為因應社會結構變遷、失能老人對長期照護需求的增加，衛生署近年來增修法案使的台灣地區護理之家的家數大幅增加。護理之家在面對護理之家的家數激增與相關制度的雙重考驗下，藉著提昇服務品質而達到永續經營是每一護理之家所必須面臨的重要課題。但目前評估護理之家服務品質的問卷，大多是從主管或護理人員的眼光來觀察且問項繁多，而非從住民的眼光來設計的精簡化問卷。故，無法得知住民的真正觀感，了解護理之家服務品質的缺口。而護理之家對於住民制式化忽略住民個人屬性的管理方法，也是本研究欲探討的層面。根據上述研究動機，本研究主要有四個目的：1. 利用深度訪談佐以文獻探討，建立從住民眼光評估護理之家服務品質的精簡化問卷。2. 利用本研究所設計之問卷，針對單一護理之家中『高度重視、低度滿意』之項目，探討顯著差異之服務品質缺口，提供明確而立即的改善方向，以提升住民的服務品質。3. 探討影響護理之家服務品質變項之個人屬性變項。4. 探討影響護理之家住民整體滿意度之個人屬性變項。本研究利用自行設計出來的問卷，佐以從P、Z、B所提出之服務品質觀念性模式修改而成的研究架構，將問卷發放於某中區護理之家，藉此知道問卷的信度並了解護理之家真實的服務品質缺口。並利用統計分析工具探討住民個人屬性對於整體滿意度的影響。經統計分析後，問卷信度皆有0.9以上，而所發放問卷的護理之家其醫療團隊目前有人力不足，住民覺得工作人員態度需更加溫和、親切的服務品質缺口。至於，住民的個人屬性對於整體滿意度而言，並無顯著性影響。 / Because elder who losing limbs’ functions are increasing and most of them are sent to long-term care facilities, The Department of Health additions and deletions law for increasing N.H.（nursing home）numbers to contain them in recent years. Because of N.M. numbers increase, it is an important issue to increase N.H. service quality for sustainable operation. Most of current N.H. service quality questionnaires have a lot of items, and these questionnaires come from managers and nurses’ view. If managers use these questionnaires, they may not know residents’ need. In this research, researcher also wants to discuss N.M. uniform management because it may not appropriate to residents. According to this background, this research has four purposes：1.Developing a subtle questionnaire which comes from residents’ view. 2. For increasing residents’ satisfaction, this research will use this questionnaire to detect N.M. service quality gaps and to tell managers improvement directions. 3. Discussion residents’ attributions variables that affect service quality variables. 4. Discussion residents’ attributions variables that affect total satisfaction degree. The research’s framework modifies from PZB conceptual model of service quality. After retrieving and analyzing questionnaires, the questionnaire’s reliability is over 0.9. That N.M. service quality gaps are shortage of staff and lacking good attitude to residents. There is no significant relationship between residents’ attributes variables and total satisfaction degree. / 中文摘要 -------------------------------------------------------------------------- i
英文摘要 -------------------------------------------------------------------------- ii
序言 --------------------------------------------------------------------------- iii
目錄 -------------------------------------------------------------------------- iv
表目錄 -------------------------------------------------------------------------- vi
圖目錄 -------------------------------------------------------------------------- viii
一、 緒論--------------------------------------------------------------------- 1
1.1 研究動機--------------------------------------------------------------- 1
1.2 研究目的------------------------------------------ 2
1.3 研究流程------------------------------------------ 3
二、 文獻探討--------------------------------------------------------------- 4
2.1 機構服務品質的發展------------------------------------------------ 4
2.2 機構品質的意涵與量測--------------------------------------------- 7
2.3 重視度-滿意度模式與改善係數--------------------------------- 16
2.4 病患滿意度與醫療服務品質的關係------------------------------ 18
2.5 機構品質指標--------------------------------------------------------- 19
2.6 影響服務品質的因素------------------------------------------------ 21
2.6.1 護理之家服務品質指標------------------------------------------ 21
2.6.2 住民個人屬性變項-------------------------------- 26
三、 研究方法--------------------------------------------------------------- 28
3.1 研究架構--------------------------------------------------------------- 28
3.2 研究假設-------------------------------------------------------------- 30
3.3 研究對象------------------------------------------ 31
3.3.1 研究機構---------------------------------------- 31
3.3.2 研究對象---------------------------------------- 31
3.4 研究工具------------------------------------------ 31
3.4.1 問卷設計---------------------------------------- 31
3.4.2 信效度測試-------------------------------------- 32
3.5 資料收集方法-------------------------------------- 33
3.6 研究變項之操作型定義------------------------------ 34
3.6.1 個人屬性變項------------------------------------ 34
3.6.2 服務品質量測變項-------------------------------- 35
