住宿式長照機構服務品質構面之研究：以人性化照顧為中心

隨著人口高齡化及家庭型態的改變，家庭的照護功能不如以往，機構式照顧的需求逐漸增加，長照機構服務品質成為大眾關注的焦點。將長照機構的服務品質分為環境設備的結構面、照顧內容與過程的過程面，以及接受照顧後改善狀況的結果面等三構面。經由探討老人福利機構評鑑之指標，可看出我國對長照機構品質之結構面衡量指標最多，對於過程面的衡量較少。現在民眾除了住宿環境之外，對於機構的服務內容及服務態度越加重視，希望住民可以受到完善的照顧之外，在機構內也可以感到愉悅、受尊重。因此民眾越加重視機構人員的服務態度、同理心等人性化照顧，也是我國長照機構服務品質尚未衡量的部分。本研究主要探討消費者對長照機構服務品質的期望，對於長照機構服務品質三構面之重視程度與條件，其中人性化照顧是否為消費者選擇機構的重要考量。本研究於2020年5月11日至17日進行網路問卷調查，共計回收586份有效樣本，並利用敘述性統計、交叉分析與卡方檢定進行探討，研究實證結果如下： 1.受訪者最重視長期照顧服務品質中的過程面，選擇機構時照顧的過程比環境設備的結構面更加受到重視，其中人性化照顧為選擇機構時的重要條件，「提供服務的過程中尊重住民的感受，充分的溝通與回應」對受訪者而言比一般的照顧過程更加重要。 2.在過程面中，受訪者認為重要的類別依序為生活照顧及醫護服務、同理心、膳食、社交活動、參與照顧決定、自主性，最後為權益保障。最重要的四項條件為「提供服務的過程中尊重住民的感受，充分的溝通與回應」、「具有日常生活的基本服務」、「日常醫療護理、藥品及復健服務便利」及「營養均衡且多變化的飲食」。 3.人性化過程面中，受訪者認為重要的類別依序為同理心、參與照顧決定以及自主性。最重要的三項條件為「提供服務的過程中尊重住民的感受，充分的溝通與回應」、「家屬可參與照顧計畫的討論」及「住民自行安排個人的日常生活活動」。 4.結構面中，受訪者認為重要的類別依序為環境設備、衛生、公共安全、人力資源及地理位置。最重要的三項條件為「環境與設備清潔的衛生」、「寢室及室內空間寬敞、明亮且通風」以及「意外與緊急事件的處理機制完善」。

關鍵字

服務品質；人性化照顧；住宿式長照機構；老人福利機構評鑑

並列摘要

With the population ageing and the change in family types, the function of family care has lost it touch, leading to an increasing demand for institutionalized care. Thus, the service quality of long-term care institutions has been foregrounded. It can be divided into three aspects: the infrastructural aspect of environmental equipment, the service process aspect of care content, and the result aspect of improvement after care. According to evaluation indicators of the elderly welfare institutions, it is clear that there are more infrastructural indicators for measuring the quality of long-term institutions in our country, but less for the process. In addition to the accommodation, the service and the care staff’s attitudes have been emphasized. This is because apart from usual care, residents’ feelings are supposed to be taken into account. Therefore, the public have put more emphasis on the humanistic care including the care staff’s attitudes, empathy and so on in LTC institutions. Humanistic care has not been measured in the service quality of LTC institutions in Taiwan. This study aims at investigating the consumers’ expectation of service quality and their perceptions of three aspects of service quality in the long-term institutions. Lastly, the author also looked into whether or not humanized care is a parameter that guides one choice. This research was conducted by administering an online questionnaire from May 11 to 17, 2020. A total of 586 valid samples were obtained and then analyzed by using descriptive statistics, cross-analysis and chi-square test. The findings are as follows: 1. Respondents valued the processing aspect of care content in long-term care service quality. The service process of care is more important than the infrastructure aspect when choosing an LTC institution. Among them, humanistic care is an important factor for choosing an LTC institution. “Respecting residents with good communication” is more important than the general care process. 2. In the service process aspect, the respondents consider life care and medical service is the most important, followed by empathy, meals, social activities, participation in care decisions, autonomy, and their rights. When choosing the service process aspect of the LTC institution, the respondents consider the four important factors. The most important factor is “respecting the residents’ feelings in the process during the service, and adequate communication and response”. The second one is “basic services of daily life”. The third one is “the convenience of daily medical care and rehabilitation service”. The last one is “balanced and varied diet”. 3. In the humanization process aspect, the respondents consider empathy is the most important, followed by participation in care decisions and autonomy. When choosing the humanization process aspect of the LTC institution, respondents take three factors into consideration. The most important factor is “respecting the residents’ feelings in the process during the service, and adequate communication and response”. The second one is “family members can participate in the discussion of care plan”. The last one is “residents can arrange their own daily life activities”. 4. In the infrastructural aspect, the respondents consider environmental equipment is the most important, followed by health, public safety, human resources and geographical location. When choosing the humanization process aspect of the LTC institution, respondents take three factors into consideration. The most important factor is “clean environment and equipment”, The second one is “spacious, bright and ventilated bedroom and indoor space”. The last one is “complete handling mechanism for unexpected and emergency events”.