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| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 張淑惠(Shu-Hui Chang),戴政(John Jen Tai) | |
| dc.contributor.author | Shu-Feng Chien | en |
| dc.contributor.author | 簡淑芬 | zh_TW |
| dc.date.accessioned | 2021-06-13T15:34:10Z | - |
| dc.date.available | 2008-08-13 | |
| dc.date.copyright | 2008-08-13 | |
| dc.date.issued | 2008 | |
| dc.date.submitted | 2008-07-11 | |
| dc.identifier.citation | 余民寧(2006)•潛在變項模式-SIMPLIS的應用•臺北：高等教育。
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| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/37594 | - |
| dc.description.abstract | 目的：病人安全已成為全球醫療體系最關注的議題，隨著國際社會重視及推動病人安全的努力，應用量表評估醫療機構員工對安全的態度認知，已是國際近年來之趨勢，本研究引入由Dr. Bryan Sexton等人設計之安全態度問卷（Safety Attitude
Questionnaire，SAQ）作為研究工具進而發展中文版SAQ，並驗證中文版安全態度問卷（SAQ）之工具信度與效度，據以評估醫療機構內員工對安全態度的認知現況，瞭解醫療機構內工作人員的個人及工作特質對安全態度認知之差異。 方法：本研究為一橫斷性研究，以北部某醫學中心4873位員工為調查對象，以普查方式進行，在普查之前本研究經原作者的授權先進行SAQ中文化，並通過內在一致性檢測。研究使用驗證性因素分析的最大概似估計法對測量模型進行估計假設模式與實際資料是否契合，進而考驗工具的信度與效度。 結果：回收問卷2926份，問卷回收率為71.1％，以護理人員的回收率最高，信度分析顯示：潛在變項的組合信度（CR）介於.77-.93，具有理想的內部一致性，但潛在變項的平均變異量抽取值（AVE）介於.40-.71，團隊合作風氣（.46）、安全風氣（.40）、對管理的感受（.44）未達標準。效度分析顯示：三十項測量變項的標準化因素負荷量估計值（ ）皆達統計水準，整體模式適配度檢核結果為 2801.323 (p=.00＜.05)，RMR=.038；RMSEA=.055；GFI=.905；TLI(NNFI)=.917；CFI=.926顯示假設模式與樣本資料適配程度良好六個構面的模式適配度均達可接受的程度，且具有相當良好的收斂及區別效度。六個構面除「對壓力認知」之外，其它構面間均有顯著的相關性（r=0.67~0.93）。經比較假設模式（六構面）與修正 模式（五構面）整體模式之適配度，評鑑結果以修正模式較為理想且符合模式簡約原則。醫療機構內人員對其服務醫院的安全態度認知以「團隊合作風氣」構面（70.99±18.45分）為最高，「對管理的感受」（58.81±19.06分）為最低，工作人員對安全態度的認知集中於「中立」到「有些同意」之間。經單變量變異數分析結果發現，機構中工作人員的性別、年齡、教育程度等個人特質因素以及醫院服務年資、不同專業人員別、任管理職位與否等工作特質因素對於安全態度的評價和看法是有顯著差異的。 結論：中文版SAQ具有可接受的信度與效度，可以提供台灣醫療機構做為評量醫療人員對病人安全態度的工具，並可適切反應該機構的安全文化。研究建議持續推廣安全教育、實施主管走訪安全模式，降低彼此對安全管理認知上的差距，並且積極建立醫事人力評估機制等，從系統性改善來落實病人安全政策。 | zh_TW |
| dc.description.abstract | Objectives: The Safety Attitude Questionnaire (SAQ) has been used in several countries to measure healthcare workers’ attitudes toward patient safety. It has not been validated in Taiwan, however. The objective of this study was to develop and validate a Chinese version of the SAQ and determine the extent to which safety attitudes varied among different types of staffs in a single hospital.
