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  • 學位論文

以服務設計觀點探討持續參與社區健康篩檢之關鍵因素

Primary Drivers of Willingness to Continue to Participate in Community-Based Health Screening from the Perspective of Service Design

指導教授 : 莊明振 陳一平

摘要


因應全球人口老化,慢性病已成為21世紀國民最大的健康威脅。研究指出,篩檢為有效地降低慢性疾病發病率及致死率關鍵要素之一;然而,雖社區健康篩檢已施行多年,卻仍有許多問題尚須克服,民眾的參與率與醫療服務的利用率偏低問題,已成為近年健康政策關注議題。 本研究目標在於 : 1)「發現」社區健康篩檢之服務缺口。 2)「定義」影響在地居民持續參與社區健康篩檢服務之關鍵誘因。 3)「發展」社區健康篩檢服務的潛在接觸點。 4)「執行」新舊服務模式比對,提出服務再設計之機會點與建議。 本研究計招募440名30-75歲之社區健康篩檢活動參與者於北台灣-基隆的安樂區、新北市的瑞芳、貢寮及萬里區進行本研究問卷及訪談調查;同時,為瞭解社區健康篩檢施行情況以及關鍵利害關係人對篩檢服務得參與動機和參與經驗,本研究以立意取樣法(purposive sampling)邀請10名具有3年以上社區健康篩檢工作經驗之篩檢醫療服務提供者接受一對一訪談。 本研究旨在探討影響在地居民持續參與社區健康篩檢之關鍵誘因並以醫療服務提供者之觀點,探討影響關鍵利害關係者持續參與的潛在原因。依本研究結果顯示,社區健康篩檢民眾參與意願與活動參與率與「社會人口因素」和「服務設計」有關;同時,現階段之社區健康篩檢仍有許多面向需要再改善,如 : 人力及專業醫療服務提供者嚴重不足、缺乏適當的活動宣傳及報名方式和服務流程設計、城鄉差距及文化背景不同所造成的醫療資源差距及溝通缺口,如地方方言及教育水平低落所造成的溝通困難等問題。綜觀上述,該因素皆須歸納社區健康篩檢服務再設計之考量因素,以利未來制定慢性病社區健康篩檢服務再設計之參考依據。

並列摘要


As the average age of the population continues to rise in the 21st century, chronic illnesses have become the most prominent threats to human health. Research has shown that early screenings for chronic diseases are an effective way of lowering incidence and mortality rates. However, low participation rates for health screening is one of the main challenges for preventive medicine. The objectives of this study were to: 1) Discover the service gaps of community-based health screening by observing the areas of screening; 2) Define the primary drivers of people to participate in community-based health screening for chronic diseases; and increase their willingness to continue to participate; 3) Develop and identifying service needs from the perspective of service providers; 4) Deliver the key factors of redesign community-based health screening. A total of 440 individuals between 30 and 75 years of age were invited to undergo a health screening and complete an interview questionnaire which were conducted in four regions in northern Taiwan and in-depth interviews were conducted with 10 experienced health service providers who had been working in a community-based health screening service for at least 3 years. This study explored the key factors which influence willingness to continue to participate in community-based health screening. In general, participation rates were determined by sociodemographic factors and the preventive services offered, while there are several aspects of health screening services for chronic diseases that are in need of improvement such as a shortage of appropriate health service providers, inadequate attendance promoting measures, a lack of continually accessible and affordable medical services, healthcare professionals who possess inadequate communication skills, and rural-urban health care disparities.

參考文獻


參考文獻
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