有形和無形醫療服務品質、針灸結果、醫病關係與病患滿意度之關係：以軟組織針灸治療為例

The Relationship among the Tangible and Intangible Health-care Service Quality, Acupuncture Outcome, Physician-patient Relationship, and Patient Satisfaction: Evidence from Patients with Soft Tissue Injury

在醫療行業裡，有關滿意度的研究不少，但是，研究中醫的文獻不僅相對較少，有關針灸治療滿意度的研究更是寥寥可數。本研究之目的即在藉由探討軟組織損傷病患接受針灸治療的滿意度，以分析影響病患滿意度的因素，並驗證影響因素之間的關聯性。本研究採橫斷式調查，以南部某區域教學醫院中醫科針灸治療之軟組織損傷病患為樣本，共收集143份問卷；研究方法以描述統計、因素分析、迴歸分析為主。結果發現：一、針灸結果與醫病關係對病患滿意度有直接影響，並能透過知覺價值的中介作用對病患滿意度產生間接影響；二、無形的服務品質對病患滿意度有直接影響，但有形的服務品質則無；三、無形與有形的服務品質皆無法透過知覺價值對病患滿意度產生間接影響；四、比較各前因變項對於病患滿意度之影響效果，其中，醫病關係對病患滿意度之預測力最高，其次是針灸結果，再次是無形的服務品質；而有形的服務品質則沒有顯著影響。由上述結果可知，對於軟組織損傷之針灸治療病患來說，醫病溝通、了解病患痛苦、看診時間、病情說明等所謂的醫病關係，是影響病患滿意度的最大因素，甚至比針灸結果的影響還大，顯示病患渴望獲得更多的醫療資訊及善待。此一研究結果，期能提供中醫醫療院所作為經營管理之參考。

Patient satisfaction has been studied a lot in health care. However, few studies focused on traditional Chinese medicine, particularly for acupuncture theory. The purpose of this study aimed to investigate the factors affecting the patient satisfaction and the relationships among those factors. This was a cross-sectional design with soft tissue injury patient receiving acupuncture therapy. One hundred and forty three questionnaires were collected from a southern regional teaching hospital. Descriptive analysis, factor analysis, and regression analysis were performed to attain the research purposes. The study found that: (1) Both “outcome of acupuncture therapy” and “physician-patient relationship” could have direct effect on “satisfaction of patients” and indirect effect on “satisfaction of patients” through perceived value. (2) “intangible service quality” could have direct effect on “satisfaction of patient,” but “tangible service quality” couldn’t. (3) Both intangible and tangible service quality could have no effect on “satisfaction of patients” through perceived value. (4) A comparison of the effect of each variable concerning patient satisfaction showed that “physician-patient relationship” was the best predictor for satisfaction; followed by “outcome of acupuncture therapy,” and “intangible service quality,” while “tangible service quality” had no significant influence. In conclusion, for patients who received acupuncture therapy to treat soft tissue injury, the “physician-patient relationship,” including communication between physicians and patients, response to patient’s suffering, consultation time, and physician explanation, were the most critical factor affecting patient satisfaction, even more decisive than outcome of acupuncture therapy. Those results showed that patients desire for more medical information and being treated in a caring manner. It is hoped that the above results can serve as future reference for the management and operation of medical institution of Chinese medicine.