Methods: The original SAQ was translated into Chinese in October 2006. There were 30 core items, measuring six domains of an organization’s safety culture: Teamwork Climate(TC), Safety Climate(SC), Job Satisfaction(JS), Stress Recognition(SR), Perceptions of Management(PM), and Working Conditions(WC). A hospital-wide safety attitude survey was conducted in one medical center in Taipei in April 2007. The reliability and validity of the SAQ were examined by confirmatory factor analysis. They rated their agreement with the items using a 5-point Likert scale. Each scale was scored by converting the 5-point Likert scale to a 100-point scale. Responses to each item in a scale were summed then divided by the number of items in that scale to create a mean score that ranged from 0 to 100. Differences in the mean scores of each scale were examined by analysis of variance among physicians, nurses, pharmacists, technicians, and non-medical staffs. Results: The overall response rate was 71.1%. The internal consistency of each domain was high (composite reliability: 0.77-0.93). The explanatory abilities of two-thirds (21/30) of the core items are considered important for the corresponding domains (squared multiple correlation [SMC] ≥ 0.5). The standardized factor loadings (λ) for most core items were statistically meaningful (λ = 0.38-0.90). The model fit was satisfactory for the six domains and for the safety culture via structural equation models. Except for Stress Recognition, all domains were highly correlated to one another (correlation coefficients: 0.67-0.93). The overall model fit was increased after removal of the SR scale. For all staffs, the mean±SD score was 70.99 ±18.45 for TC, 68.74±16.88 for SC, 68.68±22.50 for JS, 70.19±22.82 for SR, 62.84±18.95 for PM, and 65.87±18.52 for WC. There were statistically significant variations in safety attitudes among different types of staffs. Conclusions: The Chinese version of the SAQ is reliable and valid in measuring frontline workers’ safety attitudes in this healthcare organization in Taiwan. Appropriate revision of the SAQc could be considered by removing the stress recognition scale for better model fit than the original version. Significant variations in safety attitudes existed among different types of staffs within the hospital. | en |
| dc.description.provenance | Made available in DSpace on 2021-06-13T15:34:10Z (GMT). No. of bitstreams: 1 ntu-97-R95842007-1.pdf: 2321152 bytes, checksum: 0bd2a5bbadc48f461be1b6b607152e4e (MD5) Previous issue date: 2008 | en |
| dc.description.tableofcontents | 口試委員會審定書 i
誌謝 ii 中文摘要.iii 英文摘要 v 第一章 緒 論 7 第一節 研究背景與動機 7 第二節 研究目的 8 第二章 文獻探討 9 第一節、名詞定義 9 第二節、測量安全風氣的重要性 13 第三節、國外病安文化評量的工具及成果 13 第四節、SAQ安全態度問卷簡介 15 第五節、國內病人安全文化的研究 16 第六節、國外病人安全文化的研究 17 第三章 研究設計與方法 19 第一節 研究架構與假說 19 第二節 研究對象 22 第三節 研究工具 22 第四節 問卷發放 25 第五節 分析方法 26 第四章 研究結果 28 第一節 樣本基本資料分佈情形 28 第二節、中文版SAQ工具信度與效度之分析 31 第三節、工作人員個人特質與安全態度各構面之關聯性探討 50 第四節、工作人員工作特質與安全態度各構面之關聯性探討 51 第五章 討論 56 第一節、研究結果討論 56 第二節、研究限制 62 第六章、結論 63 第一節、研究結論 63 第二節、研究建議 64 參考文獻 67 附錄 77 附錄一、Safety Attitude Questionnaire(SAQ)原版問卷 77 附錄二、中文版安全態度問卷 78 附錄三、結構方程模式 