| 摘要: | 目的：本研究為探討醫護人員對專科護理師照護服務品質之重要性與績效分析。並探討影響專科護理師照護服務品質滿意度之相關因素。
方法：本研究採用問卷調查法，以結構式問卷作為調查工具，應用SERVQUAL服務品質構面發展問卷量表。在分析的部分，採用重要性-績效分析法來探討醫護人員對專科護理師照護服務品質滿意度之內涵。研究對象為南部某區域教學醫院醫護人員，以自填問卷進行資料收集，調查時間自2018年04月30日至2018年05月15日止。搜集之資料以SPSS 18.0版套裝軟體進行統計分析，包含描述性分析、獨立樣本T檢定、單因子變異數分析(ANOVA)、皮爾森相關分析、複回歸分析及重要性-績效分析法等統計方法。
結果：本研究之專科護理師在反應性構面中，經計算總平均為3.99，總構面排名為第1名。各題項平均得分方面，以(能及時且準確地回報主治醫師有關病人的處置現況)之題項為最高(4.04)，(具有拓展護理業務範圍之醫療輔助行為，發揮醫療團隊之合作能力)之題項為最低(3.93)。不同教育程度在醫護人員對專科護理師照護服務品質-滿意度五個構面的反應性滿意度，有顯著差異，其中研究所得分高於專科。不同教育程度在「醫護人員對專科護理師照護服務品質-滿意度五個構面」-反應性滿意度(P值＝0.000)、可靠性滿意度(P值＝0.019)、有形性滿意度(P值＝0.013)、保證性滿意度(P值＝0.000)、體貼性滿意度(P值＝0.000)、有顯著差異。
結論與建議：研究結果顯示各項類別只有工作單位在IPA的五個構面呈現有顯著性，而工作單位尤以研究者的外科系之滿意度皆高於其他科系。在目前職位部份，護理主管其對有形性之滿意度低於護理人員，在照護品質構面之重視度程度與滿意度程度之分析，結果顯示落在繼續維持區的有反應性，落在過度服務區的有保證性、體貼性；低優先區的為可靠性；落在加強服務區的為有形性。建議1.加強專科護理師訓練及進修管道，為提高專師參與訓練的意願，建立更完善的專科護理師進階制度，以強化優質的照護服務品質。2.提高專科護理師的學術研究，加強專業能力，重塑專業形象，以提升照護服務品質。3.由資深主治醫師訓練臨床業務、進階技能、培養批判性思考與臨床決策能力等。4.訂定明確的管理辦法及職務能力範圍，包含工作內容、服務量及升遷制度，讓專師有法可循，可降低工作壓力，提高工作滿意度。
Objectives: This study aims to explore the inner customers’ perception of the healthcare service quality on nurse practitioners. Next to explore the factors affecting the perception on that.
Methods: In this survey study, a structured questionnaire was established for the research instrument which was modified based on the theory of SERVQUAL. A self-administrated survey was adopted by the research subject from a regional hospital in southern Taiwan. A total of 204 medical staff (with 93% of response rate) completed the survey between 2018/04/30 and 2015/05/15. Importance-performance analysis (IPA) was used for research analysis to explore the inner customers’ perception of the healthcare service quality on nurse practitioners and further analyzed by the software package of SPSS18.0.
Results: In the reactive facet of this study, the total average calculated was 3.99, and the total facet was ranked first. In terms of the average score of each item, the item (which can promptly and accurately report the current status of the patient's disposal) is the highest (4.04), (with the medical assistance behavior to expand the scope of nursing business, and play the cooperation ability of the medical team). The item is the lowest (3.93). There are significant differences in the degree of education satisfaction between the medical staff and the nursing care staff's quality of care-satisfaction service-satisfaction, and the scores of the institute are higher than the specialists.
Conclusions: The results of the study showed that only the work units in the various categories showed significant significance in the five facets of the IPA, and the satisfaction of the surgical department of the work unit, especially the researchers, was higher than that of other departments. In the current position, the nursing supervisor's satisfaction with tangibility is lower than that of the nursing staff, and the degree of attention and satisfaction of the quality of the care aspect is analyzed. The results show that it is reactive in the continued maintenance area and falls on. The over-service area is guaranteed and considerate; the low-priority area is reliable; the falling-down service area is tangible. Suggest：1. Strengthen the training and training pipelines of specialist nurses. In order to improve the willingness of teachers to participate in training, we will establish a more advanced system of specialist nurses to strengthen the quality of quality care services. 2. Improve the academic research of specialist nurses, strengthen professional ability, reshape professional image, and improve the quality of care services. 3. Training of clinical business, advanced skills, and critical thinking and clinical decision-making skills by senior attending physicians. 4. Set clear management methods and scope of job capabilities, including work content, service volume and promotion system, so that the nurse practitioner can follow the rules, which can reduce work pressure and improve job satisfaction. |
