新冠肺炎病人醫務社會工作心理社會服務模式之研究──以某醫學中心為例

Medical Social Worker’s Psychosocial Service Model for COVID-19 Patients-A Study in a Medical Center Hospital

新冠肺炎引起全球大流行，台灣將其納入生物病原災害，由於感染者短時間大量入院，醫院醫療量能緊繃，醫務社會工作服務模式亦面臨挑戰與改變。本文目的為透過對新冠肺炎病人心理社會服務的經驗整理，具體提出病人與家屬的可能需求，建構更完整服務模式，以因應未來醫務社會工作師再面對生物性災難事件時之服務架構。本文以某醫學中心社會工作師2021-2022年1,191名新冠個案之紀錄作為研究素材，將社工紀錄中之處遇類別、處遇摘要及四類評估工具分數，分別進行描述性統計分析及內容分析。研究中發現，透過簡化版社會支持量表評估，以情緒性支持向度不足者較多。經PTSS-10量表檢測病人情緒狀態，2021年有40.3%，2022年有22.2%之病人顯示有PTSD廣泛症狀。死亡病人之遺屬悲傷調適評估，有4位在BSRS量表大於10分，顯示有中度以上情緒困擾。在病人及家屬需求部分，共歸納五大類，包含情緒性需求、資訊性需求、出院準備需求、溝通協調需求及經濟/物資協助需求，以情緒性需求最高。另就病人及家屬需求、文獻探討及社工服務經驗中，除建構服務指引，亦就社工服務、醫院流程及社會政策部分提出相關建議。

The COVID-19 pandemic has triggered a global pandemic, which Taiwan classifies as a biopathogenic disaster. Due to the large number of infected patients being treated in hospitals in a short period of time, the workload of hospitals has increased significantly, and the medical social work service model is also facing challenges and changes. The purpose of this study is to identify the possible needs of patients and their families through empirical collation to Psychosocial services for COVID-19 patients, and to construct a more complete service model to cope with the service structure of medical social workers in the future when they are faced with biological disasters. In this study, the social work case records of 1,191 COVID-19 cases in a medical center from 2021 to 2022 were used as research materials. Descriptive statistical analysis and content analysis were conducted on the treatment categories, treatment summaries and four types of assessment tool scores in the social worker records. The study found more subjects with insufficient emotional support when the brief social support scale was used. The PTSS-10 results showed that 40.3% and 22.2% of patients in 2021 and 2022, respectively, had general PTSD symptoms. Grief evaluation of the family members of dead patients found that four had BSRS scores >10, showing moderate and above emotional distress. Patient and family member needs could be classified into five major categories: emotional, information, discharge preparation, communication and coordination, and financial support needs of which emotional needs were the highest. Regarding patient and family member needs, the literature review and social work service experience provided recommendations for social work services, hospital processes, social policies, and service guidelines.