麻醉醫師及手術病人對麻醉醫療資訊供需差異之探討 --以北部某醫學中心為例

A Study on the Gap between Surgical Patients' Requirement and Anesthesiologists' Provision of Anesthetic Information - Using a Medical Center in North Taiwan As an Example

戴溫然(Wen-Jan Dai)

指導教授 ： 鍾國彪

國立臺灣大學/公共衛生學院/醫療機構管理研究所/碩士(2004年)

https://doi.org/10.6342/NTU.2004.02248

摘要

本研究目的在了解醫院內麻醉醫療相關資訊的供需狀況、手術病患對麻醉相關資訊提供服務之期望及實際感受之差異，並探討影響手術病患對麻醉相關資訊提供服務滿意度之因素。
本研究於2004年3月23日起至5月21日，採橫斷式調查方式，經由分層抽樣針對台北市某醫學中心146位常規手術病患與其麻醉主治醫師加以配對，採手術病患之面訪及麻醉醫師之自填問卷方式進行調查。共得136份手術病患及14份麻醉醫師之有效問卷，所得資料以SPSS 11.5v 進行建檔、除錯，使用次數、百分比、卡方檢定、成對t檢定 、因素分析、克-瓦二式單因子等級變異數分析、皮爾森積差相關及羅吉斯迴歸等統計方法進行分析，重要之研究結果如下：
一、麻醉醫師對麻醉醫療資訊服務之提供觀點
麻醉醫師的個人特性（性別、年齡、年資、執業量）對麻醉資
訊服務之提供觀點，不論在態度或提供內容上皆有不同項目之
顯著差異。
二、手術病患對麻醉醫療資訊服務之需求觀點
手術病患之「性別、婚姻狀況、有無麻醉經驗及術式」對麻醉
資訊之態度無顯著差異；對於麻醉資訊之需求內容也不因「婚
姻狀況、收入狀況、手術科別、術式及ASA分類」而有顯著差
異。
三、麻醉醫師與手術病患對麻醉醫療資訊供需服務的差異
（一）麻醉醫師及手術病患對麻醉醫療資訊之供需態度項目皆達到
顯著差異；對於麻醉醫療資訊之供需內容項目則在「麻醉方
式、麻醉過程、術後疼痛控制方法、減輕麻醉後不適」達顯
著差異。
（二）手術病患實際所感受到的服務品質得分皆低於其期望分數。
（三）手術病患期望之麻醉醫療資訊服務與麻醉醫師實際提供者除
了「提供的說明內容符合病患的需要」、「以病患能夠了解
的說詞提供説明」、「鼓勵病患發問及參與」、「及時解答
病患的問題」及「注重病患的個別性問題」等五項之差異不
顯著外，其他項目的差異皆達到統計上之顯著。
（四）手術病患實際感受與麻醉醫師實際提供之麻醉醫療資訊服務
僅在「麻醉醫師的服裝整齊」、「麻醉醫師的態度親切和
善」、「麻醉醫師有耐心地傾聽我的問題」、「麻醉醫師鼓
勵我有徵求其他醫師意見的權利 ( 第二意見 )」及「麻醉
醫師會更正錯誤的訊息」等項目之差異不顯著，其他項目的
差異皆達到統計上之顯著。
四、 麻醉醫師與手術病患對麻醉醫療資訊供需服務之滿意度差異
麻醉醫師與手術病患對麻醉醫療資訊供需服務之滿意度無顯
著差異。
五、 手術病患實際經歷及麻醉醫師處理麻醉後合併症之差異狀況
手術病患實際經歷之麻醉後合併症在「全身麻醉後喉嚨痛」
、「無力感」、「全身麻醉術中覺醒」、「靜脈注射藥物疼
痛」、「排尿困難」五項中與麻醉醫師實際處理之情況有顯
著差異。
六、影響手術病患對麻醉資訊服務滿意度之因素
影響手術病患對麻醉資訊服務之滿意度之因素有「麻醉資訊之
重要程度」、「見到麻醉醫師處」、「有無合併罹病症」、「
與麻醉醫師討論的內容」、「期望與實際感受麻醉資訊服務之
差異得分」、「手術科別」。

