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亞急性呼吸照護病房病人的家屬對醫療服務品質期望及相關影響因素探討:以北台灣某醫學中心為例

Factors influencing the expectations of patients' families about the service quality at the respiratory care center of a medical center in northern Taiwan

摘要


背景:隨著醫學進步,就醫者不只重視醫療專業技術,對醫療服務品質期望也越來越高,因此照護提供者可能需要預先瞭解病人與家屬重視的醫療服務適時給予協助。在呼吸器依賴醫療方面,預先了解其對服務的期待目前文獻尚屬少數,因此本研究希望探討家屬對醫療服務品質期望度與相關因素,以作為亞急性呼吸照護病房照護之參考。研究方法設計:本研究利用服務品質SERVQUAL問卷針對北台灣某醫學中心亞急性呼吸照護病房預轉入病人之家屬為對象,包含五個服務品質構面與22個題項進行調查,收案期間從2017年2月至2018年1月回收有效樣本共137份,所得資料以頻率、百分比、平均值、標準差、排序分析、與邏輯斯迴歸分析等統計分析。結果發現:「可靠性」構面為家屬最期望的醫療服務構面。最期望的前三項醫療服務項目為「遭遇問題時,人員展現了解決問題的誠意」、「第一次就能得到應有的照護,不必等下一次」、「人員答應進行的診療和服務有完成」。影響家屬期望因素為病人轉入前科別、轉入前是否曾嘗試移除氣管內管、轉入時是否接受氣管切開術、轉入前住加護病房天數、家屬年齡、性別與病人關係。結論與建議:瞭解家屬的醫療服務需求可以作為改進照護服務品質的指引,及醫療院所提升市場競爭力的參考。

並列摘要


Background: With advances in healthcare, patients place increased attention on medical care as well as the quality of service; therefore, care providers need to understand the concerns of patients and their families to provide timely services. Studies regarding the expectations of services in the care setting for patients with ventilator dependence are lacking. The aim of this study was to explore the factors associated with service quality to provide insights for respiratory care centers (RCCs). Methods: This study used a questionnaire survey by applying the SERVQUAL instrument for the family members of patients who were scheduled to be transferred to the RCC of a medical center in northern Taiwan between February 2017 and January 2018. The instrument consisted of 22 question items in five dimensions. We analyzed the 137 valid responses with descriptive and inferential analyses and multivariate logistic regression. Results: "Reliability" had the highest average score among the five dimensions. The items with the highest expectation for service quality included "When the patient or you have a problem, the RCC will show a sincere interest in solving it", "The RCC will perform the service right the first time", and "When the RCC promises to do something by a certain time, it will do so". Multivariate logistic regression analysis showed that factors related to the high expectations included transfer from a surgical intensive care unit, failed attempt at extubation, tracheostomy, length of stay in the intensive care unit less than 1 month, responder's age, gender and relationship to the patient. Conclusions: Understanding the family's perspective of service quality and the need for healthcare services may provide valuable insights to guide improvements in service quality and enhance competitiveness.

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