罹患肺結核的移工在台灣醫療照顧制度中的治療經驗與賦權

The treatment experience and empowerment of migrant workers with tuberculosis in Taiwan 's medical care system Yu-Hui Huang, Wei-Hsian Chi

目標：本研究分析台灣罹患肺結核病之移工的醫療照護過程，探究移工這個弱勢社群，是 否在獲得醫療照護資源的機會上面臨許多阻礙。研究中說明台灣還存在著這類問題，並試圖提 出改善的建議。方法：本研究採質性研究法，採立意取樣的方式，針對九名罹患肺結核的個案 及一名資深結核病個管師進行深度訪談，結合訪談及參與觀察的田野資料，進行質性研究方法 的分析。結果：分析發現關鍵影響結核病移工獲得照護資源的重要因子，主要有四，分別是現 行相關政策所產生的限制、文化及溝通的障礙、仲介及雇主缺乏正確的健康觀念、醫療人員的 權宜措施。結論：本研究具體建議(1)政府相關單位應強化醫療人員的多元文化照護能力；(2) 醫院應擴大參與面，善用醫療體系之外的資源改善移工的健康問題；(3)政府應加強跨部門的溝 通，創造外籍移工獲得較佳治療的機會。

Objectives: This study investigated the medical treatment of migrant workers with tuberculosis. The aim was to determine if this vulnerable group still had barriers in accessing medical care resources. Methods: Adopting a qualitative research design, this study used purposive sampling to conduct in-depth interviews with nine migrant workers infected with tuberculosis and one tuberculosis case manager. Data collected from these interviews and participant observation were analyzed qualitatively. Results: Four factors were found to influence the migrant workers' access to medical resources: constraints of current related policies, cultural and communicative barriers, job mediators' and employers' lack of medical knowledge, and the tactics of medical personnel. Conclusions: This study recommended that (1) related government departments propose projects to empower medical personnel and improve their cultural competence; (2) hospitals cooperate with civil organizations to provide different resources to solve the health problem of migrant workers; (3) the government reinforce cross-departmental communication to create a better medical treatment environment for migrant workers.