居家服務品質與家庭滿意度之關聯性：以南投縣為例

Relationship between the Quality of Home Care and Family Satisfaction in Nantou County

詹弘廷(Hong-Ting Chan)

指導教授 ： 丁志音 ； 鄭守夏

國立臺灣大學/公共衛生學院/健康政策與管理研究所/博士(2013年)

https://doi.org/10.6342/NTU.2013.01705

摘要

背景：居家服務在國家「長期照顧十年計畫」推波助瀾下，已成為成長最快的照顧服務，其品質及成效也受大眾相當之關注。因此，通過使用者參與和評估進而改善服務品質已受重視，而照顧服務如何與非正式家庭支持網絡互動應受詳細檢驗。尤其是在華人文化中，藉由支持家庭照顧的觀點，建立全面性以家庭為中心的照顧模式是關注焦點。

目標：本研究係透過使用者及其家庭照顧者對品質要素的觀點，進一步檢視居家服務品質對家庭滿意度的影響。更特別地，研究目的在於(1)評估居家服務認知品質及其決定因素；(2)檢視使用居家服務前後家庭滿意度認知的改變；以及(3)分析居家服務知品質認知與家庭滿意度之關聯性。

方法：從民國101年5月15日至101年10月7 日止，住在南投縣內接受居家服務者共計252位使用者及243位照顧者，採用面訪方式進行普查。本研究工具是自行設計之結構式問卷，包括依據Donabedian結構－過程－結果等三構面為基礎而建構的「居家服務品質量表」及引用源於Olson等人所發展之中文化「家庭滿意度量表」。

結果：研究主要發現為(1) 居家服務品質與家庭滿意度之間存在著正向的關聯性；(2)服務使用者重視「溝通性」及「禮貌性」品質要素，而照顧者重視「效能性」及「禮貌性」品質要素；(3)家庭狀態完整、獨立經濟來源、有受教育經驗及非原住民之服務使用者認為居家服務品質較重要或滿意；而總是有其他替代照顧者、有家人支持照顧、照顧家人每天時數長及正常心理健康之照顧者則對居家服務品質感到較重要及滿意。

結論：為改善居家服務品質，應同時重視服務使用者及照顧者觀點。促進長期照護服務之使用，應首先增加服務相關資訊的可得性和可近性。為建立連續性、整合性及協調性的照顧服務，應以家庭為中心並依個人特性及需求為考量。

關鍵字

居家服務 ； 社會服務品質 ； 家庭滿意度 ； 使用者參與 ； 以家庭為中心

並列摘要

Background: Under the support of the national “Ten-Year Plan for Long-term Care”, home care has become the fastest growing care service and its quality and outcomes have drawn considerable public interest. User engagement in the assessment and improvement of HCS (Home Care Service) is important. How HCS interacts with informal family support networks should be scrutinized. The establishment of a comprehensive family-centered care model which supports informal family support networks is of great concern, particularly in Chinese society.

Objectives: This study examined the impact of HCS quality on family satisfaction from the viewpoints of both users and their family caregivers. More specifically, this study aimed to (1) assess the perceived quality of HCS and its determinants; (2) examine the change in perceived family satisfaction before and after the use of HCS; and (3) analyze how perceived quality of HCS was associated with family satisfaction.

Methods: A total of 252 home care users and 243 caregivers living in Nantou County of central Taiwan were interviewed face-to-face interviewed at home from May 15, 2012 to October 7, 2012. The main instrument used for data collection was a structured questionnaire in which quality of HCS was measured by “Quality of Home Care Services Scale” constructed based on Donabedian’s structure-process-outcome framework, and family satisfaction was measured by Chinese version of “Family Satisfaction Scale” originally developed by Olson.

Results: The main findings included: (1) Perceived quality of the services was positively correlated with family satisfaction; (2) “Communication” and “politeness” were elements of HCS quality with concerned service users most, whereas their caregivers gave greater attention to “effectiveness” and “politeness” ; (3) Service users with intact family structures, independent sources of income, any formal education, and who were non-indigenous rated higher in their HCS quality; however, caregivers who were supported by the families of service users, took longer hours to provide daily care, and enjoyed better mental health status gave higher ratings.

Conclusions: In order to improve the quality of HCS, both care users and their caregivers’ viewpoints should be respected simultaneously. The first step to promoting the use of long-term care services is to increase the availability and accessibility of service-related information. To build a sustainable, integrated and coordinated system of long-term care services, individualized and family-centered approaches should be adopted.

並列關鍵字

home care ； quality of social care ； family satisfaction ； user engagement ； family- centered

參考文獻

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