動機與目的：台灣資通訊生活普及度相當高，這成為發展科技化照護服務的基礎。遠距健康照護服務所提供的延伸性照護服務，能24小時為病患健康照護做把關，可預期將能提供醫療服務者與病患之間的照護連續性。因此，本研究目的在探討遠距健康服務之照護連續性。研究方法：以南部某醫學中心為研究場域，以該院遠距健康照護中心會員與神經內科門診病患為研究對象。研究對象選取自願加入遠距健康照護的病患與未加入遠距健康照護的一般就醫模式之門診就醫三高族群病患。以問卷調查方式，完成有效樣本345人。本研究已通過人體試驗委員會核准（KMUHIRB-20150007）。研究結果：遠距健康照護連續性包含四大構面，其中以在「關係連續性」最高（平均值4.24），依序為「團隊連續性」（平均值3.95）、「彈性連續性」（平均值3.18）、「時間連續性」（平均值1.67）。透過多元線性迴歸分析，以「彈性連續性」解釋力最高（R2為92%），而「關係連續性」構面解釋力最低（R2為20%）。照護連續性對遠距健康照護服務滿意度呈現完全中介效果。結論與建議：遠距健康照護服務透過提升照護連續性，能讓病患能對現有醫療照護服務之成效。本研究針對後續研究提出相關研究建議。 Motivation and purpose: With the highly prevalence of information and communication technology on the living life in Taiwan, it has been seen the foundation of developing technology enabled healthcare. Considering the enhancement of comprehensive on healthcare services, telehealthcare provides 24-hour monitoring and seamless service to make a better continuity of care. That is, the research purpose is to explore the continuity of telehealthcare.Methods: The research sample was enrolled based on the patients from the center of telehealthcare and the department of Neurology in a medical center in southern Taiwan. The data was collected with well-trained surveyors by a structured questionnaire. A total of 345 participants were enrolled in the study by the recruitment of volunteer patients with chronic diseases. This study has been registered in the clinical trial (KMUHIRB-20150007).Results: The continuity of telehealthcare consists of four constructs, and sequentially are named "relational continuity (with a mean value of 4.24)”, “team and cross boundary continuity (with a mean value of 3.95)", and “longitudinal continuity (with a mean value of 3.18)", and "flexible continuity (with a mean value of 1.67)". Through the multiple linear regression analysis, it shows the most effect of continuity of telehealthcare is the construct of the flexible continuity (r2=0.92, p-value=0.001); relatively the least effect is the relational continuity (r2=0.2; p-value=0.001). The perceived service satisfaction is full mediated by the continuity of telehealthcare.Conclusion and suggestion: Telehealthcare can enhance the patients’ service satisfaction by improving the flexible continuity comparing to the regular healthcare. We provide some suggestion for further research.
