Empirical Investigation on Gerontological Social Work

摘要本研究旨在实证调查公共长期照护保险实施后，发生了巨大变化的老年社会工作。在研究的第一年，我们调查了社区护理管理机构的护理管理者（N=154），并评估了他们的绩效水平和冲突因素。结果发现，应用护理管理技能不足，工作条件差和倦怠感是影响有效实践的主要冲突因素。此外，对复杂个案的护理管理进行了具体的研究，并从社会工作的角度确定了必要的技能和挑战。第二年，对注册安老院的住宿社工进行邮寄调查（N=1000）。研究结果显示，福利院社工从事的工作范围较广，包括个人照护、行政管理等，而保健院社工则主要从事老年人的入、出计划工作。此外，自2004年起正式提名持证住宿护理经理的两家机构，澄清了团队方法的现状，评估了护理管理绩效并分析了其决定因素。在去年，这两个数据集被合并，并在护理经理和住宿社工之间进行了比较分析。研究发现，工作定义不清、界限模糊是影响社区机构护理经理工作效率的常见冲突因素，而倦怠感在社区机构护理经理中最为严重。此外，对这些机构的护理管理人员和社会工作人员进行了访谈，以定性地分析工人不断变化的性质和挑战。专业人员地位低、工作界限模糊、资源稀缺和护理制度不完善是两种专业人员冲突的主要因素。少

This study was conducted to empirically investigate gerontological social work which has been changing drastically since the implementation of the public long-term care insurance.In the first year of the study, care managers in the community care management agencies (N=154) were surveyed, and their performance levels as well as conflicting factors were evaluated. Resultantly, applied care management skills were found to be insufficient, and poor working conditions and feeling of burnout were major conflicting factors for effective practice. In addition, care management toward the complex cases were specifically examined, and necessary skills and challenges were identified from a social work perspective.In the second year, a mailing survey was conducted to residential social workers in the certified nursing homes for the elderly (N=1000). The results indicate that social workers in the welfare facilities for the elderly engage in a wide variety of tasks including personal care and admin … More istration, while those in the health care facilities for the elderly concentrate on intake and discharge planning. Furthermore, the current status of team approach was clarffied in both facilities where the certified residential care manager has been officially nominated since 2004, and care management performance was evaluated and its determinants were analyzed.In the last year, the two data sets were combined, and a comparative analysis was conducted between care managers and residential social workers. It is found that poor job definitions and vague boundaries are common conflicting factors for their effective and efficient practice, while feeling of burnout was the most serious among the care manager in the community agencies. Furthermore, interviews were conducted to care managers and social works in those institutions to qualitatively analyze the changing nature and challenges for workers. Low status of professionals, vague job boundaries, scarce resources and inadequate care system were found to be major conflicting factors for both professionals. Less