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「回家工作」:居家照顧服務員與部落(聚落)的協作

英文主題:
The Collaboration between Homecare Workers and Atayal SettlementsFacilities
作者:
葉怡廷(YI-TING YEH)
關鍵詞 Key words : 身體工作 ; 照顧工作 ; 居家照顧服務員 ; 原住民 ; 南澳 ; 民族誌 ; bodywork ; carework ; home care worker ; indigenous people ; Nanao ; ethnography
資料語文:繁體中文
DOI: 10.30074/FJMH.201906_32(2).0002
卷期:
32卷第2期
出刊年月:
2019年6月
起訖頁:
P.141 - 181
中文摘要:

 居家服務作為一「正式」照顧的形式,然而其可能隨族群、文化、人際網絡等因素在不同地域形塑出各異的樣貌。身體工作(body work)所指稱的是在他人身上所執行的有酬勞動,而居家照顧工作即具有這樣的特質。本研究採身體工作此一考量肉身性、時地面向的概念取徑,使南澳泰雅脈絡中的照顧關係具體現身,並探討居服員如何與部落(聚落)協作。本研究立基於居服員的觀點,呈現專業主義、組織與文化因素如何構築居家照顧服務的實作。本研究採用民族誌作為研究方法,於2017年1月至5月透過深度訪談(共6位研究參與者)與參與式觀察,實地進入案家、部落跟訪。本研究結果發現:首先,南澳的居家服務發展本身即具有宗教、部落的集體性,而居服員本身也可能是家庭的主要照顧者。接著,在日常照顧實作中,居服員會發展多元策略與擔負多元的工作角色。且,由於當地醫療社福資源的稀缺,居服員可能得設法填補空缺、符合個案需求。而她們的身體經驗可能無法轉譯成符合「評鑑指標」、「個案報告」等框架的論述,使得她們的個人知識無法被肯認。最後,部落(聚落)不僅是照顧發生的背景、地點,本身也是照顧實作中的重要因素。居服員藉由疊合個人的人際、地域網絡,成為照顧實作中的策略,此也挑戰政策與機構所建制的專業、標準化的服務關係。此外,本研究亦試圖討論泰雅「gaga」在照顧實作中的具體展現。身體照顧工作不僅限於照顧者與被照顧者的單一組合,而是同時有多個行動者涉入,甚至涵括整個部落。研究者希藉此原鄉居家研究打破政策對居家服務的單一想像,並應肯認照顧工作的價值。

英文摘要:

 Purpose: Homecare service is a type of formal care that is an essential long-term care policy in Taiwan. Its practice varies by ethnic group, culture, and social network. The goal of this study is to demonstrate how professionalism, institutional and organizational arrangement, and specific cultural practices shape the practice of homecare services from the view point of homecare workers. To capture the dynamic and diverse manifestations of carework, I applied the concept of bodywork as the analytical approach to investigate homecare practices in Nanao, Yi-Lan County, Taiwan. Bodywork is defined as paid labor carried out on the bodies of others and the management of embodied emotional experience and display. I used inter-corporeal and temporal-spatial aspects to describe the daily activities of homecare workers, the care relationships between them, the care recipients, and the tribal communities in which they living in. Methods: I conducted 6 in-depth interviews with female careworkers and engaged in participant observation of the carework in recipients' homes, in the homecare organizations, and in the tribes. I used ethnographic qualitative analysis to evaluate the data. Result: The major results are as follows: First, Nanao homecare service has collective characteristics, such as shared religious meaning, and tribe-centered indigenous care workers and recipients. The homecare workers are themselves also the main caregivers in their own homes and churches. Second, in daily care practices, homecare workers develop multiple strategies, and have the ability to take on multiple involvements and play multifunctional roles. In this way, they create practices that fit the varied and changing needs of their care recipients. When medicine and funds are scarce, they try fill in the gaps however they can, although it is extra work. The care workers have accumulated rich personal and local knowledge, but this knowledge is not recognized or adopted by the organization supervisors, or the government evaluation and care assessment system. Third, I found that the tribes/villages not only form the background for care practices, but are also important factors in daily care activity and care relationships for homecare workers. The homecare workers regard themselves as members of the tribe first, and second as a homecare worker, so they weave their own personal social network into their care practices. These practices become care strategies that cross or blur the body boundary between worker and recipient. However, the private social bond challenges the standard professional worker/recipient relationship, which government policy and the home care organizations expect. In addition, the care setting is flexible. Care might be provided outside of the recipient's home to coordinate with the daily tempo of the individual and the tribe. The actors involved in home carework are not merely the homecare workers and their care recipients; the whole tribe is included. This inclusion shapes the careworkers' work commitment and identity. Gaga, the Atayal essential traditional common law, is also embodied in home care practices between careworkers and elders. Conclusions: The analysis supports the conclusion that the government and society should value a variety of bodywork practices in homecare services. It is important to consider the specific social and cultural context in which care recipients are situated. There should not be an expectation that care practices in different cultures, areas, or organizations should be identical across situations. Home care service may not only be a labor experience, but also a kind of social relationship.

電子文章下載處:
http://www.airitilibrary.com/Publication/alDetailedMesh?DocID=10237283-201906-201907290003-201907290003-141-181
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