權力視野下的照顧關係並兼論關懷實踐的意義─長期照護機構照顧服務員的自我敘說探究   全文下載

The Caring Relationship on Power Perspectives: A Narrative Analysis of Nurse Aides’ Experiences of Long-term Care Institution

當老人接受機構式照顧，他們接觸最多的是提供第一線服務的照顧服務員。研究者以為，照顧服務是一種道德介入的行動，在照顧歷程中以自身做為工具提供服務，於焉形成照顧場域中的社會關係，並因此於所有照顧行動中隱含權力的建構與流動。本研究透過敘事研究方法，從照顧服務員的視角來理解其對於照顧關係的詮釋，並呈現照顧服務歷程中的權力影響與內涵。研究結果發現，照顧關係高度動態且互賴，照顧服務員甚至降低權威感以維持彼此友善的關係並帶動改變。在照顧場域中的權力關係是雙向流動的，看似無權力者卻經常運用權力，照顧者與被照顧者事實上交互運用各自的權力基礎。進一步亦發現，華人文化的家族主義與關係中的自我，影響其間權力的形成與改變。所謂專業的照顧者在被賦予愈多的法定權力時，實不該忽略隱匿在知識優位化趨勢下對於權力的反省。

In the context of institutional care for the aged people, nurse aides contact more frequently with the elderly than the others because they provide the frontline services. Researchers believe that care is a moral action with values. During the process of care, nurse aides provide themselves as tools for the services and the social relation is thus formed in the field of care. Hence, the action of care implies the construction and transition of power. The narrative research method is used for this study in order to understand the interpretation of the care relationship from the perspectives of nurse aides as well as the impacts and contents of power during the process of care. The results of the study indicate that care is a highly dynamic and interdependent relationship. Nurse aides even need to weaken their sense of authority to maintain friendly with aged adults for making changes. It is a two-way interactive flow of power relations in the field of care. During the process, those who seem powerless still use power from time to time. In fact, care giver and receiver interactively use their power. If they can empower each other in the process, both of them will be able to bring new self-confidence and antonomous experiences. This study also finds the formation and transition of power are influenced by the familism and the self in relation under Chinese culture. When the so-called professional care-givers are given more statutory powers, they should be more aware of the hidden powers of the knowledge predominance.