從TQM模式探討緩和醫療服務滿意度之研究──以南投市某安養中心為例

A study on the satisfaction of palliative medical services from the perspective of TQM model-taking a nursing center in Nantou City as an example

全世界人口結構急遽改變，多數先進國家即將面臨高齡社會問題，台灣老人口比例快速攀升，根據國家發展委員會推測，於2025年即將進入超高齡社會，老年人的身體多有慢性疾病，凸顯台灣很多家庭面臨照顧的需求，近幾年政府開始推動長照配套政策。安寧療護是一種生命演化和科技進步的人類醫療發展，從病人出院，返回社區轉介長照資源及後續追蹤，疾病末期住民追求舒適和無遺憾的善終；然而，安寧醫療照護在長照機構推行遇到許多困難。本研究主要使用TQM模式探討長照機構緩和醫療服務滿意相關因素，藉以深切瞭解：1.探討長照機構推行緩和醫療服務品質對住民和家屬的影響。2.探討長照機構工作人員推行緩和醫療服務品質對家屬的滿意度影響。3.探討長照機構推行緩和醫療服務使用品管工具（全面品質管理TQM）的影響。研究顯示緩和醫療雖然在醫療體系已推行有年，但許多年長者及家屬對於死亡議題選擇逃避或囿於道德觀影響，有其個別的特殊性，如何在長照機構營造善終的宗旨，需要機構工作人員規劃符合照護模式，本研究結果可以作為長期照顧產業推行緩和醫療的參酌採納，讓住民及家屬能安心找到第二個家。

The demographic structure of the world is changing rapidly, and most advanced countries are about to face the problem of aging society. The proportion of the elderly population in Taiwan is rising rapidly. According to the National Development Commission, it will enter a super-aged society in 2025. Many elderly people have chronic diseases, highlighting that Taiwan has many Families are facing the need for care, and in recent years, the government has begun to promote long-term care policies. Palliative care is a kind of human medical development based on the evolution of life and technological progress. From the discharge of the patient to the community for referral to long-term care resources and follow-up, the terminally ill residents pursue a comfortable and regret-free hospice; however, palliative care is implemented in long-term care institutions. encountered many difficulties. This study mainly uses the TQM model to explore the related factors of palliative medical service satisfaction in long-term care institutions, in order to gain a deeper understanding: 1. To explore the impact of long-term care institutions on the quality of palliative medical services on residents and their families. 2. To explore the impact of the staff of long-term care institutions on the satisfaction of family members by promoting the quality of palliative medical services. 3. To explore the impact of the implementation of quality control tools (Total Quality Management TQM) in long-term care institutions for palliative medical services. Research shows that although palliative care has been implemented in the medical system for several years, many elderly people and their families choose to avoid the issue of death or be limited by the influence of moral values, which has its own particularity. How to create a hospitable death in long-term care institutions requires institutions. The staff planning is in line with the care model, and the results of this study can be adopted as a reference for the long-term care industry to implement palliative care, so that residents and their families can find a second home with peace of mind.