軟組織損傷病患針灸治療滿意度之影響因素探討

Abstract

有關滿意度的研究相當多，醫療行業的研究亦不少，但是有關中醫的研究相對地較少，而有關針灸治療的研究更少。本研究的目的在探討軟組織損傷病患接受針灸治療後對滿意度的看法，以了解有那些影響病患滿意度的影響因素，及這些因素間的相互關係，。本研究以南部某地區教學醫院中醫科針灸治療之軟組織損傷病患為樣本，以問卷調查收集資料，從西元2009年6月15日至2009年7月15日，共計143人。 在參考國內外滿意度模式及文獻探討後，將問卷設計為:包括軟、硬體服務品質、針灸治療結果、醫病關係、知覺價值、病患滿意度等，共計六個潛在變項。 但是在問卷回收並經過因素分析後再分離出一變項「等候時間」。共計七個潛在變項來討論。 研究發現：(1)接受針灸治療之軟組織損傷患者中，以女性居多；年齡層則集中於31~40 歲，其次為41~50 歲；以服務業居多。相對於各個變項，硬體服務品質的滿意程度是最低的尤以對於針灸治療室的空間大小的滿意度是最低的。(2)「針灸結果」、「醫病關係」對「病患滿意度」產生正向影響，並且會透過「知覺價值」對「病患滿意度」產生影響；「硬體服務品質」、「軟體服務品質」對「病 患滿意度」產生正向影響，但不會透過「知覺價值」對「病患滿意度」產生影響；而「等候時間」對「病患滿意度」則不產生正向影響，亦不會透過「知覺價值」對「病患滿意度」產生影響。(3) 比較各變項對於病患滿意度之影響效果，醫病關係對病患滿意度之預測力為最高；其次是針灸結果；再其次是軟體服務品質；最後是硬體服務品質；等候時間則是影響不顯著。 研究結論：對於軟組織損傷之針灸治療病患來說，醫病溝通、了解病患痛苦、看診時間、病情說明等所謂醫病關係是影響滿意度最大的因素，甚至還比針灸結果來的大，顯示病患渴望獲得更多的醫療資訊及善待。 以上研究結果期盼能提供中醫醫療院所做為經營管理之參考。

Many studies have focused on the satisfaction of patients and medical treatments, yet few studies have been made on Chinese medical science, let alone acupuncture therapy. The purpose of this study was to investigate the satisfaction of patients who received acupuncture therapy to treat soft tissue injury, in order to determine the factors that affect the patient satisfaction and to figure out the interrelationships among these factors. In this study, 143 questionnaires were collected from patients who suffered from soft tissue injury and had received acupuncture therapy in a Southern regional teaching hospital from June 15th to July 15th in 2009. After referring to domestic/overseas satisfaction models and literature reviews, the questionnaire was designed to include six potential variables: service quality of hardware, service quality of human ware, outcome of acupuncture therapy, physician-patient relationship, perceived value and satisfaction of patients. Another variable: “waiting time” was identified after collecting the questionnaires and factor analysis. The seven potential variables were discussed in this study. The study found that: (1) Patients who received acupuncture therapy to treat soft tissue injury were mainly female and mostly aged 31 to 40, followed by 41 to 50; most of them worked in the service industry. Among the variables, service quality of hardware had the lowest level of patient satisfaction, especially in regard to the space of the therapy room for acupuncture. (2) Both “outcome of acupuncture therapy” and “physician-patient relationship” could have positive influence on “satisfaction of patients” and would have influence on the “satisfaction of patients” through perceived value , although “service quality of hardware” and “service quality of human ware” could also have positive influence on “satisfaction of patient”, but not through “perceived value”; however, “waiting time” had no positive influence on “satisfaction of patient” and it could not influence “satisfaction of patient” through “perceived value”. (3) A comparison of the influence of each variable concerning patient satisfaction showed that “physician-patient relationship” was the best predictor to forecast patient satisfaction; the second best was “outcome of acupuncture therapy”; the third was “service quality of human ware” and then the “service quality of hardware”. Meanwhile, “waiting time” showed insignificant influence on patient satisfaction. In conclusion, for patients who received acupuncture therapy to treat soft tissue injury, the “physician-patient relationship”, including communication between physician and patient, response to patient’s suffering, consultation time, and physician explanation, was the most critical factor affecting patient satisfaction, even more decisive than outcome of acupuncture therapy. The result suggested that patients yearn for more medical information and being treated in a caring manner. It is hoped that the above results can serve as future reference for the management and operation of medical institution of Chinese medicine.