以TPB理論探討護理人員於病歷隱私認知暨保護的行為意圖──中部某教學區域醫院的實證研究

Based On The Theory of Planned Behavior of Cognition of Nursingstaff On Medical Records Privacy and The Protection of Theempirical Research On The Intention of A Teaching Hospital In Central

目的：以計畫行為理論探討影響護理人員保護病歷隱私的行為意圖，了解影響護理人員保護病歷隱私之因素。方法：以中部某一區域教學醫院之護理人員（827位）為研究調查對象，採橫斷式研究與便利性取樣方式實施問卷調查。共計發放400份問卷，整體有效問卷回收率為99.75%。採用SPSS 22、SEM-AMOS工具與質性訪談做為資料分析。結果：護理人員對於病歷隱私保護行為的態度越高，其保護病歷隱私行為呈正向影響。另在「職級」對態度的影響，經多重比較檢定（scheffe）亦有顯著差異，顯示職級越高，對於保護病歷隱私的態度越正向。本研究在TPB、TRA二個預測行為的量性迴歸分析中，以直接測量的計畫行為理論預測模式解釋力62.6%高於理性行為理論57.3%。在驗證性因素分析，以結構方程模式-AMOS標準化回歸徑路係數解釋變異量為68%，亦具高度解釋力。結論：研究結果再次驗證「計畫行為理論」模型的解釋力優於「理性行為理論」模型之論點。「態度」對保護病歷隱私保護之行為意圖的預測，較主觀規範及知覺行為控制的預測能力佳，也就是說，當護理人員對病歷隱私都持正向的態度並認同保護病歷隱私之重要性，態度越強，行為則就不易改變。

Objective: To explore the behavioral intention of nursing staff to protect the privacy of medical records by the theory of plan behavior and to understand the factors that affect the privacy protection of nursing staff. Method: Taking the nursing staff (827 persons) in a teaching area hospital in the middle part as the research object, a questionnaire survey was conducted on the crosssectional study and convenience sampling method. A total of 400 questionnaires were issued, the overall effective questionnaire recovery rate was 99.75%. Using SPSS 22, SEM-AMOS tools and qualitative interviews were used as data analysis. Result: The higher the attitude of the nursing staff to the privacy protection behavior of the medical record, the positive effect of the protection of the medical record privacy. In addition, there is a significant difference between the rank of the rank and the scheffe, and the higher the rank is, the more positive the attitude towards the protection of the medical record privacy. In the qualitative regression analysis of TPB and TRA predictive behavior, 62.6% of the predictive model of direct measurement behavior theory was 57.3% higher than rational behavior theory. In the confirmatory factor analysis, the structural equation model - AMOS standardized regression path coefficient to explain the variation of 68%, also a high degree of explanatory power. Conclusion: The research results reaffirm that the explanatory power of the ''Theory of Planned Behavior'' model is superior to the ''Theory of Reasoned Action'' model. The predictive of the intentions of the ''attitude'' to protect the privacy protection of the medical records is better than the predictive ability of the subjective and perceptual behavior control, that is, when the caregiver has a positive attitude towards the privacy of the medical record and agrees with the importance of protecting the medical record privacy, The stronger the attitude, behavior is not easy to change.