兒科病患家屬對家庭醫師制度的認知與態度之研究

Studying patient guardian’s cognitions and attitudes toward the family doctor system in the pediatrics department

林彩鳳(Tsai-feng Lin)

指導教授 ： 林孟璋 ； 龔建吉 ； 許哲翰

中臺科技大學/管理學院/健康產業管理研究所/碩士(2010年)

摘要

面對當今醫療市場競爭日益激烈，醫療環境日趨複雜及民眾對醫療品質的要求與自身權益之維護日益提高，醫病關係已逐漸變化。本研究旨在探討兒科病患家屬對家庭醫師制度之認知與態度，透過問卷調查方式，瞭解兒科主要照顧者對家庭醫師制度的認知與其態度情形，在測量工具部份，分認知、感覺、行為等三個構面來進行。另外本文於蒐集專家群體決策之意見後，採用模糊德菲法與項目分析將內容從原有45題項篩減至34題之正式問卷。整體問卷Cronbach’s α值為0.851，屬於高信度問卷，具內部一致性信度。抽樣採分區的方式，共發放研究問卷400份，回收347份，有效問卷為86%。經由變異數分析，探討兒科病患家屬之基本資料對家庭醫師制度的影響程度，其中發現：1.加入及未加入家庭醫師整合性照護計畫之家屬對家庭醫師制度的認知（p=0.014）、態度（p=0.000）及行為（p=0.000）有顯著差異，尤其在態度及行為層面中影響最大。2.是否為孩童監護人對家庭醫師制度的認知（p=0.910）及態度（p=0.202）無顯著差異，行為（p=0.023）具顯著差異。3.孩童家屬性別對家庭醫師制度的認知（p=0.638）及態度（p=0.072）無顯著差異，行為（p=0.043）則具顯著差異。茲針對上述結果提出建議：（一）建議政府能夠繼續支持及擴大實施，尤其是鄉下及偏遠地區讓他們更了解且能夠得到更好的照顧；（二）政府相關機關可透過媒體或社區醫療時，讓民眾更了解家庭醫師可以幫助他們改善許多疑難雜症；（三）同時，可以改善醫療品質，又可以降低醫療資源的浪費，讓小病在小醫院就醫，大病在大醫院就醫。

中文關鍵字：家庭醫師制度、兒科病患家屬、認知、態度。

關鍵字

兒科病患家屬 ； 認知 ； 態度 ； 家庭醫師制度

並列摘要

The face of today''s increasingly competitive healthcare market, the increasingly complex health care environment and public demands for quality of care and the purpose of doctor-patient relationship has gradually changed. The purpose of this study was to investigate the perception and attitude of pediatric patient’s families in family physician system through a questionnaire survey, to understand the families of pediatric patients awareness of family physician system and its attitude towards the situation. Through expert analysis of fuzzy linguistic variables Delphi method of triangular fuzzy numbers relative to collect the opinions of expert group decision making, problem screening questionnaire reduced to 34 from 45 questions. Partition sampling method adopted by the clinic nursing staff of the questionnaire issued by the clinic on July 1,2010 ~ August 31,2010 , granting of a total of 400 questionnaires were returned 347, the valid questionnaires was 86%. By analysis of variance of the families of pediatric patients with basic information on the degree of influence of family physician system, which found that 1. Joining and not joining the family physician integrated care plan system of family recognition of family physician (p = 0.014) , attitude (p = 0.000) and behavior (p = 0.000) were significantly different, especially in the attitude and behavior level, the greatest impact, 2. whether the child guardians of family physician system of cognitive (p = 0.910) and attitude (p = 0.202) no significant differences in behavior (p = 0.023) with significant differences, 3. children families family physician system of gender on cognitive (p = 0.638) and attitude (p = 0.072) no significant differences in behavior (p = 0.043) with significant difference. Hereby recommend the above results: (1) recommended that the Government will continue to support and expand the implementation, especially in rural and remote areas to enable them to better understand and better care; (2) the relevant authority or community health through the media when Allow people to better understand the family physician can help them improve many incurable diseases; (3) the same time, can improve the quality of care, while reducing the waste of medical resources, so that minor illnesses in small hospitals, serious illness in a large hospital.

keywords: family physician system, pediatric patient’s guardian, cognitive, attitude

並列關鍵字

pediatric patient’s guardian ； cognitive ； attitude ； family physician system

參考文獻

王柏青、侯錦雄（1995）。關渡濕地遊客環境態度類群之研究。觀光研究學報，1（4），1-20。

休慧蘭（2006）。諮商與心理治療理論與實務。台北市：雙葉。

林恆慶、吳傳頌、許佑任、陳楚杰（2005）。台灣基層醫師對家庭醫師制度的認知、態度及認可之模式。台灣家醫誌，15（1），11-24。

林恆慶、許銘恭（2003）。基層醫師對國內實施論人計酬制度可行性認知調查研究。台灣家醫誌，13（1），57-70。

邱珍琬（2007）。親職教育。台北市：五南。