臺北縣市呼吸器依賴病患決策家屬選擇呼吸照護病房因素之研究

近年來醫療消費者要求高品質的醫療服務，醫療機構的選擇已被認爲是消費者重要的決策行爲。本研究旨在探討呼吸器依賴病患家屬選擇呼吸照護病房時較重視的因素，以及影響選擇的因素。採橫斷式研究設計，以臺北縣市41所呼吸照護病房爲母群體，隨機抽出20所，以進住呼吸照護病房一年內的病患的主要決策家屬爲調查對象，以自編的結構式問卷進行調查，共發出320份，回收有效問卷288份（回收率94.4%）。所得資料以頻率、百分比、平均值、標準差、Mann-Whitney test、Kruskal-Wallis test、Spearman等級相關等進行統計分析。結果顯示：在選擇呼吸照護病房的五個構面因素中，決策家屬的重視度依序爲：醫療專業服務、價格因素、方便因素、作業服務與硬體規畫；選擇呼吸照護病房時最重視醫德、護理人員服務態度及醫術。影響選擇呼吸照護病房的因素，病患部分包括性別、年齡、有無社會福利補助、有無接受洗腎。決策家屬部分包括與病患的關係、婚姻狀況、教育程度、訊息來源足夠度。研究結果將可做爲呼吸照護病房提升服務品質的重要參考。

關鍵字

呼吸照護病房；決策者；呼吸器依賴病患

並列摘要

Medical consumers have begun recently to request high quality medical services. Factors affecting hospital choice are very important for decision behavior of consumers. The purpose of this study was to determine the factors affecting the selection of Respiratory Care Wards (RCWs) for families of ventilator-dependent patients. The study employed a cross-sectional design. Structured questionnaires were developed to survey the main family decision-maker of ventilator-dependent patients from 20 randomly selected ones among 41 RCWs in Taipei. Out of 320 self-reported questionnaires sent out, 288 (94.4%) valid questionnaires were returned. Descriptive statistics, Mann-Whitney test, Kruskal-Wallis test and Spearman rank correlation coefficient were utilized. The survey results showed that family decision-makers focused on the following five subscale factors affecting the selection of RCWs, which were ranked-ordered as follows: professional services, price factor, convenience factor, hospitalized services and hardware plan. Reported the most common selection of RCWs based on subscales of 5 structure factors: physician moral values, nurse attitude, and physician skill. Patient characteristics affecting selection of RCWs included gender, age, social welfare help and hemodialysis service. The relationship with the patient, marriage, personal education and sufficient information resources were the factors for affecting family decision-makers. These survey results provide an important reference for promoting the quality of RCWs.