提升糖尿病共照網營養衛教滿意度

Improving Patient Satisfaction with Nutrition Counseling in Diabetes Shared Care

目的：南部某區域教學醫院，院內糖尿病健康促進機構每年進行的病人服務滿意度調查，結果顯示 105 年度營養師的滿意度總平均未達閥值，故擬以品管圈活 動來進行改善計畫，以提升營養衛教滿意度。

方法：經品管圈成員腦力激盪，完成魚骨圖選出主要影響營養衛教滿意度低之要因，分析討論後，提出三個對策實施，分別為增訂二線營養師支援機制、配 合時令節慶制定共同衛教內容，及請衛教師以便條紙備註病人飲食問題轉介營養師。

結果：對策實施後，效果確認進行營養衛教滿意度問卷調查總份數為 50 份，改善 後整體滿意度平均由 4.53 分增至 4.68 分，進步率為 3.3%，目標達成率為750%，其中原滿意度分數最低的外食節慶飲食注意事項由 4.47 分增至 4.7 分，進步率為 5.1%，目標達成率為 287.5%。

結論：運用品管圈活動結合營養師與衛教師，透過團隊合作溝通協調討論進行改善，確實可提升糖尿病共照網營養衛教滿意度。

Aims: An annual diabetic patient satisfaction survey obtained from a diabetes health department at a southern regional hospital in 2016 indicated the satisfaction scores of diabetes mellitus patients receiving nutrition counselling were lower than the threshold. Therefore, the quality control circle technique was applied to improve patients’ satisfaction with nutrition counselling.

Methods: The root causes of patients’ dissatisfaction with nutrition counselling were determined through team brainstorming and fishbone diagrams. After discussing cause and effect analysis, the group proposed the following solutions to problems: adding a secondline dietitian as a support mechanism; creating dietary guidance related to festivals and special events; assessment and recording of patients’ nutrition status by health educators followed by referral to a dietitian.

Results A total of 50 questionnaires were collected for the diabetic patients’ satisfaction survey after implementing solutions. Diabetic patients’ satisfaction scores rose from 4.53 to 4.68. The improvement rate was 3.3% and the goal achievement rate was 750%. Patients’ satisfaction scores with personalized dietary guidance related to festivals and special events were the lowest before implementing solutions and rose from 4.47 to 4.7. The improvement rate was 5.1% and the goal achievement rate was 287.5%.

Conclusions: Application of the quality control circle technique by dietitians and health educators to identify, analyze and solve nutrition problems of diabetic patients could improve patients’ satisfaction with nutrition guidance in a diabetes shared care program.