以劇場理論探討焦慮與信任對服務價值感的影響-以檢查病人為例

Using Dramaturgical Theory to Investiagate the Effect of Anxiety and Trust on Sense of Service Value – A Study of the Patient Received Medical examined

陳佩君(Pei-Chun Chen)

指導教授 ： 秦兆瑋

長榮大學/健康科學學院/醫務管理學系(所)/碩士(2016年)

摘要

研究背景：醫療機構擔負著救治病人之重要任務，導致行銷中許多重要要素的設計有其倫理及實行困難的限制。近年來許多醫療機構改變內外觀設計及醫療流程，以使就醫民眾有更好的視覺及服務感受，這些會影響對醫院整體的服務價值感，更是就醫選擇的重要因子。焦慮與信任是病人常見的矛盾心理，在過去研究中是探討：(1)透過如音樂、芳療、衛教等方式減少病人的焦慮。(2)實體環境、專業知識會增加病人的信任，都屬於劇場理論四構面其中一部分。因此本研究以劇場理論為基礎探討病人檢查時的醫療劇場對焦慮、信任、服務價值感的影響。
研究方法：本研究為橫斷式研究，採用調查研究法以南部某區域教學醫院接受門診檢查或回門診看檢查報告的病人為研究對象，利用便利抽樣法發放375份研究問卷，有效問卷為350份，有效回收率93%。針對本研究各構面進行因素分析與信效度分析，並運用結構方程模式作假設驗證，以了解醫療劇場、焦慮、信任、服務價值感間的直接關係，並分析焦慮與信任是否具有中介效果。
研究結果：1.病人對檢查的醫療劇場感受越好，對醫院的服務價值感、信任有正向影響。2.病人對檢查的醫療劇場感受越好，對焦慮沒有負向影響。3.病人對檢查的焦慮越低，對醫院的服務價值感沒有正向影響；但有越高的信任時，對服務價值感則有正向影響。4.檢查的醫療劇場不會透過病人焦慮的降低，而增加醫院的服務價值感；但會透過病人對信任的提升，增加醫院的服務價值。
研究建議：劇場理論可以綜合起來從多角度的方向去了解民眾對醫療環境、醫病關係、對醫療從業人員服務態度的感受、滿意度、品牌口碑。從本研究結果得知，善用劇場理論可以增加病人對醫院的服務價值感以及增加對醫療人員或醫院的信任程度。因此建議未來可以擴大在以劇場理論為基礎在醫療產業上的研究。

關鍵字

醫療機構 ； 劇場理論 ； 焦慮 ； 信任 ； 服務價值感

並列摘要

Introduction：Medical institutions are responsible for providing patient treatment, resulting in many of the key marketing elements subject to the limitations and restrictions of ethical obligations and execution difficulty. In recent years, many medical institutions change hospital interior and exterior design and their medical procedures so that people seeking medical treatment may experience better visual perception and service, the feelings of which will have an impact on the overall value of hospital service, also referred to as important factors to determine choice of medical treatment. Anxiety and trust often appear in patient’s ambivalence. The studies in the past are to explore (1) the intervention of music, aromatherapy, health education, and so on to reduce the anxiety of patients. (2)Physical environment and professional knowledge will improve patients’ trust. All described is part of the four tactical arms of the Dramaturgical Theory. Therefore, this study aims to examine the impact of Medical Theatre on patients’ anxiety, trust and sense of service value during their check-ups.
Methods：This is a cross-sectional study. Survey research was conducted among patients who received outpatient checkup or returned to check their report on their second visit in a regional teaching hospital in Southern Taiwan. With the use of convenience sampling, a total of 375 copies of the questionnaire were distributed, 350 copies of which were valid. The recovery rate of (93%) was considered valid. In this study, each dimension was evaluated through factor analysis and validity analysis and the hypothesis was tested with the application of structural equation modeling in order to understand the direct relationships among medical theatre, anxiety, trust and sense of service value and analyze whether anxiety and trust are intermediary variables.
Results：(1) High levels of patients’ feelings regarding the execution of checkups in the setting of medical theatre are positively associated with sense of service value and trust in medical institutions. (2) Lower levels of patients’ feelings regarding the execution of checkups in the setting of medical theatre are not negatively associated with anxiety.(3) Lower levels of patients’ anxiety towards checkups are not positively associated with sense of service value for the hospital while higher level of patients’ trust is positively associated with sense of service value.(4) As for the execution of checkups in the setting of medical theatre, sense of service value towards medical institution is not affected due to lower anxiety in patients but affected by the increased trust in patients.
Suggestions：The multi-perspectives of dramaturgical theory help better understand patients, such as their understanding of medical environment and of the doctor-patient relationship as well as their feelings and satisfaction of service attitude of medical professionals and brand reputation. This study shows the use of dramaturgical theory can increase patients’ sense of service value of the hospital and the degree of their trust towards medical professionals or the hospital. It is recommended that more studies in the field of medical industry based on dramaturgical theory can be further discussed in the future.

並列關鍵字

medical institutions ； dramaturgical theory ； anxiety ； trust ； sense of service value

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