影響持續使用居家醫療服務因素之探討

Exploring factors influencing continuation of home healthcare services

目標：居家醫療有助於提升患者的生活品質也能夠減輕醫療體系的壓力，長照政策在台灣受到大力的推動，為了提供並促進高效能的居家醫療服務持續使用，了解居家醫療訪視之案家的被訪意圖或者對於服務提供的期望是必要的。方法：本研究採立意抽樣方式由患者及其案家之家屬或照護者協助訪問研究。採用質性研究法藉由深度訪談來了解案家對於居家醫療訪視的使用持續意圖與態度與其相關因子。結果：依安德森模型歸納發現，使能因素的影響是最常被提起的因素，其餘依次為傾向、需求因素，其中以醫療品牌的選擇、隨時保持聯繫、多樣化的服務及有正向態度的服務提供者為最多，因此在討論提升居家醫療持續使用意圖時，使能及傾向因素應該是較需被重視的條件。結論：本研究從使能、傾向、需求及其成效探討了解案家期待在一個高度可近及可用性條件下的可選擇自己喜愛的醫療品牌，在固定的條件之下，獲得能同時照護到身心靈的居家醫療服務，並且讓患者能夠願意持續接受醫療服務。

Objectives: Home healthcare contributes to improving patients’quality of life and alleviating pressure on the healthcare system. As such, long-term care policies have been vigorously promoted in Taiwan. To provide and promote the continuous use of efficient home healthcare services, it is essential to understand the intentions or service expectations of patients and their families regarding home healthcare visits. Methods: Employing purposive sampling, interviews were conducted with patients and their family members or caregivers. A qualitative research method was adopted using in-depth interviews to understand the intentions of and attitudes toward the continuous use of home healthcare visits and their related factors. Results: According to the Andersen Healthcare Utilization Model, enabling factors are the most frequently mentioned influences, followed by predisposing factors and need factors. Among these, the most critical aspects include having the choice of healthcare brand, maintaining constant communication, and having access to diversified services, and service providers with positive attitudes. Therefore, in order to enhance the intentions to continue using home healthcare utilization, enabling and predisposing factors should be prioritized. Conclusions: This study explores the importance and effectiveness of enabling, predisposing, and need factors, and how they impact home healthcare. Being able to choose a healthcare brand is an enabling factor that is crucial for patients when deciding to use home healthcare. Given consistent conditions, the availability of home healthcare services that address physical, mental, and spiritual well-being encourage patients to receive medical care continually.