應用SERVQUAL量表探索台灣中南部偏遠地區長期照護服務使用者與家屬對長照據點滿意度與相關因素

Exploring user satisfaction with factors related to long-term care service stations in remote areas of Taiwan using SERVQUAL

目標：由「服務品質模式」（PZB model）缺口五角度切入，檢視偏遠地區及資源不足區長照服務據點之滿意度及相關因素。方法：本研究發展的SERVQUAL問卷內容效度與信度良好。以方便抽樣於各偏遠長照據點訪問6-10名服務使用者，共完成23個據點有效樣本206份。結果：受訪者有六成來過據點，使用者多為女性、失能程度較低。約六成的據點成立不到3年，照顧管理個案量高。服務品質滿意度得分以保證性最高、有形性最低，總平均分數為4.37分。受訪者認為據點的功能以直接服務顯著高於整合平台與衛教。不同失能程度在可靠性、反應性、關懷性與滿意度總分有顯著差異，而事後檢定發現無失能者在可靠性、滿意度總分顯著高於輕度失能者。衛生所（30.4%）承接的據點滿意度較高，在有形性、關懷性與滿意度總分有顯著差異。回歸結果顯示，了解據點功能及由衛生所承接的據點對使用者及家屬滿意度有正向且顯著影響。結論：本研究結果建議強化使用者及家屬對據點功能之了解以及未來由衛生所承接的政策考量。

Objectives: To examine user satisfaction and factors influencing the function of long-term care service stations in remote areas of Taiwan. Methods: In a PZB model, 6-10 users were recruited by convenience from each long-term care service station to complete the SERVQUAL questionnaire. A total of 206 user questionnaires from 23 long-term care service stations were collected. Results: Sixty percent of the respondents had been to the service stations, and most users were female or with a mild disability. Nearly 60% of the service stations had been set up for fewer than three years, and a large caseload was managed by each care manager. From the respondents’ perspective, the highest satisfaction was in the assurance domain, and the lowest in tangibles. The mean score was 4.37. More users perceived the function of service stations as providing direct service rather than functioning as integration platforms or health education facilities. There were significant differences in the accessible, reliable, and empathy domains and total scores for satisfaction at different levels of disability. Scores in the accessible domain and total scores for non-disabled users were significantly higher than those of those with a mild disability. There was also higher user satisfaction in the tangibles and empathy domains and total score if their health station (30.4%) provided services. Finally, regression analysis showed that there were positive significant effects on the respondents’ satisfaction with clear recognition of the function of long-term care service stations and the services they provided. Conclusions: This study suggested that in order to promote user satisfaction, it would be useful to deliver a clear message about service station features and the services they provided. (Taiwan J Public Health. 2018;37(2):148-164).