管理主義效應下的醫務社會工作：醫療臨床的觀察

醫務社工在管理主義興盛的醫院工作，臨床上與醫療團隊合作密切，因此臨床醫務社工受影響處境與醫療團隊對於醫務社工的認知與期待有關。本文係探討醫務社工與醫療團隊互動下對管理主義的回應策略。本文採取質性研究法，深度訪談醫院主管、社工主管、臨床醫務社工、醫務社工組織代表共18位。研究發現提出管理主義對臨床醫務社工所產生的效應，高度與醫療團隊對臨床醫務社工認知與期待有關。本研究彙整臨床醫務社工的回應策略包含（1）溝通與說服－發揮論述與溝通能力以彰顯專業功能、（2）支持及內控－穩固社工內部以展現自我照顧及成長、（3）教育與傳播－種下改變種子以建立未來友善環境。最後，提出討論與建議，以醫務社工的回應策略做總結。  Medical social workers show suppression of hospital managerialism and expectations of medical teams. This study aimed to investigate the responsive strategies of clinical medical social workers toward managerialism based on the interaction between its and medical teams. This study conducted 18 in-depth interviews. The effects of managerialism on clinical medical social workers were derived from cognition and the expectation gap between medical teams and clinical medical social workers. This study generalized the professional responsive strategies of clinical medical social workers as follows: (1) communication and persuade: demonstration of discussions and communication competency to reveal professional functions, (2) support and internal control: stability of internal aspect of social workers to facilitate self-care and growth, and (3) education and spread: making changes to construct a friendly environment. Finally, this study proposes discussions and suggestions and concludes the responsive strategies of medical social work.