從需求理論探討病人權利的落實認知與管理

Using Maslow's Hierarchy of Needs to Investigate the Cognitive Recognition and Management of Patients' Rights

林秀碧(Hsiu-Pi Lin) ； 蔡永杰(Yung-Chieh Tsai) ； 蔡政庭(Cheng-Ting Tsai)

《醫務管理期刊》 14卷1期 (2013/03) Pp. 18-37

https://doi.org/10.6174/JHM2013.14(1).18

摘要

目的：本研究旨在從民眾的角度來探討台灣醫療機構病人權利的「知」與「行」，進而以需求理論的觀點探討病人權利的落實認知與管理。方法：採結構性問卷，依南部某醫學中心2010年門診、急診及住院就診人數分層等比例抽樣。問卷施測620份，回收有效問卷600份，回收率97%。透過因素分析，問卷有良好的建構效度，Cronbach’sα 介於0.69-0.95，顯示問卷具有良好的信、效度。結果：第一，病人權利的內涵可以分為平等權、知情同意權、病人自主權、隱私權、妥善醫療權、臨終照護、文件請求權、申訴權八個構面。第二，「平等權」是民眾認知醫院落實程度最高的構面；反之，「文件請求權」與「臨終照護」的落實程度較低；民眾最滿意「平等權」，較不滿意「申訴權」和「文件請求權」。第三，「申訴權」、「文件請求權」、「隱私權」、和「妥善醫療權」是影響病人權利整體滿意度的重要因素。第四、內、外、婦、兒各科別病患關注不同的權利構面。結論：以需求理論來看，各科別的民眾對病人權利有不同的需求，醫療機構病人權利的管理須兼顧使用者的期待與供給者落實的需求，研究結果可做為醫療機構病人權利落實與管理的參考。

關鍵字

需求理論 ； 病人權利

並列摘要

Objective: This research investigated ”cognition” and ”implementation” in terms of patients’ rights in Taiwan’s medical institutions from the perspective of the patients. We further investigated cognition and management using Maslow’s Hierarchy of Needs.Methods: A structured questionnaire was adopted. Sampling was conducted according to the number of outpatients, emergency visits, and hospitalized patients in a medical center located in southern Taiwan in 2010 year. A total of 620 questionnaires were distributed and 600 (97%) were returned. Factor analysis showed that the questionnaire had an excellent structural validity. Cronbach’s alpha values ranged between 0.95-0.69, implying good reliability and validity.Results: Patients’ rights include the right to equality, the right to informed consent, the right to autonomy, the right to privacy, the right to appropriate medical care, the right to end-of-life care, the right to request documentation, and the right to appeal. The right to equality was the one best implemented by the hospital; in contrast, the right to request documentation and the right to end-of-life care were relatively poorly implemented. The public was most satisfied with the right to equality and less so with the right to appeal and the right to request documentation. The right to appeal, the right to request for documentation, the right to privacy, and the right to appropriate medical care were the most crucial factors that affected patients’ satisfaction with their rights. Medical, surgical, gynecological, and pediatric patients focused on different aspects of their rights.Conclusion: From the perspective of Maslow’s Hierarchy of Needs, different patients from the various departments had different demands with regard to their rights. Management of patients’ rights in medical institutions should consider users’ expectations and the requirements needed by suppliers to implement those rights. The results of this research can be used as a reference for the management and implementation of patients’ rights by medical institutions.

並列關鍵字

Maslow's Hierarchy of Needs ； patients' rights

參考文獻

吳仁光、蔡銘雄、陳經緯（2006）。醫 學倫理與法律病例研討。澄清醫護管 理雜誌，2(3)，60-66。

汪淑娟、劉邦立、施予婷（2008）。大 學生的求醫經驗與對病人權利態度之 初探。澄清醫護管理雜誌，4(1)，10-15。

許淑嬌（2010）。病人權利認知與就醫 忠誠度關聯性之研究－以病人權利滿 意度為中介變項（未出版之碩士論 文）。中臺科技大學，台中。

陳榮基（2008）。病人權利與責任。健 康世界，268，3。

黃慧滿、高家常、孫凡軻、侯佩儀 （2010）。隱私權及病人隱私權之概 念與法律規範。長庚護理，21(3)，314-322。