運用重要－－表現分析法探討老人福利機構服務品質－－以中部某養護中心為例

Applying Importance-Performance Analysis as a Service Quality Measure in Welfare Institutions for the Elderly-A Case Study of a Long-term Care Institution in Central Taiwan

目的：本研究旨在探討中部某養護中心住民的服務重視度及滿意度，提供管理者擬定服務品質改善項目優先順序參考。方法：本研究為一橫斷性研究，以結構式問卷調查住民對機構環境設施、服務項目的重視度及滿意度。統計分析先以t檢定檢視住民對服務的重視度與滿意度間是否存在顯著差異，再以「重要－－表現分析法」探討重視度高滿意度低的服務項目。結果：住民在九個服務構面中有6個構面的重視度與滿意度達顯著差異；96個服務項目中有55個項目之重視度顯著高於滿意度；19個項目須優先改善。結論：機構可增設地板求助鈴或導入高科技智能手環，裨益住民主動求援；機構照顧應避免「全控機構」式的理念，朝「住民為中心」的服務模式努力；人力可採外聘、內留雙軌方式，充足照服員人力，另，可考慮賦權照服員使其具有較高的工作控制，提升專業形象，提高留任意願。此外，藉由團體規範、多元團隊服務，發展具機構特色的服務模式，提供適當且具經濟效益的服務。

Objectives. This study aimes to explore the residents’ perceptions of importance and their perceived performance with regards to the services provided by a senior caring center in central Taiwan area. The study results will provide useful information for the managers to prioritize the services that require quality improvement. Methods. This is a cross-sectional study using structured questionnaire to collect data through measuring the senior center services quality based on two dimensions: institutionenvironment facilities and service items. The t-test was used to test the difference between the residents’ perceptions of importance and their perceived performance of the provided services. The importance performance analysis was adopted to explore the satisfaction items for further improvement. Results. Residents’ perceived importance for six service dimensions and 55 service items were found significantly higher than their perceived performance. Nineteen service items were identified as the first priority needed to be improved immediately. Conclusion. We suggest the senior caring center to install the floor emergency bell and provide the high-tech monitoring devices for the detection of emergent situations occurred for the residents. A culture change from an institutional model of care to a more individualized, resident-oriented practice that embraces choice and autonomy for residents and caregivers is highly suggested. The number of nursing assistants can be maintained through recruitments and retentions; in addition, empowering nursing assistants to have more job control and promote their professional images may increase their willingness of retention. Finally, developing an institutional features service model based on group norms and multidiscipline is expected to be able to provide high-quality services. (J Med Health. 2016;5(1):67-84)