病人家屬對全責照護模式服務之觀點：質性研究

背景：衛生署自2006年起委託辦理「全責照護計畫」積極推行使用者付費原則之「全責照護模式」（Skill Mix），即以經過訓練的照顧服務員來協助護理人員執行病人基本護理照顧活動，而此服務由病人自行付費。此照護模式主要目的可舒緩護理人力短缺問題、降低住院病人家屬之照顧負擔及提升照顧品質。目前平值此照護模式成效相關研究非常有限，更顯少研究探討家屬對此照護模式的看法。目的：本質性研究主要探討接受全責照護模式住院病人家屬對服務之觀點。方法：本研究以立意取樣東部某區域醫院住院病人家屬研究對象，研究者以深入訪談方式針對八位受訪者進行資料收集，訪談過程以錄音方式轉為逐字行為過程記錄，以主題分析法進行分析歸納。結果：研究發現家屬的觀點有四大主題：一、傾心為親、不畏艱難；二、全責出擊、載滿溫暖；三、共獻良策、再造福澤；四、全責永續、有助經濟。結論：全責照護模式為一可行且有助於減輕家屬照護負荷的照護服務，本研究結果可為有計畫推行全責照護模式醫院管理者參考，以期提供病人及家屬更完善的照護服務。

關鍵字

全責照護模式；家屬；護理；質性研究

並列摘要

Background: In 2006, the Department of Health conducted a Skilled Mixed Care Model project and actively promoted the idea of ”pay for service”. In this model, a registered nurse helps train a nurse’s aid to provide basic daily living care for patients who pay for this service. This skilled mixed care model can relieve nursing shortage problems and reduce the care burden of families. Research related to the evaluation of this care model is very limited in Taiwan, and little is known about family perspectives. Purposes: This study aimed to explore the perspectives of families of inpatients concerning the service of the Skilled Mixed Care Model. Methods: A qualitative research design was used. A purposive sample of subjects from a regional hospital in eastern Taiwan was recruited. [Dear Author: Is this what you mean?] The families of eight patients were recruited and underwent in-depth interviews. The interviews were tape-recorded and transcribed. The interview data were analyzed using thematic analysis. Results: Four themes emerged from families’ perspectives as follows: 1. Unfearful to the hardship for the sake of the patients. [Dear Author: The previous sentence is completely unclear and I could not guess your meaning. Please rewrite.] 2. The warmth of the nursing staff could be felt with the skilled mixed care model. 3. A holistic care plan can contribute to the well-being of patients and 4. The model can reduce the costs of health care. Conclusions: The model is a feasible and useful service to reduce the care burden for families of inpatients. The findings of this study can provide a reference for hospital administrators who want to implement the model to provide a comprehensive care service for patients.