3.6.3 整體服務品質滿意-------------------------------- 35
3.7 資料分析方法-------------------------------------- 36
四、 研究結果--------------------------------------------------------------- 37
4.1 住民個人屬性變項之敘述性統計-------------------------------- 37
4.2 住民服務品質問卷之敘述性統計---------------------- 38
4.3 住民服務品質滿意度問卷之因素分析------------------ 40
4.4 照護服務品質缺口之假設檢定------------------------ 45
4.4.1 假設檢定---------------------------------------- 45
4.4.2 討論-------------------------------------------- 55
4.5 住民個人屬性之統計變量假設檢定-------------------- 59
4.5.1 個人屬性對服務品質變項之差異性分析-------------- 59
4.5.2 個人屬性變項對整體服務品質滿意度之差異性分析---- 60
五、 結論--------------------------------------------------------------------- 63
5.1 重要結果討論--------------------------------------------------------- 63
5.1.1 研究對象特性------------------------------------ 63
5.1.2 因素分析之結果---------------------------------- 63
5.1.3 服務品質缺口之分析結果-------------------------- 65
5.1.4 個人屬性對服務品質變項之分析結果---------------- 66
5.1.5 個人屬性對整體服務品質滿意度之分析結果---------- 66
5.2 研究限制------------------------------------------ 67
5.2.1 問卷問項之限制---------------------------------- 67
5.2.2 機構住民之限制--------------------------------------------------- 67
5.3 後續研究建議-------------------------------------------------------- 68
5.4 研究應用--------------------------------------------------------------- 69
中文參考文獻 -------------------------------------------------------------------------- 70
英文參考文獻 --------------------------------------------------------------------------- 72
附錄一 住民認知服務品質問卷--------------------------------------------- 78
附錄二 醫療團隊認知服務品質問卷--------------------------------------- 81
附錄三 單位主管認知服務品質問卷--------------------------------------- 85
表 目 錄
表1 服務品質概念----------------------------------------------------------------- 7
表2 服務品質量測---------------------------------------------------------------- 8
表3 SERVQUAL量表構面與認知項目------------------------------------------- 15
表4 服務品質指標----------------------------------------------------------------- 20
表5 各問卷的Cronbach’s α係數表------------------------------------------ 33
表6 資料分析目的與統計方法-------------------------------------------------- 36
表7 有效樣本住民個人屬性變數資料統計表-------------------------------- 37
表8 住民服務品質問卷之敘述性統計表-------------------------------------- 39
表9 各問卷類別之MSA值-------------------------------------------------------- 40
表10 住民服務品質滿意度問卷之轉軸結果----------------------- 41
表11 住民服務品質滿意度問卷之因素分析----------------------- 41
表12 「服務品質變項」敘述統計分析表-------------------------- 44
表13 「住民對護理之家服務品質之重視度」與「主管認知住民對護理之家服務品質之重視度」之檢定結果表---------------------
46
表14 「主管認知住民對護理之家服務品質之重視度」與「主管認知護理之家服務品質之執行度」之檢定結果表-------------------
47
表15 「主管認知醫療團隊對護理之家服務品質之執行度」與「醫療團隊認知照護服務傳遞之執行度」之檢定結果表---------------
48
表16 「住民對護理之家服務品質之滿意度」與「醫療團隊照護服務傳遞之執行度」之檢定結果表-------------------------------
49
表17 「住民對護理之家服務品質的重視度」與「住民對護理之家服務品質的滿意度」之檢定結果表------------------------------
50
表18 「主管認知住民對護理之家服務品質之重視度」與「醫療團隊認知住民對護理之家服務品質之重視度」之檢定結果表---------
51
表19 「醫療團隊認知照護服務傳遞之執行度」與「醫療團隊認知住民對護理之家服務品質之重視度」之檢定結果表---------------
52
表20 「住民對護理之家服務品質之重視度」與「醫療團隊認知住民對護理之家服務品質之重視度」之檢定結果表-----------------
53
表21 照護服務品質缺口之假設檢定結果表----------------------- 54
表22 醫療團隊之5個因素的SERVQUAL點數----------------------- 56
表23 住民之5個因素的SERVQUAL點數-------------------------- 57
表24 服務品質指標改善順序表-------------------------------------------------- 58
表25 個人屬性對於服務品質變項之變異數分析------------------- 59
表26 個人屬性對於整體服務品質滿意度之變異數分析------------- 60
表27 個人屬性之統計變量假設檢定結果表----------------------- 62
表28 SERVQUAL問卷、醫療服務品質及滿意度問卷與機構服務品質問卷之異同表-----------------------------------------------
64
圖 目 錄
圖1 研究流程圖------------------------------------------------------------------ 3
圖2 10個決定因素濃縮為5個決定因素示意圖----------------------------- 10
圖3 服務品質的觀念性模式圖-------------------------------------------------- 11
圖4 重視度-滿意度分析模式--------------------------------------------------- 17
圖5 研究架構圖-------------------------------------------------------------------- 29
圖6 護理之家服務品質之重視度-滿意度分析模式------------------------ 57
| Identifer | oai:union.ndltd.org:TW/092YUNT5031070 |
| Date | January 1992 |
| Creators | 林裕勳, Yuh-Shine Lin |
| Contributors | 洪正芳, none |
| Publisher | 雲林科技大學, 工業工程與管理研究所碩士班 |
| Source Sets | National Digital Library of Theses and Dissertations in Taiwan |
| Language | 中文 |
| Detected Language | English |
| Type | 碩士 |
| Format | 88 |
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