比較住院病人對病人隱私重視程度與獲得程度之差異

To compare the different between respect and acquire of patient privacy in hospital

李秋桂(Chiu-Kuel Li)

指導教授 ： 林秋芬

臺北醫學大學/護理學院/護理學研究所/碩士(2011年)

摘要

本研究旨在了解住院病人對病人隱私權重視程度與獲得程度之差異。採橫斷式研究設計，針對全國隨機抽樣3家醫院(包括特優、優等、合格醫院各ㄧ家)，採隨機抽樣方式選取個案，自100年6月17日起至6月24日止，經過醫院之IRB審核通過，並取得院方同意後，進行資料收集，此期間共發出350份問卷，回收問卷320份，回收率91%，總計有效樣本296份，有效回收率為85%。研究工具採自擬「病人隱私權量表」，本量表經信效度檢定，效度採專家效度，信度採內在一致性及再測信度，內在一致性Cronbach’s α值為 .966；再測信度為 .793。
本研究結果：1.住院病人對病人隱私權重視程度（M=4.22， SD=0.71）大於獲得程度（M=4.14，SD=0.66），呈現統計學上的顯著差異，顯示病人期望的比實際獲得的高，此易造成病人的不滿，值得注意。2. 在醫院類型合格醫院比優等及特優醫院、住健保房比單人及雙人房之病患重視程度較低。3.在獲得程度部分單人房病患比健保房及雙人房皆來的低，合格醫院比優等及特優醫院的病患低，內科病人獲得程度較低。4.病人為男性、年齡越大、教育程度越低、從事勞工行業者對病人隱私的重視及獲得程度皆較低，且達到統計學上顯著差異。
住院病人對病人隱私權的重視程度比獲得程度高，可能造成對隱私權獲得的不滿，對於治療服務不滿意，增加醫療糾紛的發生率，值得關注。在醫院類型部份合格醫院比優等及特優醫院，不論是病人的重視程度與獲得程度都來得低，表示合格醫院對於病人隱私權，雖然評鑑有要求，但表示還是有改善的空間，可能是醫院的政策與制度、病人未要求，醫療人員不知如何做或沒時間做等等，是可在進一步探究。值得讚許的是病人對於病人隱私的重視程度與獲得程度的得分，介於重視與非常重視及總是獲得與經常獲得之間，表示不論在病人對於他應獲得的權利非常清楚，且醫療院所在這部分經由不斷的教育及評鑑改善，已有相當大的進步。未來各醫療機構，可利用本研究所擬之病人隱私量表，了解病人隱私落實的情形，針對未執行的項目，擬定配套措施，相信可提昇醫療機構的醫病關係、醫療照護品質及病人滿意度。

關鍵字

住院病人 ； 病人隱私權 ； 重視程度 ； 獲得程度

並列摘要

This study is cross-sectional study was designed, random sampling from hospitals from all country (including each one of extremely excellent, excellent, and qualified hospitals) and random sampling for case selection。After gaining the hospital's IRB approval and agreement, data was collected by research tools as "patient privacy scale", which was tested by the reliability and validity test. Validity was tested by expert validity; reliability was tested by internal consistency and retest reliability, and Cronbach's α value of internal consistency was .966 and test-retest reliability was .793. There were 350 questionnaires sent out, and 320 questionnaires were returned .The returned rate was 91%; total valid samples were 296, and the effective rate was 85%.
Results: 1. Inpatients valued the importance of patient privacy (M = 4.22, SD = 0.71) greater than the access of patient privacy (M = 4.14, SD = 0.66). 2. Inpatients in qualified hospital valued less importance of patient privacy than they in extremely excellent and excellent hospitals did. Patients living in “insurance-bed” wards valued less importance of patient privacy than patients living in “double-bed” or “single-bed” wards. 3. Inpatients in qualified hospital accessed less patient privacy than they in extremely excellent and excellent hospitals did. Patients living in “insurance-bed” wards and medical wards accessed less patient privacy than patients living in “double-bed” or “single-bed” wards. 4. If patients were male, older, less educated or they were labor workers, they might have shared lower patient privacy importance and access level, and reached statistically significant difference.
Inpatients valued more importance of patient privacy than their access of privacy that might cause dissatisfaction of health care services and increase incidence of medical malpractice. Inpatients of qualified hospital viewed less importance of patient privacy and accessed less patient privacy than inpatients of extremely excellent and excellent hospitals did. Even though patient privacy is a part of hospital accreditations, it will be still long way to go in qualified hospitals. The reasons might be policy and philosophy of hospitals, requirement of patients, and lack of knowledge or time for nursing stuffs. They will be investigated in further researchers. Inpatients scaled importance of patient privacy between “very important” and “important”, which meant they knew their privacy rights clearly. Inpatients scaled the access of patient privacy between “always” and “usually”, meant that had been getting great progress after continuous education and ongoing improvement. Institutions could use this “patient privacy scale” to understand real situation of patient privacy in hospitals, set implementations and develop supporting measures. I believe that patient-institutions’ relationship, health care quality of patient privacy and patient satisfaction will be enhanced in the future.

並列關鍵字

inpatients ； patient privacy right ； respect ； acquire

參考文獻

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