题名

醫務社工人員對管理主義效應的理解與因應：醫院管理角度之觀察

并列篇名

Understanding and Response to the Influence of Managerialism on Medical Social Worker: Observation of Hospital Management

DOI

10.6687/JSDS.202309_(32).0005

作者

侯建州(Chien-Chou Hou)

关键词

管理主義 ； 醫務社工 ； 社工專業發展 ； 健康照顧 ； 醫務管理 ； managerialism ； medical social work ； development of the profession of social work ； health care ； hospital management

期刊名称

社會發展研究學刊

卷期/出版年月

32期（2023 / 09 / 01）

页次

127 - 158

内容语文

繁體中文;英文
中文摘要

管理主義的影響已非商業部門專利，連以往較為科層的政府部門與偏向慈善的非營利部門，也都無形中存在著管理主義的元素。管理主義的思潮下，不只在國家政治與福利思維受到左右，對於健康醫療領域更是有大幅影響。本研究欲探討醫務社工人員受到管理主義之影響為何，醫務社工人員是如何對管理主義做出因應。本研究以深度取樣與分層立意取樣來選取11位豐富資訊個案做深度訪談，包含社工主管7位、社工人員4位。訪談完成後轉為逐字稿，以跨受訪者分析、資料詮釋、形成組型等方式進行質性分析。研究發現管理主義對於醫務社工人員的影響有：（1）顧客導向下的以客為尊與排擠弱勢不利社工專業及服務使命；（2）成本管控下的一切從簡及難以兼顧，侷限了社工專業效能與個案福祉；（3）績效管理下的信念思維產生凌駕專業的問題，造成威脅專業自主而曲解專業意義；（4）管理技術廣用下產生的壓力若過度使用，則會影響原有服務。對於前述管理主義影響內涵，醫務社工人員的因應作為有：（1）避開醫院禁忌、順應醫管邏輯、學習環境文化，甚至需爭取主管認同；（2）醫務社工順利發展的方針，宜自主爭取資源；彈性解釋成效、順勢發揚社工、提出專業主張，並在獲得醫院認同後，把握發揮及主張社工專業的時機。
英文摘要

The effects of managerialism exist not only in commercial sector but also in the bureaucratic governmental sector and in the charitable nonprofit sector. In the trend of thinking of managerialism, it not only influences national politics and ideology of welfare, but also significantly affects health and medicine. This study aimed to explore the effect of managerialism on medical social workers and how medical social workers respond to managerialism. By intensity sampling and stratified purpose sampling, this study conducted in-depth interviews in 11 cases with rich information, including seven supervisors of social workers and four social workers. According to research findings, the effects of managerialism on medical social workers are shown below: (1) Customer first and discrimination of vulnerable groups negatively influenced the work and missions of services. (2) Due to cost control, the professional efficacy and the wellbeing of clients were limited. (3) Under the performance management, the beliefs and ideology were not acclimated, and the excessive use of performance management led to an obsession over this topic, destroyed professional autonomy and twisted the professional meaning of social workers. (4) The use of management techniques led to learning stress and the excessive use of these techniques tended to negatively affect traditional services. As a result, the responses of medical social workers to the previous effects of managerialism are below: (1) They avoided the taboos in hospitals, followed the logic of medical management, learned the culture and even fought for the supervisors' recognition; (2) for the concern of successful development, medical social workers must fight for resources, flexibly explained the effects, highlighted social works and proposed professional suggestions. After the recognition of hospitals, they seized the time to demonstrate the specialties of social workers. Finally, this study had related discussions and proposed suggestions.
主题分类 社會科學 > 社會學
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