台北市民眾對於病人安全的認知與態度之研究

The Perception and Attitude of Public toward Patient Safety in Taipei

黃寶萱(Pao-Hsuan Huang)

指導教授 ： 許怡欣

臺北醫學大學/公共衛生暨營養學院/醫務管理學研究所/碩士(2005年)

摘要

本研究之主要目的在於瞭解民眾對於我國推動病人安全的認知與態度、及民眾個人對於病人安全的認知、態度與行為，並探討其影響因素，期能作為衛生主管機關及醫療院所未來向民眾推動病人安全時之參考。 本研究為橫斷性研究，以台北市民眾為研究對象，研究內容分為質性研究與量性研究兩部份。在質性研究方面，分別於民國94年2月及5月，針對台北市信義區里長進行焦點團體座談，以深入瞭解信義區里民代表們對於病人安全的看法。量性研究方面，於民國94年4月15日至94年4月28日，以電話訪問方式，針對居住在台北市且年滿20歲之民眾進行問卷調查，以瞭解民眾對於我國推動病人安全的認知與態度、及民眾個人對於病人安全的認知、態度與行為。總共撥出7,857通電話，共完成507份有效問卷。 本研究之主要結果如下： 一、 民眾對病人安全的認知： 有88.4%的受訪者沒有聽過「病人安全」這個名詞。 二、 在「民眾對於我國推動病人安全的認知」方面，民眾較缺乏的是： 1. 若醫師在事前將病人的手術位置做下記號可以避免開錯刀。 2. 若醫護人員使用二種以上的病人資料來辨別病人身份，可減少認錯病人的事件。 3. 醫護人員執行跌倒防範措施，可以減少病人發生跌倒的情形。 三、 在「民眾對於我國推動病人安全的態度」方面： 1. 95%以上的受訪者都覺得問卷中所列的病人安全措施是醫護人員應該做到的。 2. 「醫護人員應該多洗手來防止細菌傳播」是受訪者認為最多醫護人員會做到的項目，亦是受訪者評價最高的項目。 四、 「民眾對於我國推動病人安全的認知與態度」之影響因素： 1. 職業對「民眾對於我國推動病人安全的認知」有最顯著之影響。 2. 在「民眾對於我國推動病人安全的態度」上，則沒有影響特別顯著之變項。 五、 在「民眾個人對於病人安全的認知」方面，民眾最缺乏的是： 「看病前，可以把自己的症狀、身體狀況及任何的問題先寫在紙上，看病時再提出來和醫護人員討論」，這個觀念是最少民眾知道的，也民眾最做不到的。 六、 在「民眾個人對於病人安全的態度」方面： 1. 95%以上的受訪者都覺得問卷中所列的就醫注意事項是病人應該做到的。 2. 「在看病時，會把自己的身體狀況清楚詳細的告訴醫護人員」是受訪者認為最多病人在就醫時會做到的項目。 3. 「在看病前，會把自己的症狀、身體狀況及任何的問題先寫在紙上，看病時再提出來和醫護人員討論」是受訪者認為最少病人在就醫時會做到的項目。 七、 在「民眾個人對於病人安全的行為」方面： 「在看病前，會把自己的症狀、身體狀況及任何的問題先寫在紙上，看病時再提出來和醫護人員討論」是受訪者最不會做到的項目，只有37.8%的受訪者表示他們通常都會這樣子做。 八、 「民眾個人對於病人安全的認知、態度與行為」之影響因素： 1. 性別及住院經驗對「民眾個人對於病人安全的認知」有最顯著之影響。 2. 在「民眾個人對於病人安全的態度」上，則沒有影響特別顯著之變項。 3. 性別、年齡、及手術經驗對「民眾個人對於病人安全的行為」有最顯著之影響。 根據研究結果，本研究提出以下建議：一、衛生主管機關可建立與民眾間的病人安全及醫療問題溝通平台，由此單位負責統籌規劃對民眾的病人安全教育、推廣與傳播衛生主管機關推動病人安全的成果、並且接受民眾的意見、增加與民眾互動的機會。二、醫院可針對病人及家屬容易看到、容易感受的項目，來規劃、推動及展現病人安全成果，並訓練醫院義工向病人及家屬推廣病人安全衛生教育、提供病人安全方面的協助，藉此營造更良好的醫病關係。三、建議後續研究者可在病人安全推行一段時間後，再進行病人安全相關的成效分析，另外，媒體是民眾接受資訊的最大來源，媒體的報導方式會深深影響民眾的認知，因此以媒體為研究對象進行之病人安全研究亦相當重要。

