護理之家人性化照護品質指標之發展－德懷研究與層級分析

爲因應我國邁入高齡化社會的趨勢，長期照顧服務需求增加，本研究目的為建立護理之家人性化照護品質指標。本研究從文獻整理出人性化照護品質指標，以德懷研究確認人性化照護品質指標的專家效度，並以層級分析評定指標的權重分數。經歷三回合德懷研究，發展出護理之家人性化照護品質指標共47項，分別歸屬於三個層面八個類別：結構層面-友善的生活環境，過程層面-全人觀、同理心、個別性照顧、自主性、參與照顧決定、適當使用照顧設備/器材，結果層面-滿意度。層級分析的評比結果顯示：結構層面之權重分數為29％，過程層面之權重分數為45％，結果層面之權重分數為26％。在過程層面有6個類別進行權重評比，結果如下：全人觀類別之權重為20％、同理心類別之權重為21％、個別性照顧類別之權重為29％、自主性類別之權重為15％、參與照顧決定類別之權重為9％、適當使用照顧設備/器材類別之權重為6％。研究結果將人性化照護從抽象的概念，轉化為具體可評量的指標，建議未來可以進行相關研究以建立本研究指標的實證基礎。

關鍵字

人性化照護；品質指標；護理之家

並列摘要

The increase in elderly people is a global issue. In response to increasing demands in caring for the elderly and disabled, this study develops Humanistic Care Indicators (HCIs) for nursing homes to improve their quality of care. The Delphi technique was used to validate HCIs and the analysis hierarchy process (AHP) was used to judge the allocation of index weight. Through 3 rounds of Delphi questionnaires, 47 HCIs for nursing homes were identified and grouped into three domains with 8 elements: structure domain- friendly environment, process domain -holistic care, empathy, individualization, autonomy, participating in decision-making, appropriate use of care tools, and outcome domain- satisfaction. The results of AHP indicate that, the weight values are 29% for structure domain, 45% for process domain and 26% for outcome domain. The weight values of 6 elements of process domain are as follows: 20% for holistic care, 21% for empathy, 29% for individualization, 15% for autonomy, 9% for participating in decision-making, and 6% for appropriate use of care tools. The results of this study transform the concept of humanistic care from an abstract idea into concrete indicators. Further studies are required to test the practicality of HCIs and evaluate the outcomes of applying HCIs in nursing homes.