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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 鍾國彪 | |
dc.contributor.author | Wen-Chi Hsu | en |
dc.contributor.author | 許文琪 | zh_TW |
dc.date.accessioned | 2021-06-08T06:21:00Z | - |
dc.date.copyright | 2006-08-11 | |
dc.date.issued | 2006 | |
dc.date.submitted | 2006-08-03 | |
dc.identifier.citation | 中文文獻
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dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/25608 | - |
dc.description.abstract | 隨著醫療科技複雜化、慢性病況的增加,使得原本缺乏組織與設計不良的醫療照護系統,產生了許多醫療資源不當使用的問題,病人安全也似乎受到妥協,導致病人遭受許多可避免的醫療錯誤與傷害。
美國國家醫學研究院(Institute of Medicine, IOM)於2003年提出以「專業能力為基礎的醫療教育」,做為解決現今醫療品質裂縫與鴻溝的方法之一,意即醫療專業者必須具備五項核心能力:「身為專業整合團隊的一員,提供以病人為中心的照護,強調以實證醫學為基礎的執行、採行品質改善,並善用資訊科技。」藉此表現地與以往不同,以合乎目前病人的需求,提供安全與有品質的醫療照護。 本研究主要想瞭解醫師對專業能力的態度與執行程度自我評價的情況,並探討兩者之關係以及相關影響因素,採橫斷性研究,使用結構式問卷,針對十家個案醫院住院醫師以上的醫師進行問卷調查,實際回收份數為591份,回收率40.18%。 本研究之問卷具有高度內部一致性,態度量表與自我評價量表Cronbach α值分別為0.972與0.967。因考慮本研究目的具有成對比較的概念,因此本研究並未針對量表內容進行因素分析。本研究之主要結果如下: 一、在醫師對專業能力的態度方面,80%的醫師對各專業能力敘述的同意程度都在同意或非常同意。而在執行程度的自我評價,有將近40%~50%認為自己的專業能力表現為經常如此,有20%~30%認為適中。 二、整體來說,醫師對專業能力的認同程度由高到低依序為:專業整合團隊、病人為中心的照護、善用資訊科技、實證為基礎的專業執行、採行品質改善。執行程度的自我評價由高到低依序為:病人為中心的照護、專業整合團隊、善用資訊科技、實證為基礎的專業執行、採行品質改善。而態度與執行程度的落差較大者為:採行品質改善、善用資訊科技與實證為基礎的專業執行。 三、許多自變項與醫師態度和自我評價有顯著相關,包括性別、教育程度、有無非醫學領域的學位、資歷、醫院權屬別與醫院層級別。 四、而在控制醫師個人特質後發現: 1.醫師對「病人為中心的照護」的態度會影響醫師在「病人為中心的照護」的提供程度,且呈正相關。 2.醫師對「專業整合團隊」與「採行品質改善」的態度會影響醫師在「專業整合團隊」的合作程度,且呈正相關。 3.醫師對「專業整合團隊」的態度會影響醫師在「實證為基礎的專業執行」程度,且呈負相關。醫師對「實證為基礎的專業執行」與「採行品質改善」的態度會影響醫師在「實證為基礎的專業執行」程度且呈正相關。 4.醫師對「採行品質改善」的態度會影響醫師在「品質改善」的參與程度,且呈正相關。 5.醫師對「善用資訊科技」的態度會影響「資訊科技」的使用程度,且呈正相關。 | zh_TW |
dc.description.abstract | With the complexity of the modern technology and a growing need for care for chronic conditions to the once predominant need for acute episodic care, make healthcare system shows many problems associated with underuse, overuse and misuse. The health care system has became not as safe as it promise to be. Institute of Medicine (IOM) claims that 'the competence-based medical education' is the one of the solutions to the current healthcare system’s problems, which means: 'All health professionals should be educated to deliver patient-cantered care as member of an interdisciplinary teams, emphasizing evidence-based practice, quality improvement approaches, and informatics'.
