正向情緒與病人參與：自我效能與他人效能之中介效果

Patient Positivity and Participation: The Mediating Effects of Self-Efficacy and Other-Efficacy

目的：本研究以正向情緒之擴展與建構理論出發，結合三元效能信念模式中的自我效能與他人效能，探討病人參與的前置因素及分析病人參與對互動服務品質的影響，並驗證自我效能、他人效能在正向情緒與病人參與間的中介效果。方法：採用橫斷式研究設計；以南部某地區醫院之婦科門診病人為研究對象，有效問卷共計481份；研究資料以偏最小平方法進行模式分析及假說驗證，以及Sobeltest作為中介效果檢驗。結果：病人的正向情緒正向影響病人參與；自我效能在正向情緒與病人參與具有部分中介效果，他人效能在正向情緒與病人參與則具有完全中介效果；病人參與正向影響互動服務品質。整體模式分析顯示，自我效能與他人效能完全中介正向情緒對病人參與的直接效果。結論：本研究建議醫療機構管理者在擬定病人參與的策略時，適度給予病人正向的情緒支持、強化其自我效能，以及對醫師專業能力之他人效能，進而增進病人參與行為，提升醫病間的互動服務品質。

Purposes This study employs the broaden-and-build theory of positive emotions combined with the concept of self-efficacy and other-efficacy in the tripartite efficacy framework to examine the factors for patient participation, analyze the effects of patient participation on interactive service quality, and validate the mediating effect of self-efficacy and otherefficacy in positive emotions and patient participation. Methods This cross-sectional study collected 481 valid questionnaires from outpatients of the gynecology department at a local hospital in southern Taiwan. The data were analyzed using the partial least squares method. The Sobel test was applied to determine the mediating effect. Results Empirical results confirmed that positive emotions affect patient participation. In addition, self-efficacy showed partial mediating effects between positive emotions and patient participation, whereas other-efficacy showed complete mediating effects between positive emotions and patient participation. Overall model analysis revealed that selfefficacy and other-efficacy can completely mediate the direct effects of positive emotions on patient participation. Conclusions We recommend that healthcare managers draft patient participation strategies that provide appropriate positive emotional support to patients as well as increase self-efficacy in patients and other-efficacy in medical professionals. These measures may improve participation behavior in patients and the interactive service quality between physicians and patients.