社區整合型服務中心個案管理師工作現況與困境之初探

A Study on the Work-related Dilemmas of Case Managers at Community Integrated Service Centers

臺灣已於2018年正式邁入高齡社會，隨著老年人口比例的增加，以及國人平均餘命延長，老年人各類慢性疾病的長期照顧需求，已成為醫療體系資源分配上的最大隱憂，整合長期照顧資源以推展社區照顧之個案管理師應運而生；本研究旨在探討社區整合型服務中心個案管理師之推展現況與工作困境，採用質性研究，以臺灣北部某縣市之社區整合型服務中心個案管理師為研究對象，透過半結構式訪談大綱作為研究工具，藉以瞭解其工作現況與工作困境；本研究結果顯示，社區整合型服務中心個案管理師之工作現況依據政策滾動式修正服務內容，其工作困境為專業在職培訓的機會不均，以及人力不足且工作負荷量大。據此，本研究建議中央部會及地方政府應提供充足的專業訓練與建立督導制度，並鼓勵社區整合型服務中心單位主管適當進用人力以紓解工作負荷量，並且營造互助且正向的工作團隊氣氛。

Taiwan officially became an aged society in 2018. Amid Taiwan’s ever-increasing proportion of elderly people and growing life expectancy, long-term care for chronic geriatric conditions has become the most significant resource allocation issue in the nation’s healthcare system. This has led to the emergence of case managers responsible for integrating long-term care resources to develop community care. This study explored the current development and work-related dilemmas of case managers working at community integrated service centers. The study examined case managers at community integrated care centers in a specific county and city in northern Taiwan. A semi-structured interview outline was used to understand the managers’ work situation and dilemmas. The results of this study show that case managers in community-integrated service centers is based on the policy rolling revision of service content, and their work difficulties are uneven opportunities for professional on-the-job training, insufficient manpower and heavy workload. Accordingly, this study suggests that should provide professional training and a supervisory system, and appropriately employ manpower to relieve workload and create a mutually supportive and positive environment.