研究目的: 在台灣65歲以上老人有2,180,230人,老年人口比率9.6﹪,早已達聯合國世界衛生組織所訂的7%高齡化社會指標,因此應該關心老人族群。而根據北縣社會局93年度老人福利機構評鑑結果,因評鑑等級比例懸殊,似乎顯示機構品質良莠不齊,未立案者或極少數床位者也藏在社區中營運,甚至有床數與通報不符等怪現象,使得無知的民眾進住安養、照護,乏人監督,讓人質疑其照護品質及安全性。本研究主要是探討接受服務的老人住民(及家屬)對於機構所提供之服務品質的認知是否與主事者有差異存在,加以實證研究,並從問卷得知生活品質情形及與服務品質之相關性,進而從中收集相關人士的看法、探討影響的各個層面及問題的整體相關建議等。 研究方法:研究對象是台北縣長期照護管理中心監督機構:安養中心、養護中心及護理之家等,機構內65歲以上、護理人員評定意識清楚、有表達能力之老人;主事者為機構負責人、護理主管及社工師等。研究時間為橫斷性,94年1月15日至94年4月15日,為期三個月。以立意抽樣,共發放90家,988份問卷。收集樣本數571份問卷,回收率達57.8 %。研究工具:Servqual結構性問卷(五個構面、22個項目)及台灣版WHOQOL-brief問卷。 研究結果:整體來說,服務品質方面,主事者的平均重視度顯著高於老人的部份,而老人最重視的項目有:服務人員及同住的老人儀容整潔、乾淨和對機構的一切服務有安全感等二項,對內部設施及外部休閒環境項目次之。主事者與老人的滿意度整體比較結果,發現無顯著差異。只有在訪視人員及時間安排方面,老人的滿意度沒有主事者高,有顯著差異。老人最滿意項目為服務人員態度親切有禮貌,滿意度最低者為機構的位置、交通問題 及 與家人、朋友的來往等二項。 在生活品質評價上,大部份都是中等程度以上,只有「享受生活」及「足夠的金錢應付所需」,二項,未達中等程度滿意。 老人基本資料統計(以性別、年齡、學歷、宗教、活動能力、退休前工作及自費照護費用共七項)分析結果,在服務品質重視度方面,活動能力及自費照護費用等二項呈有顯著差異;在服務品質滿意度方面,學歷、宗教、退休前工作、活動能力及自費照護費用等項呈有顯著差異,在生活品質分析方面:性別、宗教及退休前工作等項呈有顯著差異。此方面建議,應該做顧客關係管理,並減少落差,以達合乎顧客(老人)為中心的生活品質之完善服務品質系統。
Purpose: There are 2,180,230 senile people in Taiwan, rating 9.6% of the general population. It has reached the 7% level of ageing society defined by World Health Organization of United Nation. We should pay attention to senile population. According to the accreditation for Senile Welfare Organization held by Taipei County Government Social Affairs Bureau in 2004, there were great differences in quality between Long term care facilities of different accreditation grade. Some of them were not registered or had few beds which still run in the community underground Some had bed count different from claimed one. The civilians who do not know the situation still use the facilities which are beyond custody. The quality and safety of these facilities are in doubt. This study would like to explore if there is difference between the care givers and dwellers or their families in perception of service quality, by evidence-based study and using questionnaire to find out the relationship between life quality and service quality. In the succeeding, we collect the viewpoints of the related personals, study every level of coverage, and the suggestions of the problems as a whole. Materials and methods: In Long-term care facilities that are governed by the Long-term Care Management Center of Taipei County Government, including senior center, disability elder center, and nursing home, people above 65 years old with clear consciousness, communicability defined by nurses were studied. Service providers such as responsible persons in the facilities, nursing managers, social workers and etc represent another group for study. Cross-sectional study was done for 3 months from January 15th, 2005 to April 15th, 2005. Purposing sampling of 90 long-term care facilities with disseminating of 988 questionnaires. There are 571 questionn -aires came back. Response rate was 57.8%. We use Servqual constructional questionnaire ( 5 constructions, 22 items ) and WHOQOL-brief Taiwan version questionnaire. Results: As a whole, in service quality, the mean of value judgment is high in service providers than the senile. The items valued highest by the senile include: the primness and cleanliness of service personnel and roommates, and safeties of services provided. The internal facilities and external leisure environment are in the second rank. In level of satisfaction, there is no significant difference between the two groups. The only item that shows significant difference is the schedule arrangement of interview personnel, while the service providers show greater satisfaction than the senile. The senile satisfied the most in the affability of service personnel, while the least in location of the facilities, traffic issue and visiting of families and friends. In the evaluation of life quality, most of the items are at in the middle class , except the evaluations of “ enjoyment of life” and “enough money to deal with demand” are beyond the middle class. When we analyze the demography data of the senile ( gender, age, education, religion, activity capability, pre-retirement job and self-care fees, 7 items), the activity capability and self-care fees show significant difference in valuing of service quality. In satisfaction of service quality the variables of education, religion, activity capability, pre-retirement job and self-care fees show significant difference. In life quality analysis, it shows significant difference in gender, religion, pre-retirement job and self-care fees, We suggest there should be customer relationship management which can reduce the difference between long-term care facilities to reach the goal of customer-centered perfect service quality system .
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