關鍵字

病人安全 ； 民眾 ； 認知 ； 態度

並列摘要

The purpose of the research is to understand the perception and attitude of the population toward the implementation of patient safety as well as the perception, attitude and behavior of patient safety during the utilization of health care service. Also, the influence factors are discussed. The cross-sectional study is based on the population of Taipei City, divided by qualitative study and quantitative study. In qualitative study, two forums of village officers by focus group method were held in Shin-Yi District of Taipei in February and May 2005 separately in order to well understand the opinions of patient safety by the representatives of villages. In quantitative study, the questionnaire executed by phone interview targeted at the citizens living in Taipei City, age by 20 and above in April 2005, to understand the perception and attitude of the population toward the implementation of patient safety as well as the perception, attitude and behavior of patient safety during the utilization of health care service. 7,857 calls were made, and 507 valid correspondents collected. The results of the survey are as follows: 1. The perception of “patient safety” for the population: 88.4% of the correspondents answered never hear of “patient safety”. 2. Regarding the perception of population toward the implementation of patient safety, the correspondents had less perception in the following items: （1） Physicians mark the operational site prior to the start of surgical procedure can eliminate wrong-site surgery. （2） Caregivers use at least two patient identifiers can prevent mis-identification of patients. （3） Caregivers take action to fall risks can reduce the risk of patient harm resulting from falls. 3. As to the attitude of population toward the implementation patient safety, it is briefed as follows: （1） More than 95% correspondents regarded the implementation as the caregivers’ responsibilities. （2） The most recognized item evaluated by correspondents is “Caregivers wash hands before and after having direct contact with patients can prevent bacteria and virus”. 4. Regarding the factors of influencing the perception and attitude of population toward the implementation patient safety: （1） Vocation display significant difference respectively in the perception of population toward the implementation patient safety. （2） None of the variable shows the significant difference in the attitude of population toward the implementation patient safety. 5. In the aspect of the perception toward patient safety during the utilization of health care service, what patients lack most is as follows: Prior to visit the doctor, the patient can write down the symptoms, physical status and inquiry to discuss and consult with the caregivers. 6. In the aspect of the attitude toward patient safety during the utilization of health care service: （1） 95% of the correspondents regarded all active participating patient safety as the patients’ responsibility. （2） Make sure that all of the patients’ caregivers know about everything patients are taking is the most implemented item by patients during visits. （3） It is the least item for the correspondents to write down information about the symptoms, physical status and any inquiry prior to utilizing the health care service. 7. In the aspect of the behavior toward patient safety during the utilization of health care service: It is shown the least item that the correspondents write down information about the symptoms, physical status and inquiry prior to utilizing the health care service, only 37.8% of correspondents replied regular practicing the behavior. 8. The influential factors for the perception, attitude and behavior of patient safety during the utilization of health care service resulted in: （1） Gender and experience of admission displayed statistically significant difference in the perception. （2） None of the variables showed significant difference in the attitude. （3） Gender, age and experience of operation resulted in significant difference in behavior. According to the findings in the thesis, some suggestions are concluded as follows: 1. Some platform to communicate patient safety and health care issues should be established by the supervised governmental organizations. The responsibilities of the platform is to plan and develop the education of patient safety, promote and communicate the performance of patient safety implementation, collect patients’ opinion and expand interactions with patients. 2. Hospitals should plan, practice and display the performance of patient safety by focusing on those easily received and perceived items by patients and their families. Also, hospitals should initiate training program for volunteers at first and then provide patient safety education and assistance to patients in order to sustain patient-doctor relationship. 3. It is suggested the further researches may be focused on the effectiveness analysis of patient safety implantation. Moreover, since mass communication media is one of the most important information sources for people, therefore, the reported issues of media will deeply influence the perception of people. As a result, researching on media for patient safety issues will be another key field in the future.

並列關鍵字

Patient Safety ； Public ； Perception ； Attitude

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