醫院照顧服務員之角色知覺、角色期待、角色實踐與照護品質相關性之探討

The study of the relationship among role perception, role expectation, role performance and quality of care in hospital nursing attendant

林純如(Chun-Ju Lin)

指導教授 ： 高美英

臺北醫學大學/人文暨社會科學院/醫學人文研究所/碩士(2014年)

https://doi.org/10.6831/TMU.2014.00021

摘要

本研究旨在探討照服員在臨床醫療場域中對自己工作角色知覺、角色期待、角色實踐與是否會影響對病人的照護品質之相關性；同時比較不同角度對照服員角色與其照護品質的看法差異性。本研究採橫斷式研究，以北部某醫學中心「合約廠商內聘僱之照服員」被派班到病房單位服務之照服員為母群體，依該機構合約之三家廠商照服員採分層抽樣；並以照服員、護理人員、病人進行不同研究資料之三角檢證。研究工具依三種研究對象設計三種版本之研究問卷，問卷總量表皆為Cronbach’s α .96 ~ .98，屬於高信度之測量工具，最後以問卷中開放性問題的整合分析探討不同角度對照服員的角色期待和照護品質之看法。
研究收案照服員與護理人員各117位、病人53位，可配對研究組數為53對。結果分析後發現：(1)有宗教信仰背景特質之照服員會影響個人提供的照護品質表現，並可作為照護品質之預測因子；(2)照服員對醫院照顧服務工作的角色知覺、角色期待、角色實踐與照護品質的看法，彼此之間存在正相關性；(3)照服員、護理人員、病人三組配對結果在對照服員的角色期待上，量化分析結果無統計上差異，開放性問題歸納分析後顯示三者對照服員有相同的角色期待；(4)護理人員與病人對照服員的角色期待能夠用來預測對照服員提供的照護品質之滿意度；(5)照服員的角色實踐與病人衡量的照護品質呈現負相關性，顯示不適切照護會影響被照顧者的主觀感受。本研究結果的呈現可增加醫院照服員工作角色在急性醫療場域之能見度；在臨床實務上作為促進醫院照服員協同團隊照護病人的共識，以提升對病人的照護品質。

關鍵字

照顧服務員 ； 角色知覺 ； 角色期待 ； 角色實踐 ； 照護品質

並列摘要

Nursing attendants were members of nursing service, whose role were to perform basic and simple nursing task advising by nursing professionals. Meanwhile, we compared different viewpoint to the role and care quality of nursing attendants. The role perception, expectation, and performance of nursing attendants will affect the quality of care. The objective of this study was to determine the effect of role perception, expectation, and performance of nursing attendants on care quality. We conducted a cross-sectional study by using data triangulation method, and collected data from three kind of population, nursing attendants, nursing professionals, and patients. Stratified sampling design was used to select nursing attendants from three contract nursing attendant company A, B, and C in a medical center of northern Taiwan. Nursing professionals and patients matched by the sampling nursing attendants in the same care team were also selected. We designed three different questionnaires, all with high reliability(Cronbach’s α .96 ~ .98) ,for the nursing attendants, patients, and nursing professionals respectively. We also analyzed the results of open questions from the three kinds of study populations on the relationship between role expectation and care quality.
We initially included 117 nursing attendants, 117 nursing professionals, 53 patients, and then fully matched 53 sets as study population. The results showed (1) whether nursing attendants had her/his own religion will affect care quality, and it could be a predicting factor of care quality (2) there was positive correlation among role perception, role expectation, role performance, and care quality of nursing attendants (3) with regard to role expectation on nursing attendants of three persons each matched sets, though there was no statistical difference on quantitative analysis, we found the same role expectation on the open question analysis of nursing attendants, nursing professionals, and patients (4) the role expectation on nursing attendants of nursing professionals and patients were predicting factors of care quality satisfaction.(5) there was negative correlation between role performance of nursing attendants and patients assessed quality of care, which implied patients' subjective feelings could be affected by inappropriate care. The expected clinical implication of this study were to enhance the visibility of nursing attendants in the acute care, and facilitating the consensus among nursing attendants and the health care team in order to improve the quality of care.

並列關鍵字

nursing attendant ； role perception ； role expectation ； role performance ； quality of care

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