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    標題: 從消費者角度探討糖尿病個案管理模式之成效: 服務主導邏輯理論觀點
    To Investigate the Effectiveness of Diabetes Case Management Model From a Consumer Viewpoint:The Service Dominant Logic Perspective
    作者: 王玉霞
    貢獻者: 醫務管理系
    林為森
    嚴玉華
    關鍵字: 服務主導邏輯
    糖尿病個案管理模式
    消費者
    Service-Dominant Logic
    Diabetes Case Management
    Consumer
    日期: 2014
    上傳時間: 2015-10-26 20:27:56 (UTC+8)
    摘要: 糖尿病盛行率隨著年齡與年代的增加而升高,因此罹病時間延長造成民眾生命威脅與隨之而來的經濟負擔。而個案管理模式是以病人為中心的管理制度,不僅使糖尿病病患可以獲得完整、連續、專業及整合性的醫療照護品質,亦可有效監測及控制疾病的變化。近年來醫療機構在競爭經營環境之下 ,醫療產業亦由以往的供給導向轉變為顧客導向,內部重視醫療品質,對外則以病患為決定價值,應以視病猶親的精神,為醫療機構創造更人性化的醫療。本研究主要以服務主導邏輯理論為基礎,探究醫院推動糖尿病個案管理模式成效之研究,藉由問卷調查法預以施測醫療服務、病人參與過程等滿意度及其結果,提供執行疾病管理模式之修正,以強化管理模式運作效果,並期提升糖尿病之照護品質。研究對象為南部某區域醫院內分科門診之病患,經醫師診斷糖尿病(ICD-9-CM前三碼為250)確立者為研究範圍,進行問卷調查,獲得有效問卷310份。本研究在服務主導邏輯於醫療服務滿意度理念中,清楚萃取五個因素,包括「病患參與」、「醫療服務技能」、「醫病互動關係」、「醫療服務專業」、「資訊揭露」,對後續研究應有所助益。本研究結果發現:1:糖尿病個案因為病患參與,對於醫療滿意度有顯著正向影響。2:糖尿病個案因為醫療服務技能,對於醫療滿意度無顯著正向影響。3:糖尿病個案因為醫病互動關係,對於醫療滿意度無顯著正向影響。4:糖尿病個案因為醫療服務專業,對於醫療滿意度無顯著正向影響。5:糖尿病個案因為資訊揭露,對於醫療滿意度有顯著正向影響。本研究限制與建議:由於僅針對糖尿病門診病患,若能擴大調查不同科別門診病患之需求,更能拉近病患與醫療團隊關係提升照護品質。若將資源整合,積極推廣現今內科標準治療流程至非專科,建議凡是糖尿病個案皆能以此套標準照護、享有共同資源,將是患者一大福音。
    With human longevity increases, the prevalence and the prolonged course of diabetes are predictably to burden the patients both physically and economically. Diabetes case management model is a patient-centered management system that can provide complete, continuous, professional and integrated healthcare services for patients with diabetes, as well as allow healthcare providers to monitor and control disease progress more effectively. In recent years, the increase competition in the healthcare industry has shifted the previous provider-oriented environment to a more consumer-oriented one. This suggests that apart from the quality of care, patients’ general profile may also be applied for the evaluation of the services an institution provides.Adopting service-dominant logic theory, this research is to investigate the efficacy of the implementation of diabetes case management model in a hospital. It is to survey patients’ satisfaction on the received medical services, level of participation and the desirable outcomes using a self-designed questionnaire. The results are then utilized to enhance and reinforce the disease management model to promote the quality of care for diabetic patients. Patients who visited a regional hospital in southern Taiwan and were diagnosed as diabetes (ICD-9-CM 250) were targeted research subjects. Questionnaires were distributed and 310 valid copies were retrieved. Five elements were extracted from the service-dominant logic for the questionnaire design, namely patient participation, healthcare service techniques, physician-patient interaction, healthcare profession, and information provision.Results: The results found that patient participation and information provision are positively correlated with patient satisfaction on received healthcare services, whereas no such correlations exist between healthcare service techniques, physician-patient interaction, healthcare profession and patient satisfaction.Limitations and recommendations: The investigation may also be conducted in patients suffer from other chronic conditions to explore patients’ needs, which may assist in improving the relationship between patients and healthcare providers, and to enhance the quality of care. In addition, if the same diabetes management model can be utilized in all diabetes patients regardless the specialty of the physician they visit, the resources will be best available for these patients and the goal of achieving a better long term diabetes management is possible.
    關聯: 網際網路公開:2019-08-05,學年度:102,119頁
    顯示於類別:[醫務管理系(所)] 博碩士論文

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