部落文化健康站的照顧實踐與服務困境之研究：一個實務工作者的反思

Research on the Caring Practices and Service Difficulties in Tribal Culture and Health Service Stations: A Practitioner's Reflections

本文旨在探討部落文化健康站落實在地老化的照顧實踐與服務困境，以及部落文化健康站邁向永續發展的可能。為達此目的，本研究採訪談法針對臺中市大安溪流域泰雅族部落4位照顧服務員進行質性資料的蒐集分析。研究發現原鄉部落醫療照顧資源長期匱乏，族人的醫療人權一向被忽視，目前文健站是部落高齡族人主要的健康促進和人際互動平台，但文健站仍礙於年輕專業人力不足、服務使用者名額限制、族群別資格認定限制（非原民身份不符合資格）及醫療照顧設備缺乏等因素影響，而使文健站的營運效能受到影響。循此，本研究提出幾項提升文健站之服務量能與邁向永續發展的政策省思：（一）增加照顧資源讓部落失能長者獲得充足的照顧服務；（二）補充專業人力來減輕照顧服務員工作負荷；（三）隨著高齡化速度加快應放寬文健站服務人數限制；（四）在多元族群融合氛圍下應打破服務使用者族群別資格限制；（五）補足文健站醫療照顧設備；（六）培力照顧服務員專業能力來促進其職涯發展；（七）制訂照顧服務員薪資分級制和暢通升遷管道；（八）政府應力推年輕族人返鄉從事部落照顧工作並從耆老身上傳承原住民族深度文化體系。

 

This paper discusses the implementation and difficulties of caring services and practices in taking care of the elders in the Tribal Culture and Health Service Stations, as well as the Stations’ possibilities in sustainable development. To achieve this goal, this research interviewed and gathered data from four nursing assistants in the Atayal Tribes around the Da’an River Region for further analysis. Research found that the medical and caring resources are scarce for a long time in aboriginal communities and aboriginals’ medical rights have been neglected. At present, the Stations are aboriginal elders’ main platform for health promotion and social interaction. Stations’ performance, however, are affected by (a) the lack of young professionals, (b) the limited capacity of people to be served, (c) restrictions on ethnic groups’ qualifications (aboriginals only; non-aboriginals are not qualified), and (d) the lack of medical and caring facilities. This article, therefore, depicts several points in promoting the service momentum of the Stations, and in re-thinking the policies of a sustainable development: (1) increase the care resources for tribal disabled elders and they can receive adequate services; (2) provide more health professionals to reduce the workload of nursing assistants; (3) release of restriction on the number of people served at Tribal Culture and Health Service Stations as accelerated aging; (4) break the restrictions on ethnic groups’ qualifications of service users in a multi-ethnic environment; (5) add more medical care equipment to Tribal Culture and Health Service Stations; (6) train nursing assistants to increase their professional ability in order to promote their career development; (7) create a salary grade chart and promotion channels for nursing assistants; (8) the government should encourage young aboriginal people to do tribal health care jobs, then they are able to learn and inherit aboriginal cultures from elders.