產科醫療品質看法之研究：比較醫護人員和產婦的觀點

Quality of Obstetric Care：Perspectives of the Professionals and Clients

張雅渏(Ya-Chi Chang)

指導教授 ： 陳彰惠

高雄醫學大學/護理學院/護理學系研究所/碩士(2004年)

摘要

隨著社會變遷、經濟快速發展、健保制度的改變、顧客意識抬頭，
醫院經營面臨考驗與衝擊，提昇醫療品質及效率已成為醫療院所重要的
經營理念。本研究為一橫斷性調查研究，採立意取樣，以醫療品質問卷
和顧客滿意度問卷等結構式問卷訪談高雄市五家醫療院所產科醫師、護
理人員等專業人員及產婦共246 位，主要目的在探討產科醫師、護理人
員等專業人員及產婦對產科醫療品質重視程度之比較，以及探討產婦對
醫療品質之滿意度及相關因素。
研究結果發現醫療品質問卷經由因素分析可以歸類為「行政管理及
後續服務」、「服務態度及成效」與「硬體設施」三構面。產科醫師、護
理人員等專業人員及產婦對醫療品質三構面重視程度皆介於「重要」與
「非常重要」之間，其中產科護理人員及產婦皆認為「服務態度及成效」
構面之醫療品質最為重要，而產科醫師則認為「硬體設施」構面之醫療
品質最為重要。產科醫師、產科護理人員及產婦對「行政管理及後續服
務」、「服務態度及成效」與「硬體設施」等不同構面醫療品質的重視程
度有顯著差異。在人口學基本屬性中，產科醫師的服務醫院層級會顯著
影響其對「整體醫療品質」、「行政管理及後續服務」及「服務態度及成
效」構面等醫療品質的重視程度；護理人員產科服務年資會顯著影響其
對「整體醫療品質」、「行政管理及後續服務」及「服務態度及成效」構
面醫療品質的重視程度；產婦的配偶教育程度及社經階層會顯著影響其對「服務態度及成效」構面醫療品質的重視程度。
產婦對醫療品質滿意度平均而言是「滿意」，其中產婦對「服務態度
及成效」構面之醫療品質滿意度最高，「行政管理及後續服務」構面之醫
療品質滿意度次之，「硬體設施」構面之醫療品質滿意度最低。由逐步複
迴歸分析的結果，產婦對「整體醫療品質」的重視程度越高、配偶教育
程度越低、產婦教育程度越低及為初產婦者，其對醫療品質的滿意度越
高。
建議可將研究結果運用於臨床實務、行政及教育訓練方面，以減少
醫師、護理人員及產婦對醫療品質看法之差異，並可針對產婦所重視的
醫療品質項目與滿意度較低之醫療品質項目進行改善，使醫護人員能提
供真正符合產婦所重視之醫療品質，提昇產婦對醫療品質之滿意度及整
體的醫療品質，以達以「顧客為中心」的醫療服務。

關鍵字

產科專業人員 ； 產婦 ； 醫療品質 ； 滿意度

並列摘要

The ever-changing society, the fast economic development, the medical
insurance, and customer awareness are factors to force all hospitals to improve
their medical quality and efficiency in order to gain competitive edges to
survive in the throat-cutting competition. This research employs a
cross-sectional survey. Questionnaires were given to 246 individuals including
obstetricians, nurses, and parturients in five hospitals in Kaoshiung City to
inquire them about the medical quality of and their degree of satisfaction with
the hospitals. The main purpose of this study was to look at the medical quality
from the perspectives of the obstetricians, the nurses, and the parturients, and
to make inquires about the degree of satisfaction of the parturients as far as
medical quality is concerned.
The results of the survey on medical quality fall into three categories:
administration and follow-up service, attitude and efficiency, and hardware
facilities. All the obstetricians, the nurses, and the parturients surveyed regard medical quality as important or very important. Among them, the nurses and the parturients think that attitude and efficiency is the most important, while the obstetricians think that hardware facilities are the most important. The obstetricians, the nurses, and the parturients had significantly different rating on the importance of the three facets of medical quality i.e., administration and follow-up service, attitude and efficiency, and hardware facilities. Demographically speaking, the rank of hospitals at which the
obstetricians work remarkably influences their ideas about the importance of
total medical quality, administration and follow-up service, and attitude and
efficiency. Years of service of the nurses affect their ideas about the importance of the total medical quality, administration and follow-up service, and attitude and efficiency. The educational level of the parturients’s spouses and socioeconomic status greatly affect their ideas of the importance of the facet of attitude and efficiency of the medical quality.
On average, the parturients are satisfied with the medical quality. Among
the three facets of medical quality, they show the highest degree of satisfaction with attitude and efficiency, then with administration and follow-up service, while they are least satisfied with the hardware facilities. The result of the stepwise multiple regression analysis indicates that the more the parturients stress the total medical quality, the lower the level of education of the parturients’s spouses, parturients who are lower educated and the primipara show the highest degree of satisfaction with medical quality.
It is suggested that the findings of this study could be put into practice in
clinic, administration, and educational training so as to reduce the differences
among obstetricians, nurses, and parturients toward medical quality. And it is
hoped that the items of the medical quality the parturients stress and the items
of medical quality the parturients are least satisfied with could be improved, so that the goal of “customer-centered” medical service can be realized, where the medical professionals are able to offer high quality medical service to satisfy all the parturients.

並列關鍵字

Perspectives ； partiurient ； medical quality ； satisfaction

參考文獻

王瑋、陳玉枝(1995)･因應全民健保— 談醫院護理品管的趨勢

･護理新象， 5(2)， 57-73。

尹衍樑(1983)･就醫態度與轉院行為關係之研究･未發表之碩

士論文， 台北： 台灣大學。

石曜堂(1978)･醫院品質評估･醫院， 11(2)， 106-109。