健康專業服務的改善：應用理性行為理論解釋護理人員通報病患安全事件意願的影響因素

Improving Health Professional Services: Applying the Theory of Reasoned Action to Examine Determinants of Intention to Report Patient Safety Events

病患安全是健康專業服務中關鍵的品質指標，過去文獻中較少以個體行為的角度來探討護理人員通報病患安全事件(在醫療及照護過程中病患健康受到傷害的事件)意願的影響因素，亦未依與自己相關或與他人相關的病患安全事件來區分通報意願，因此，本研究探討護理人員通報與自己及與他人相關的病患安全事件意願的影響因素，並使用理性行為理論進行解釋，發現專業承諾與通報自己相關的病患安全事件有正向關係，而知覺通報效果、誠實、及遵守規定則與通報自己相關及與他人相關的病患安全事件的意願均有正向關係。本研究應用理性行為理論，提出四項可預測通報意願的因素，增進服務科學的知識，並提供管理者有效地提升通報意願的建議。 Patient safety is a crucial quality indicator in health professional services. The perspective of individual behavior has seldom been adopted in previous studies when addressing the determinants for intention of nurses to report patient safety events (events in which patient health is harmed). Additionally, most previous works do not distinguish between the intention of reporting self-related events and that of reporting others-related events. Therefore, this study discusses the determinants of the intention to report self-related and others-related patient safety events, and explains it in terms of the theory of reasoned action. Analytical results indicate that professional commitment is positively linked to the intention to report self-related events. The perceived effect of reporting, honesty and obeying rules are positively related to both the intention to report self-related and others-related events. This study employs the theory of reasoned action to propose four determinants of intention to report, thus increasing the knowledge of service science, and providing insights for health professional service managers.