condition of policies and carriers.
Therefore, this study suggests four policy recommendations for promoting the Kaohsiung youth to participate the long-term care as nursing aids: 1. To improve the social support to crate the sustainable long-term care workforces. 2. To establish the industry-academic medium platform of nursing aids of long-term care to start economic key. 3. To build the foundation of long-term care value to start the educational key. 4. To examine the multi-round judgment and decision-making analysis with policy learning perspective. It can take the methods and results of this study as reference to provide the long-term care policy to the government and clarify multiple complex governance cognition analysis and how to conduct a consensus conference.
致謝辭 ii
摘要 iii
Abstract v
目錄 vii
圖次 xi
表次 xiii
第壹章. 緒論 1
第一節. 研究背景與動機 1
一. 研究背景 1
二. 研究動機 4
第二節. 研究理論架構 5
一. 公共事務管理架構 5
二. 跨域治理分析 8
第三節. 研究目的 10
第貳章. 理論與文獻探討 12
第一節. 「以人為中心」之跨域治理相關理論 12
一. 多角色(multiple role) 12
二. 多層次結構(multilayer structure) 14
三. 多中心治理(polycentric governance) 16
第二節. 長期照顧政策與人力相關研究 17
一. 全球老化與長期照顧需求 17
二. 台灣長期照顧政策制度發展脈絡 19
三. 照顧服務員人力相關研究 21
四. 其他國家長期照顧人力解決方案 27
第三節. 跨域治理判斷與決策相關理論 28
一. 判斷與決策分析理論方法 28
二. 社會判斷理論:事實與價值判斷 36
三. 互動管理:群體互動結構 42
第四節. 跨域治理應用研究架構與課題案例 46
一. 跨域治理應用架構 46
二. 長期照顧治理結構跨域分析之區塊解析及操作步驟 54
第參章. 群體互動系統研究設計與分析 61
第一節. 議題設定與研究程式 61
一. 議題設定 61
二. 參與者選定 61
三. IM 研究程式 61
第二節. 群體互動建構之結果與分析 63
一. 名義群體技術結果 63
二. 增強結構圖結果詮釋 67
三. 十二項策略說明 71
第肆章. 個體認知系統之研究設計與分析 76
第一節. 個體認知系統之研究設計 76
一. 受測者與實驗設計 76
二. 問卷設計與決策參考變數選取 78
第二節. 個體認知之研究結果 81
一. 應屆畢業生群組個體判斷結果 81
二. 一般民眾群組個體判斷結果 88
三. 公務人員群組個體判斷結果 95
四. 照顧服務員群組個體判斷結果 103
五. 各群組共識判斷結果 108
第伍章. 討論與建議 111
第一節. 學理論證 111
一. SJT研究結果討論 111
二. IM會議結果討論 112
三. 檢驗跨域治理應用架構與PAM整合-跨域治理週期回合操作 115
第二節. 政策實務驗證 121
一. 提高社會支持力以創造長照人力永續 121
二. 從小紮根長期照顧價值以啟動教育關鍵 121
三. 建立長期照顧服務員之產學媒介平臺以啟動經濟關鍵 123
四. 以政策學習觀點檢視多回合判斷決策分析 123
第三節. 研究限制與後續研究建議 125
參考文獻 127
中文文獻 127
英文文獻 134
附錄一 互動管理會議 白皮書 141
附錄二 SJT問卷 157
中文文獻
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