比較兩岸醫師對於病人安全文化認知

Comparison of Patient Safety Culture Perception Among Physicians Across the Taiwan Straits

黃志璿(Chih-Hsuan Huang) ； 吳信宏(Hsin-Hung Wu) ； 李怡慶(Yii-Ching Lee) ； 李荔(Li Li)

《澄清醫護管理雜誌》 14卷3期 (2018/07) Pp. 16-24

摘要

目的：透過調查兩岸醫師對於病人安全文化認知，進行比較分析，對醫療機構管理者提出相應的改善病人安全管理的意見及建議。方法：本研究採用臺灣財團法人醫院評鑑暨醫療品質策進會修改之中文版病人安全態度量表（Safety Attitudes Questionnaire）衡量病人安全文化，並以大陸武漢地區與臺灣中部某區域醫院之醫師為對象。利用皮爾森相關分析、獨立樣本t檢定、逐步迴歸分析等方法檢核醫療機構建病人安全文化的重要因子。結果：兩地的研究結果皆顯示管理感受與工作狀況呈現高度相關性，管理者越支持病人安全工作，則醫師工作狀況也會越好。而醫療機構中的安全風氣也分別與工作狀況、工作滿意、團隊合作、管理感受呈現顯著且高度的相關。相較於大陸武漢地區醫療機構，臺灣中部地區醫療機構的醫師更處於高壓的工作狀況。另外，兩岸醫師對於身處的工作狀況皆不甚滿意。結論：醫師是服務病患的第一線核心人員之一，若能加強其對病人安全文化的態度，不但能減少醫療糾紛的發生，也能落實以病人安全為中心的醫療品質。本研究建議兩岸醫療機構管理者可從改善工作狀況、提升病安氛圍與提供紓壓管道三方面著手。

關鍵字

病人安全文化 ； 岸比較研究 ； 安全態度量表

並列摘要

Purposes: This study aims to provide implementations for hospital managers to improve patient safety management by investigating and comparing the awareness of physicians across the Taiwan Straits in patient safety culture. Methods: The Chinese version of safety attitudes questionnaire (SAQ) that was modified by the Taiwan Joint Commission on Hospital Accreditation was used to assess the perceptions of patient safety culture of physicians in a regional teaching hospital in China and Taiwan, respectively. Pearson correlation analysis, independent sample t-test, and stepwise regression analysis were used to examine important factors for establishment of patient safety culture in healthcare organizations. Results: The results of this study from across the Taiwan Straits showed that management support are strongly correlated with working conditions, as increased support from hospital management is associated with better working conditions for physicians. The safety climate in hospitals is highly correlated with working conditions, job satisfaction, teamwork, and management perceptions. Compared to physicians working in the case hospital in Wuhan, China, physicians working in the case hospital in Taiwan have more stressful working conditions. Additionally, inappropriate working conditions were identified by both physicians in China and Taiwan. Conclusions: Physicians are one of the core first-line personnel servicing patients. If the perceptions of physicians towards patient safety culture can be strengthened, this will not only reduce the occurrence of medical disputes but also improve patient-oriented medical quality. Three implementations are suggested based on the current study: improving work conditions, enhancing safety climate, and decreasing stress.

並列關鍵字

Patient safety culture ； Comparison studies across the Taiwan straits ； Safety attitudes questionnaire