80 附錄四、驗證性因素分析 85 附錄五 觀察變項X的迴歸方程式 93 附錄六、驗證性因素模式之主要矩陣 95 （一）外生因素間之共變數矩陣 95 （二）因素負荷矩陣 95 （三）測量誤差之共變數矩陣 96 （四）觀察變項之共變數推導舉例 96 附錄七、Amos輸出報表解讀 98 （一）變項摘要 98 （二）參數摘要 98 （三）模式註解 98 （四）參數估計值 99 （五）樣本共變數矩陣 108 （六）假設模式隱含共變數矩陣 109 （七）適配殘差矩陣 110 （八）標準化殘差矩陣 111 （九）適配度摘要 112 附錄八、測量模式之區別效度 114 附錄九、測量模式之聚斂效度 130 圖目錄 圖一、中文版SAQ多因素斜交模式之驗證性因素分析概念模式圖 20 圖二、研究概念架構圖 21 圖三、回收樣本中各專業人員百分比分布圖 28 圖四、假設模式徑路圖及標準化估計值 32 圖五、中文版SAQ刪除對壓力的認知構面之修正模式概念圖 40 圖六、修正模式徑路圖及標準化估計值（刪除對壓力的認知構面） 41 圖七、各部科工作人員對各項及整體安全態度的正向評分百分比分布圖 47 表目錄 表一、國外學者對安全風氣的定義 11 表二、國外學者對安全文化的定義 12 表三、國際常用病人安全問卷調查量表 14 表四、病人安全態度各構面題項分配 24 表五、資料建檔之譯碼及資料屬性 24 表六、模式中所有觀察變項之偏態與峰度分配 27 表七、問卷發放與回收情形 28 表八、樣本基本特質(n=2926) 29 表九、樣本工作特質(n=2926) 30 表十、中文版SAQ六構面之信度考驗 33 表十一、中文版SAQ驗證性因素分析模式考驗摘要表 35 表十二、中文版SAQ各潛在構念之單面向測量模式的配適度評鑑 36 表十三、中文版SAQ之區別效度分析 38 表十四、安全態度問卷（SAQ）六個構面的相關性比較 39 表十五、SAQ六項構面與五項構面之CFA分析結果比較 43 表十六、中文版SAQ五構面之信度考驗 44 表十七、工作人員對安全態度的認知 45 表十八、工作人員個人及其工作特質對安全態度及各構面的認知 46 表十九、工作人員對其服務醫院的安全態度認知之百分比分布 49 表二十、工作人員不同「性別」於各項安全態度之差異性檢定 52 表二十一、工作人員不同「年齡層」於各項安全態度之差異性檢定 52 表二十二、工作人員不同「教育程度」於各項安全態度之差異性檢定 53 表二十三、工作人員不同「醫院服務年資」於各項安全態度之差異性檢定 53 表二十四、不同專業人員於各項安全態度之差異性檢定 54 表二十五、工作人員「任管理職位與否」於各項安全態度之差異性檢定 54 表二十六、工作人員不同的「受雇身分」於各項安全態度之差異性檢定 55 表二十七、工作人員不同接觸病人的頻率於各項安全態度之差異性檢定 55 | |
| dc.language.iso | zh-TW | |
| dc.subject | 工作滿意度 | zh_TW |
| dc.subject | 對壓力認知 | zh_TW |
| dc.subject | 對管理的感受 | zh_TW |
| dc.subject | 團隊合作 | zh_TW |
| dc.subject | 工作的狀況 | zh_TW |
| dc.subject | 安全態度問卷 | zh_TW |
| dc.subject | 安全文化 | zh_TW |
| dc.subject | 安全風氣 | zh_TW |
| dc.subject | 病人安全 | zh_TW |
| dc.subject | Working Conditions | en |
| dc.subject | Patient Safety | en |
| dc.subject | Safety Culture | en |
| dc.subject | Safety Attitude Questionnaire | en |
| dc.subject | Teamwork Climate | en |
| dc.subject | Safety Climate | en |
| dc.subject | Job Satisfaction | en |
| dc.subject | Recognition of Stress | en |
| dc.subject | Perceptions of management | en |
| dc.title | 中文版安全態度量表之信效度評估與應用-某醫學中心病人安全文化之初探 | zh_TW |
| dc.title | Evaluation of Reliability and Validity of Safety Attitude Questionnaire in Chinese Version : An exploratory study of Patient Safety culture in a Medical Center | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 96-2 | |
| dc.description.degree | 碩士 | |
| dc.contributor.advisor-orcid | ,戴政(jjtai@ntu.edu.tw) | |
| dc.contributor.coadvisor | 李偉強(Wui-Chiang Lee) | |
| dc.contributor.oralexamcommittee | 陳玉枝(Yu-Chih Chen),陳秀熙(Tony Hsiu-Hsi Chen) | |
| dc.subject.keyword | 病人安全,安全文化,安全態度問卷,團隊合作,安全風氣,工作滿意度,對壓力認知,對管理的感受,工作的狀況, | zh_TW |
| dc.subject.keyword | Patient Safety,Safety Culture,Safety Attitude Questionnaire,Teamwork Climate,Safety Climate,Job Satisfaction,Recognition of Stress,Perceptions of management,Working Conditions, | en |
| dc.relation.page | 136 | |
| dc.rights.note | 有償授權 | |
| dc.date.accepted | 2008-07-14 | |
| dc.contributor.author-college | 公共衛生學院 | zh_TW |
| dc.contributor.author-dept | 流行病學研究所 | zh_TW |
| 顯示於系所單位： | 流行病學與預防醫學研究所 | |
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| 檔案 | 大小 | 格式 | |
|---|---|---|---|
| ntu-97-1.pdf 未授權公開取用 | 2.27 MB | Adobe PDF |
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