The purposes of this study are to understand physicians' attitude of professional competence (IOM five core competences) and how well they do by self-evaluation, and the relationship between them. This is a cross-sectional study with structural questionnaires that sent to physicians worked in sample hospitals and voluntarily participated in this study. The response rate was 40.18 percent. Major findings of this study were listed below: 1.There are 80 percent physicians agree or strongly agree with all professional competence statements, and the self-evaluation part, there are 40 percent to 50 percent physicians considerate that they often follow these statements. 2.The most drops between physicians' attitude and self-evaluation are: 'applying quality improvement', 'using informatics' and 'emphasizing evidence-based practice'. 3.According to the hypotheses testing, those factors related to physicians' attitude and self-evaluation are: gender, physician's qualification, hospital's property and hospital's level. 4.According to the hypotheses testing, physicians' attitude toward the part of professional competence had positive effects on physician's self-evaluation of the same part of professional competence. | en |
dc.description.provenance | Made available in DSpace on 2021-06-08T06:21:00Z (GMT). No. of bitstreams: 1 ntu-95-R93843015-1.pdf: 960510 bytes, checksum: 151cca37ef12c7e5ed0e74c204b9d110 (MD5) Previous issue date: 2006 | en |
dc.description.tableofcontents | 第一章 緒論 1
第一節 研究背景與動機 1 第二節 研究目的 4 第二章 文獻探討 5 第一節 醫師專業能力之定義 5 第二節 醫師專業能力的測量工具 14 第三節 醫師專業能力的培育與確保 17 第四節 專業能力相關實證研究 20 第三章 研究方法 26 第一節 研究架構與假說 26 第二節 研究變項與操作型定義 27 第三節 問卷發放研究對象 30 第四節 資料來源與材料 30 第五節 資料處理及分析方法 31 第四章 研究結果 32 第一節 描述性統計 32 第二節 雙變項分析 54 第三節 多變項分析 97 第五章 討論 120 第一節 方法學的討論 120 第二節 研究結果討論 122 第三節 研究限制 127 第六章 結論與建議 128 第一節 結論 128 第二節 建議 131 參考文獻 133 中文文獻 133 英文文獻 134 附 件 142 表目錄 表3-2-1 自變項之操作型定義 28 表3-2-2 依變項操作型定義 29 表3-3-1 本研究之個案醫院簡介 30 表4-1-1 變項合併對照表 33 表4-1-2 回收樣本之基本資料 34 表4-1-3 醫師對專業能力態度之描述性分析 43 表4-1-4 態度量表之分佈情形 45 表4-1-5 醫師對專業能力自我評價之描述性分析 48 表4-1-6 自我評價量表之分佈情形 50 表4-1-7 醫師對專業能力的態度與自我評價的比較 53 表4-2-1 態度量表與自我評價量表之信度 54 表4-2-2 醫師態度「病人為中心的照護」與自變項之雙變項分析 65 表4-2-3 醫師態度「專業整合團隊」與自變項之雙變項分析 68 表4-2-4 醫師態度「實證為基礎的專業執行」與自變項之雙變項分析 71 表4-2-5 醫師態度「採行品質改善」與自變項之雙變項分析 74 表4-2-6 醫師態度「善用資訊科技」與自變項之雙變項分析 77 表4-2-7 醫師自我評價「病人為中心的照護」與自變項之雙變項分析 80 表4-2-8 醫師自我評價「專業整合團隊」與自變項之雙變項分析 83 表4-2-9 醫師自我評價「實證為基礎的專業執行」與自變項之雙變項分析 86 表4-2-10 醫師自我評價「採行品質改善」與自變項之雙變項分析 89 表4-2-11 醫師自我評價「善用資訊科技」與自變項之雙變項分析 92 表4-2-12 醫師態度與自我評價的相關分析 95 表4-4-1 醫師態度「以病人為中心」之複迴歸分析 105 表4-4-2 醫師態度「專業整合團隊」之複迴歸分析 106 表4-4-3 醫師態度「實證為基礎的專業執行」之複迴歸分析 107 表4-4-4 醫師態度「採行品質改善」之複迴歸分析 108 表4-4-5 醫師態度「善用資訊科技」之複迴歸分析 109 表4-4-6 醫師自我評價「以病人為中心的照護」之複迴歸分析 110 表4-4-7 醫師自我評價「專業整合團隊」之複迴歸分析 111 表4-4-8 醫師自我評價「實證為基礎的專業執行」之複迴歸分析 112 表4-4-9 醫師自我評價「採行品質改善」之複迴歸分析 113 表4-4-10 醫師自我評價「善用資訊科技」之複迴歸分析 114 表4-4-11 醫師態度與自我評價「以病人為中心」之複迴歸分析 115 表4-4-12 醫師態度與自我評價「專業整合團隊」之複迴歸分析 116 表4-4-13 醫師態度與自我評價「實證為基礎的專業執行」之複迴歸分析 117 表4-4-14 醫師態度與自我評價「採行品質改善」之複迴歸分析 118 表4-4-15 醫師態度與自我評價「善用資訊科技」之複迴歸分析 119 圖目錄 圖2-1-1 IOM五大核心能力(Five Core Competencies) 8 圖4-3-1 確保醫師專業教育在各發展階段的方法 18 圖3-1-1 研究架構 26 圖4-1-1 醫師態度「病人為中心的照護」總分分佈圖 45 圖4-1-2 醫師態度「專業整合團隊」總分分佈圖 46 圖4-1-3 醫師態度「實證為基礎的專業執行」總分分佈圖 46 圖4-1-4 醫師態度「採行品質改善」總分分佈圖 47 圖4-1-5 醫師態度「善用資訊科技」總分分佈圖 47 圖4-1-6 醫師自我評價「病人為中心的照護」總分分佈圖 50 圖4-1-7 醫師自我評價「專業整合團隊」總分分佈圖 51 圖4-1-8 醫師自我評價「實證為基礎的專業執行」總分分佈圖51 圖4-1-9 醫師自我評價「採行品質改善」總分分佈圖 52 圖4-1-10 醫師自我評價「善用資訊科技」總分分佈圖 52 附件目錄 附件一 專家效度名單 142 附件二 本研究問卷 143 附件三 有進行因素分析之研究結果147 | |
dc.language.iso | zh-TW | |
dc.title | 醫師對專業能力的態度與自我評價間關係之研究 | zh_TW |
dc.title | The Study of Relationship between Physicians' Attitude toward Professional Competence and Self-evaluation | en |
dc.type | Thesis | |
dc.date.schoolyear | 94-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 鄭守夏,楊哲銘 | |
dc.subject.keyword | 醫師專業能力,自我評價,病人為中心的照護,醫療專業團隊,實證醫學,品質改善,醫療科技, | zh_TW |
dc.subject.keyword | professional competence,self-evaluation,patient-centered care,interdisciplinary team,evidence-based medicine,quality improvement,medical informatics, | en |
dc.relation.page | 192 | |
dc.rights.note | 未授權 | |
dc.date.accepted | 2006-08-03 | |
dc.contributor.author-college | 公共衛生學院 | zh_TW |
dc.contributor.author-dept | 醫療機構管理研究所 | zh_TW |
顯示於系所單位: | 健康政策與管理研究所 |
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