請用此 Handle URI 來引用此文件:
http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/68050
標題: | 住院期間陪病者對住院病患就醫經驗與病患觀點出院狀態之影響 The Influence of Hospital Companion on Patient Experience and Self-Reported Outcome |
作者: | Ju-Chieh Lin 林汝潔 |
指導教授: | 郭年真(Nien-Chen Kuo) |
關鍵字: | 家庭參與,家庭陪病,以病患為中心照護,調節效果,中介效果, Family engagement,Family Companion,Patient-Centered Care,Moderator Effect,Mediatior Effect, |
出版年 : | 2020 |
學位: | 碩士 |
摘要: | 研究目的:國外許多研究皆已證實家庭能夠作為病患的代理人,與醫護人員溝通、並且調整照護,進而滿足病患真實需求並且達到更好的照護效果,而以病患為中心的照護在照護過程中扮演重要的腳色,然而也有研究認為家庭參與不一定會為病患滿意度或是健康結果帶來正面影響。目前國內對於家庭參與照護之相關研究較少,本研究主要想探討家庭參與對於病患整體就醫以及出院復原狀態是否有影響,並且了解以病患為中心的照護模式在照護過程中產生的影響,作為未來醫療院所照護流程改善的依據,也期望本研究能夠強化家庭在照護中的量能,提供政策制定者未來擬定相關策略之考量重點。
研究方法:採橫斷性研究設計,以全國與健保合作之醫療院所作為收案院所,針對年齡大於20歲以上的出院病患作為收案對象,並以自填式問卷收集資料,問卷收集方式有出院告知、網路、郵寄以及電話訪問,最後分析11,819份問卷,經過除錯後樣本數為11,202份,再將資料遺漏且無法插補之之資料刪除,最終共7,623筆資料納入本研究。描述性統計說明資料的分布;推論性統計分為雙變量分析以及多變量分析,雙變量分析以單因子變異數分析(One-way ANOVA)進行,觀察樣本的分布情形;多變量分析以複迴歸進行分析,了解陪病者身份與結果變項之間的關聯性以及以病患為中心照護是否有調節的效果;最後,以路徑分析進行中介變項是否存在。 研究結果:研究結果發現親友陪病能夠提升病患就醫經驗分數以及病患自評出院復原狀態。調節作用方面,本研究發現部分的以病患為中心照護面向(醫師照護、護理照護以及整體就醫推薦)與陪病者身份,在整體就醫經驗評分方面,具有調節效果,但對於出院復原狀態並無調節作用。最後,本研究亦發現以病患為中心照護對於陪病者與病患整體就醫經驗評分、病患自評出院復原狀態之間存在中介效果;而有無醫院看護則是會直接影響整體就醫經驗評分/病患自評出院復原狀態,以病患為中心不屬於中介效果。 結論:根據本研究之發現,陪病者對於就醫經驗的影響會透過以病患為中心照護作為中介變項,再影響到結果。而親友參與能夠提升以病患為中心之照護,進而帶來正向的就醫評分與出院復原。因此,政策制定者應該將以病患為中心之照護納入品質評鑑之依據;醫療院所方面,應強化家庭在照護中的參與度,對於無陪病或是看護陪病的病患,須格外加強以病患為中心的照護模式,提供高品質的醫療服務,使病患獲得較好的就醫經驗與健康復原。 Objective: Literature shows that Families are key to better health outcomes. Families, who serve as patients’ agents and communicate with the health care provider, play an important role in the context of patient-centered care. Although most studies reveal that family companion is associated with positive outcomes as well as a better relationship between physicians and patients, some studies find inconsistent results. In Taiwan, rare studies explore how family-engagement impacts on health outcomes. Thus, this study aims to examine whether family-engagement lead to better inpatient experience and patient-reported outcome, and also explore the role of PCC against outcomes. Method: This study employed a cross-sectional research design. Data were collected from a sample of 11,819 discharged patients in Taiwan through either online surveys, mail surveys, and telephone interviews. After excluding data that is missing or incomplete, 7,623 data remaining. A multiple regression analysis was performed to explore the relationship between companion and patient experience and also self-reported outcomes. The moderator role of PCC is examined by testing the significance of interaction between PCC and companion types. Path analysis was performed to test whether PCC is a mediator between companion and outcomes. All the data was processed by SAS 9.4. Result: Family companion is significantly related to higher patient satisfaction and patient self-reported outcome. We also found that family companion lead to better PCC. PCC partially portrayed a moderator role between PCC and patient satisfaction but not in the patient’s self-reported outcome. Finally, the result showed that PCC is a mediator between companion and patient satisfaction. Conclusion: This study provides preliminary evidence to support that encouraging family companion can lead to better PCC, patient satisfaction, and self-reported outcomes. |
URI: | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/68050 |
DOI: | 10.6342/NTU202003816 |
全文授權: | 有償授權 |
顯示於系所單位: | 健康政策與管理研究所 |
文件中的檔案:
檔案 | 大小 | 格式 | |
---|---|---|---|
U0001-1708202017173700.pdf 目前未授權公開取用 | 3.04 MB | Adobe PDF |
系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。