門診病患對醫院以「病人為中心」的照護感受及其相關因素之探討

Study on Outpatients' Perception of Patient-Centered Care and Its Related Factors

本研究之目的為： （l ）瞭解門診病患對醫院所提供以病人為中心之照護 感受。（2 ）分析影響門診病患以病人為中心照護感受之相關因素。研究以彰 化縣某區域教學醫院門診候診病志為封象進行橫斷面調查，收得502 名有效樣 本進行分析。以自擬式結構問卷進行病患人口學特質、就醫情形、醫病關係 的信念與以病人為中心之照護感受之資料收集，問卷之效度採專家內容效 度， CVI{宜介於80%-100% '信度則採內容一致性檢測（Cronbach'α） ， α 介 於.9354-.9444 。以SPSS 12.0 統計軟體進行分析，結果顯示： （1） 門診病患其 整體以病人為中心的照護感受總平均值為2.73 '處於「沒意見」與「同意」 之間，以其四大構面進行排列， í 分享構面」得分最高，其他依序為「關懷 構面」、「參與構面」、「滿意構面」。（2） 醫病關係信念會因對醫師不同的信 任程度有顯著差異。（3 ）看診科別、對醫師的信任程度、實際減期望看診時 間差距、醫病關係信念可解釋整體以病人為中心照護感受總變異量達25% 。 本研究結果未來可提供醫院、政府及消費者評估與改善醫療服務品質之參 考。

The purposes of this study were: (1) to describe the perception of patient-centered care at outpatient clinics in regional hospital, (2) analyze the correlations of patient-centered care perceptions among demographic characteristics, medical utilization, and the belief of doctor-patient relationship. A cross sectional survey is conducted and 502 subjects for analyzed of a regional hospital in ChangHua country. A self designed questionnaire was used and it concluded demographic variables, medical utilization, the belief of doctor-patient relationship and the perception of patient-centered care. Content validity and internal reliability are done. CVI between 80%-100%, and Cronbach’s between .9354-.9444. Statistical analysis are done using SPSS version 12.0. The results shows: (1) The mean score of outpatients’ perceptions of patient-centered care is 2.73, that is between “non opinion” and “agree”. The priority of patient-centered care four domains are information sharing, caring, participation and satisfaction. (2) There exist significant differences between the differential belief of doctor-patient relationship and the trust level of doctor. (3) The differential clinics, trust level of doctor, the difference of practice minus expect examination time and the belief of doctor-patient relationships can explain 25% total variances. Crossing this research, to provide the evidence- based to hospitals, government, consumer to evaluate and improvement the quality of medical services.