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營養諮詢需求評估: 痛風患者、醫護人員與營養師之觀點

Need Assessment for Nutrition Counseling: Viewpoints from Gout Patients, Physicians Nurses, and Dietitians

摘要


本文為營養諮詢需求評估系列研究(民國八十八至八十九年間)中的量性問卷結果。研究設計為立意取樣方式,以半開放、結構式三種自填式問卷,對台北地區兩位醫生之痛風病患、四所醫院之內科醫護人員、及十一所醫院之營養師分別對理想營養諮詢形式、營養師工作項目、影響營養諮詢服務品質因素、收費標準及專業人員素養要求作意見調查。有效問卷結果為營養師(九所醫院營養室n=54)、痛風病患 (兩處門診n=124)以及內科系的醫護人員(三所醫院n=127),經由分析得知痛風病患曾接觸過飲食指導的比例約為15%,認為資訊可信度排序高者為醫護人員、專業營養師、報章雜誌、廣播電視、親朋好友,再下來才是傳統醫學及傳銷人員。有60%以上認為傳銷直銷人員不可信及非常不可信。有將近五成(48.6%)的病患希望營養諮詢的時間為15~30分鐘。對於營養諮詢門診的收費,51%覺得營養諮詢的收費並不會影響到尋求幫忙的意願,但也有38%回答收費會影響他們尋求營養諮詢的意願。營養諮詢的收費能接受的範圍額度大部份的人都是在50-200元之間。醫護人員中有8%的醫護人員不知到醫院有營養諮詢門診,醫護人員中高達98%認為門診病患營養諮是非常重要的營養師的職責。營養師認為影響病患尋求營養諮詢門診的因素,影響最高依次為營養師的表達能力、飲食指導的內容、營養師的親和力及病患改變的動機,由此可見營養師本身的人格特質、指導的內涵及病患的動機是營養師認知到病患尋求營養諮詢門診重要影響因素。醫護人員及營養師對收費的方式沒有偏好,分佈性也都約100-300元間,一般而言營養師不贊成完全免費諮詢,有85%的營養師認為需要部份負擔。

並列摘要


This study describes quantitative results from one of the three methods in need assessments for nutrition counseling in a research series between 1999 and 2000. Three structured, semi open-ended, self-administered questionnaires designed for dietitians (11 hospitals), gout patients (two clinics), and medical staff including physicians and nurses in internal medicine departments (four hospitals) were designed to collect opinions regarding nutrition counseling. Total 54 dietitians from nine hospitals, 124 gout patients from two physicians' clinics and 127 medical staff from three hospitals completed the questionnaires. Fifteen percent of the gout patients had experiences on nutrition counseling. The order of credibility for gout-related education information was from medical staff, dietitians, newspapers magazines, television radio, friends relatives, then traditional medicine staff and direct sales(with 60% participants considering direct sales to be an unreliable source). Almost half(48.6%)of patients had the opinion that the duration of nutrition counseling should be 15 to 30 min. Nearly half of the patients did not consider the fee charged to be the limiting factor for the motivation for nutrition counseling. Nevertheless, 38% of the participating patients thought that the charge would be an influential factor and the acceptable range was NT $50 to 200. Eight percent of the medical staff did not aware that the nutrition counseling service existed in the hospital, with 98% of them regarding this as a very important service to patients. The participating dietitians thought that communication skills, contents, human skills, and patient motivation were important contributing factors for the success of nutrition counseling. Moreover, most dietitians and medical staff did not have preferences for the charging systems. They suggested that the fee could be NT $100 to 300 per section. Most dietitians disagreed with providing free services; however, 85% of them agreed with the co-payment system.

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