身心障礙學童利用長照2.0陪同就醫與陪同外出服務現況與障礙

Current Status and Barriers to the Use of Long-term Care 2.0 Escorted Medical and Outreach Services for Students with Disabilities

根據衛生福利部105年「身心障礙者生活狀況及需求調查報告」中指出，六歲以上未滿十二歲者，78.74%外出需要陪同，因此長照2.0提供陪同就醫及陪同外出服務，透過照顧服務員可以協助家庭照顧者接送的工作，如此可以有效協助身心障礙學童的就學跟黃金療育期，進而減輕家庭的負擔。本研究主要目的在於探討身心障礙學童對長照2.0陪同就醫與陪同外出服務之需求評估，主要著重於利用的現況與困境分析。本研究以質性研究的方式進行資料收集，研究對象為12位身心障礙學童之家庭照顧者，資料收集以半結構式訪談大綱為依據，訪談大綱經過專家效度檢視，確保問題的合適度。經過個案簽署訪談同意書後開始進行一對一的訪談，訪談過程以錄音與摘要記錄進行資料收集。最後將訪談結果謄打成逐字稿，並使用內容分析法進行資料分析。研究結果顯示身心障礙學童利用有7位（58.33%）曾經利用過長照2.0陪同外出服務，普遍覺得該制度好用又實在。但陪同就醫服務僅有1位（8.33%）曾經利用過，制度雖好，但實際上利用率極低。在長照2.0陪同就醫與陪同外出服務之使用困境方面，主要來自交通工具取得困難、專業服務人力較缺乏、以及執行單位認知差異等三方面，這些障礙值得後續克服，以提升長照2.0使用率。

According to the Taiwan Ministry of Health and Welfare’s“2016 Survey on the Living Conditions and Needs of People with Disabilities”, 78.74% of people over the age of six and under the age of twelve need to be accompanied when they go out, therefore, Longterm Care 2.0 provides escort services to medical appointments and outings. This can effectively assist students with disabilities in their schooling and golden years of care, thus reducing the burden on families. The main purpose of this study was to examine the needs of students with disabilities for escorted medical care and escorted outreach services in Long-term Care 2.0, focusing on the current situation and barriers of utilization. The data were collected from 12 family caregivers of students with disabilities using a semi-structured interview protocol that was validated by experts to ensure the appropriateness of the questions. Face to face interviews were conducted after the case signed the interview consent form, and the interviews were recorded and summarized for data collection. Finally, the interview results were transcribed into verbatim transcripts and analyzed using content analysis. The results of the study showed that 7 (58.33%) of the students with disabilities had used the Long-term Care 2.0 escort service, and generally felt that the system was useful and practical. However, only one (8.33%) of the students had used the escorted medical service, which is a good system, but the actual utilization rate is extremely low. The difficulties in the use of Long-term Care 2.0 escorted medical care and escorted outreach services are mainly due to the difficulties in obtaining transportation, the lack of professional service manpower, and the difference in awareness of the implementation units. These obstacles are worth overcoming later to increase the usage of Long-term Care 2.0 scheme.