從服務使用者的觀點探討居家護理品質

A Study of Home Nursing Quality from the Perspective of Service Users

10.6225/JNHR.10.3.229

邱啟潤(Chii‐Jun Chiou)；李逸(I Lee)

居家護理 ； 服務品質 ； 使用者觀點 ； home nursing ； quality of care ； user's perspective

護理暨健康照護研究

10卷3期（2014 / 09 / 01）

229 - 239

繁體中文

背景：居家護理是最早開辦的長期照顧服務之一，為了貼近以個案為中心的護理理念，從使用者觀點探討服務品質是不可或缺的。目的：從服務使用者的觀點探討居家護理品質的現況。方法：採橫斷性調查研究設計，以居家護理品質量表、滿意度量表收集資料。樣本來自台灣15個縣市之27家醫院附設型態的居家護理機構，共有294位居家護理服務使用者參與研究。結果：居家護理品質量表總分的指標分數為88.0（滿分為100分）；三個次量表之指標分數依序為：「可靠性」89.6、「有用性」87.5、「溝通技巧」86.6，各題目的平均得分在3.3-3.7（滿分為4分）。滿意度方面，「改善病人健康狀況」的滿意程度平均為87.7±11.5（滿分為100分），「整體服務」的滿意程度為90.8±8.5（滿分為100分）。結論／實務應用：（1）居家護理品質受到服務使用者的肯定，（2）居家護理品質量表的內涵與理論相呼應，可提供給居家護理機構使用，作為提升品質的參考，（3）未來研究可針對非醫院型態的居家護理機構進行探討。

Background: Home nursing service is one of the first programs promoted in long‐term care. Due to the critical role of home nursing service in the philosophy of client‐centered care, it is essential to explore the actual quality of these services from the perspective of the home nursing service user. Objectives: This study investigates the quality of home nursing services from the perspective of service users. Methods: A cross‐sectional survey was used in the study. Data were collected using a home nursing quality scale and satisfaction questionnaire. Twenty‐seven home nursing facilities from 15 cities in Taiwan participated in this study and a total of 294 home‐nursing‐service users completed the questionnaire. Results: The mean total score on the home nursing quality scale was 88.0 (out of a total possible 100 points), with scores for the 3 subscales as follows-reliability: 89.6, usefulness: 87.5; and communication skills: 86.6. The mean for each item was 3.3-3.7 (out of a total possible 4 points). On the satisfaction questionnaire, the mean for ＂Improving the health status of patient＂ was 87.7 ± 11.5 (out of a total possible 100 points) and the mean for ＂Overall satisfaction with the service＂ was 90.8 ± 8.5 (out of a total possible 100 points). Conclusions/Implications for Practice: (1) Participants rated their home nursing services highly; (2) the content of the home nursing quality scale has a strong theoretical founding and thus is valid for use by home nursing facilities as a reference to improve their service quality; and (3) future research may explore the quality of service provided by other types of home nursing facilities.