The Study of Medical Social Work Role within the Context of Holistic Medicine View - An Investigation of Service Users' Perspective.

[[abstract]]論文摘要 本研究的目的在探討立基於全人醫療的脈絡下，從服務使用者的角度來探討醫務社會工作專業所提供的服務及其所展現的角色與功能，以及服務使用者對於所接受之服務的各種看法與感受，最後則藉此檢視醫務社會工作專業的實際定位與存在價值。另外，在研究架構的部分則採用生態系統理論，以瞭解服務使用者與其他系統間的互動狀況，而在研究方法上，本研究採用質化研究的方式，經由立意取樣，共選取十二名符合標準的服務使用者，接著透過深度訪談方法蒐集服務使用者對於與醫務社會工作者接觸的經驗與看法。研究發現歸納如下： 一、 醫務社會工作者的服務對象：從受訪對象的組成可以發現服務使用者的組成是多元的，並非僅僅只是病患本身，還包含了主要照顧者；另外在全人醫療理念下，服務使用者的求助內容多半集中於經濟問題、照顧問題，且對於服務使用者與醫務社會工作者的接觸多半是較為間接的方式，因此建議醫務社會工作者能夠在服務時採取中立的立場，並試著主動積極的服務，以避免未來退居二線的角色。 二、 對醫療相關制度的反思：文獻指出醫療團隊的服務方式可為服務使用者帶來許多優點，且在就醫的過程中，服務使用者亦須與其他醫療團隊成員接觸，例如：醫生、護理人員…等，因此建議在全人醫療理念、醫療評鑑制度以及醫療團隊的概念上可依照服務使用者的實際需求將其置於中心位置來思考相關的服務策略，針對現行之缺失加以修正與倡導，將使得全人醫療的理念能夠具體落實。 基於上述的研究發現，研究者最後則分別針對醫務社會工作專業、醫療院所、醫療評鑑制度、全人醫療以及未來研究方向給予具體建議，盼此能對服務使用者所接收的服務狀況有所改善。 關鍵詞：醫務社會工作、全人醫療、服務使用者、生態系統理論[[abstract]]Abstract Nowadays medical social work exists in the context of Holistic medicine. Therefore this study aims to explore the role and function of medical social work from service users’ perspectives and opinions. This study also examines the orientation and value of medical social work. The study adopts the ecological perspective and uses qualitative research method to probe the interaction between the various systems and service users. This study collects the data about experience and opinions from twelve service users. 1. Medical social worker and the service users : The component of interviewees is diverse. They have different illness and they include patient and carers. Their problems are mostly economic issues, the problems of being nursed. The contact between the service users and medical social workers is indirect. Therefore, the researcher suggests that medical social workers have to take a neutral stance to try to offer a proactive service, and to avoid being a second part of the professional in hospital. 2. The introspection of the health care system : The literature reveals that medical team can bring many advantages for service users and have to take medical treatments for service users. For this reason, researcher suggests that when hospital accreditation and medical team planning service strategy, it must be based on service users’ actual demand to carry out the ideas of Holistic medicine. Based on these findings, this study gives many suggestions for medical social work profession, medical institution, Holistic medicine and research directions, and hopes these suggestions will improve the service environment and the condition for service users in the future. Key words：Medical Social Work, Holistic Medicine, Service Users, Ecological perspective[[note]]碩