Abstracts: The purpose of the study was to compare the efficacy and cost between intravenous patient-controlled analgesia (PCA) with intramuscular (IM) analgesics for women in the first two days after surgery. The study included 200 patients who were assigned to receive PCA or intramuscular injections opioid during a period of 2 days after surgery. The PCA group included 124 patients and IM group had 76 patients. The data were collected using a structured questionnaires, patient chart review and hospital charge data. The several findings were observed in this study. 1. The pain level in the PCA group was significantly lower than in the IM group (P< 0.01). The PCA group had significantly greater satisfaction with pain control than those in IM group (p< 0.01). The influence of activity by pain in the IM group had significantly greater than those in PCA group (p< 0.05). 2. The incidence of skin itching in PCA group was significantly higher than in the IM group ¡]P< 0.01¡^.3. Cost per patient was higher for PCA group¡]NT$ 420.9¡Ó22.6¡^than IM group¡]NT$228.4¡Ó60.1¡^. In conclusion, PCA produced better pain relief, get better patient¡¦s satisfaction than conventional on-demand IM opioid injections but it was more expensive.

Based on the 2011 annual report of the United States Renal Data Library System (the USRDS), the prevalence and incidence of dialysis patient in Taiwan were the first and second in the world and the population of dialysis patient has exceeded six million (65883). Where can provide dialysis medical services called the hemodialysis center. According to the setting standards of medical institutions,provisions of the Department of Health, hemodialysis center can be set by the hospitals under the division of of Nephrology (Medical Center, regional teaching hospital, district hospital) and also set by the specialised clinics, hemodialysis centers will attached to the hospital or the clinic. Taiwan have 571 hemodialysis centers where can provide dialysis medical services , separated to 262 hospitals and 309 clinics. We want to study the difference of quality of health care services provided by these two center categories ? Is it different from their patient satisfaction and patient behavioral intention ? Whether their own merits, can each play? This study is based by the 5Qs the model proposed by Zineldin (2006) upon the hemodialysis patients, we have chosen four quality dimensions including the quality of object, quality of process, quality of communication and the quality of atmosphere to see which quality of health care services will affect their satisfaction and behavioral intentions, and look forward to the results of a study on the different category of hemodialysis centers in the future to improve the quality ofhealth care services, strengthening the competitiveness and sustainable management, to provide effective strategic direction.The study included patients from the three hemodialysis centers, each centers have received 100 questionnaires (one is regional teaching hospital, one is district hospitals and the rest is nephrologist clinics ). Effective returned questionnaires is 240 and the rate is 80%. In this study, the quality of healthcare services is based on four quality dimensions as the unit of analysis, the patient`s satisfaction, patient`s behavior intension. The results of this study are summarized as follows: 1. Quality of healthcare services " quality of object " and " quality of process ", "quality of atmosphere " has a positive significant impact on patient`s satisfaction, particularly in the " quality of process ",but " quality of interaction " has no significant relationship. The quality of healthcare services, " quality of process " has a positive significant impact on patient behavior intentions, but the " quality of object " ," quality of process " and " quality of interaction " have no significant relationship. 3 Patient`s satisfaction has positive and significant impact to behavioral intentions each other. 4.Different category of hemodialysis centers all have significant correlation for the " quality of object ", " quality of process ", " quality of interaction ", "quality of atmosphere ", patient`s satisfaction and patient`s behavior intention".

Patients experience some degree of pain accompanying all surgical procedures. If this pain is not adequately treated, it will cause severe physiological and psychological damage. It will even affect patients' postoperative recovery. However, if preemptive analgesia is administered before noxious stimuli arise, rather than afterwards, it is significantly more effective. The purpose of this study is to recognize that reasonable effort and time should be spent to determine a patient's tolerance level towards pain before surgery. Then, the appropriate dosage of analgesia can be given immediately after surgery to alleviate pain. By administering effective pain relief, it will improve patient¡¦s satisfaction with medical services. Using classic experimental design (which consists of an experimental group and a control group), this study focuses on cases of patients who had hemorrhoid surgery in a certain hospital in southern Taiwan. The experimental group and the control group consist of a total of 75 valid samples. The experimental group received customizing analgesic postoperative care, while the control group received conventional analgesic postoperative care. Patient¡¦s satisfaction questionnaires were gathered from patients on the day they were discharged from the hospital. Instruments used in the experiment include VAS, PThM, and patient¡¦s satisfaction questionnaires.To examine the basic characteristics of the samples in both the experimental group and the control group, two statistical methods, Chi-square test and independent T test, were adopted. For patient¡¦s satisfaction questionnaires, Mann-Whitney-Wilcoxon test of nonparametric method was adopted to examine if obvious differences in satisfaction levels existed between the two groups. The result of the experiment shows the analgesic effect from customizing analgesic postoperative care is far better than conventional care. The patient¡¦s satisfaction toward the doctor's professional skill was higher as well. On the other hand, the patient¡¦s satisfaction level toward the whole medical process had no obvious improvement. This study proves that customizing analgesic postoperative care can effectively prevent postoperative pain from occurring. However, to raise patient¡¦s satisfaction towards the whole medical process, better professional medical skill is required as well as improved medical services.

The final thesis follows up the quality of health care. This topic has been nowadays much discussed and is very current. The aim of this work was to bring the issue of health care quality and analyze the quality of health care in the facility Dr. Pírko Clinic by using a questionnaire to research the satisfaction of it's patients.