本研究建議相關單位於提供麻醉醫療資訊服務時，可參
考本研究麻醉資訊服務品質差異構面所涵蓋的項目，並考慮影響滿
意度之因素，於擬定麻醉醫療資訊服務時予以調整並作長期之追蹤
調查，將可獲得更有效的資訊，藉此提供使手術病患更滿意之麻醉
醫療資訊服務品質。

關鍵字

麻醉資訊 ； 手術病患滿意度 ； 麻醉醫師

並列摘要

The purpose of this study is first to understand anesthetic information requirements of surgical patients and provided information by the anesthesiologists, second to understand the gap between the expectations and perceived anesthetic information service, and third to explore the related factors which affect the surgical patients’ satisfaction about the anesthetic information service.
From 23rd March to 21st May 2004, a cross sectional survey was carried out in a medical center in Taipei city by enrolling a stratified sampling of 146 elective surgical patients and their paired anesthesiologist. Two questionnaires were developed, one for face-to-face interviews with surgical patients and the other for the anesthesiologists to fill in. One hundred and thirty-six valid patient questionnaires and 14 anesthesiologist questionnaires were obtained within the collection period. The statistic software SPSS (Version 11.5) was applied for the data analysis. Major approaches include frequency distribution, percentage, Chi-square test, paired t-test, factor analysis, Kruskal-Wallis statistic, Pearson product-moment correlation coefficient and logistic regression with the following main results:
（1）The characteristics of anesthesiologists (e.g.
gender, age, practice years, work loading) affect
their point of view on providing anesthetic
information.
（2）The characteristics of surgical patients (e.g.
gender, marital status, anesthetic experience and
operation）make no significant difference in their
attitude toward anesthetic information requirement, as
well as marital status, income, operation and ASA
status makes no significant difference in the content
of anesthetic information requirement.
（3）The gap of anesthetic information service between the
surgical patients and anesthesiologists shown as the
following:
i.A significant difference exists in the attitude toward
requirement and provision of anesthetic information
between surgical patients and anesthesiologists. There
are significant difference regarding the content of
requirement and provision of anesthetic information in
anesthesia type, the anesthetic process, postoperative
pain control and post-anesthetic complications.
ii.All perceived scores of surgical patients are lower than
expectation score.
iii.Between anesthesiologists’ provision and surgical
patients’ expectations, no significant difference can
be found in providing the anesthetic information
which meet patients’ needs , providing the information
via understandable words , encouraging patients to
question and participate , answering patient’s
questions promptly, giving attention to patient’s
personal questions. All other items show a significant
difference in the statistical analysis.
iv.No significant difference between anesthesiologists’
provision and surgical patients’ actual perception can
be found in five items, such as the anesthesiologist is
neatly-dressed, the anesthesiologist’s attitude is kind
and friendly, the anesthesiologist listens to my
question patiently, the anesthesiologist encourages me
to seek a second opinion and the anesthesiologist
clarifies my misunderstanding about anesthesia, all the
other items showing a significant difference.
（4）There is no significant difference between surgical
patients and anesthesiologists’ satisfaction about
the anesthetic information service.
（5）A significant difference can be found between
patients’ experience of anesthetic complications and
the treatment anesthesiologists actually give, e.g.
sore throat, weakness, awareness during general
anesthesia, pain sensation in injecting the
intravenous anesthetics and dysuria .
（6） There are several factors which affect surgical
patients’ satisfaction about the anesthetic
information service, such as the understanding of the
importance on anesthetic information, the location to
meet the anesthesiologist, comobidity, the content
discussion about the anesthesia with the
anesthesiologist, the score of gap between the
expectations and perceived anesthetic information
service in surgical patients, surgery specialty.
According to the statistical analysis results of this study, hospitals are advised to pay more attention and consideration to the gap between the expectations and perceived anesthetic information service, as well as factors that affect the surgical patients’ satisfaction. Besides, a long-term follow up is needed in order to further improve the quality of the anesthetic information service.

並列關鍵字

anesthesiologist ； anesthetic information

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