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研究生:許雯綾
研究生(外文):Wen-Ling Hsu
論文名稱:高齡者醫療消費體驗與醫療滿意度之相關性研究-以接受術後加速康復照護模式為例
論文名稱(外文):Correlation between medical consumption experience and medical satisfaction of the elderly-Take Enhanced Recovery After Surgery care model as an example
指導教授:邱怡玟邱怡玟引用關係
指導教授(外文):Yi-Wen Chiu
口試委員:李秋香楊維宏
口試委員(外文):Chiu- Hsiang LeeWei- Hong Yang
口試日期:2023-07-18
學位類別:碩士
校院名稱:中山醫學大學
系所名稱:護理系長期照護碩職專班
學門:醫藥衛生學門
學類:護理學類
論文種類:學術論文
論文出版年:2023
畢業學年度:111
語文別:中文
論文頁數:82
中文關鍵詞:高齡者醫療消費體驗醫療滿意度術後加速康復
外文關鍵詞:elderlymedical consumption experiencemedical satisfactionEnhanced Recovery After Surgery
DOI:10.6834/csmu202300214
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臺灣將於2025年進入超高齡社會,因此高齡族群之醫療需求也日益受到重視與考驗,當其需要外科手術及麻醉介入治療時,卻常因術前禁食時間過長、體液補充不平衡、手術期低體溫、術後傷口疼痛等因素而延緩下床,或因相關併發症或感染等,進而影響其出院時間、再入院率、醫療品質及滿意度,因此提供高齡長者適當、快速恢復及高品質的手術醫療,成為現今醫療服務的主要目標。本研究的目的為探討使用「術後加速康復」照護模式之高齡手術患者的醫療消費體驗與醫療滿意度相關性,採橫斷式研究設計,以自擬式問卷調查方式進行資料蒐集。研究結果顯示,高齡者對ERAS的醫療消費體驗和醫療滿意度均為中高程度,經濟狀況與整體醫療消費體驗及其五個構面均呈顯著差異,而年齡僅與醫療消費體驗之感官構面具有顯著差異;此外,婚姻狀況、經濟狀況與高齡者的醫療滿意度亦存在顯著的差異性,且高齡者的醫療消費體驗與醫療滿意度之間存在著顯著正相關,即醫療消費體驗越好,醫療滿意度越高。本研究結果能瞭解接受「術後加速康復」照護模式之高齡長者對手術全期的醫療消費體驗感受及醫療滿意度,並可作為日後提供高齡者手術全期醫療照護之參考。
Taiwan will enter a super-aged society by 2025, and the medical needs of the elderly population are increasingly receiving attention and challenge. When they need surgery and anesthesia intervention, they often delay getting out of bed due to factors such as prolonged preoperative fasting time, fluid imbalance, perioperative hypothermia, postoperative wound pain, etc., or due to related complications or infections, which affect their discharge time, readmission rate, medical quality and satisfaction. Therefore, providing appropriate, rapid recovery and high-quality surgical care for the elderly has become the main goal of current medical services. The purpose of this study is to explore the correlation between medical consumption experience and medical satisfaction of elderly surgical patients using the “Enhanced Recovery After Surgery” (ERAS) care model. A cross-sectional study design was adopted and data were collected by a self-designed questionnaire survey. The results showed that the elderly had a medium-high level of medical consumption experience and medical satisfaction with ERAS. There were significant differences in economic status and overall medical consumption experience and its five dimensions, while age only had a significant difference with the sensory dimension of medical consumption experience. In addition, there were significant differences in marital status, economic status and medical satisfaction of the elderly, and there was a significant positive correlation between medical consumption experience and medical satisfaction of the elderly, that is, the better the medical consumption experience, the higher the medical satisfaction. The results of this study can understand the medical consumption experience and medical satisfaction of the elderly who receive the “Enhanced Recovery After Surgery” (ERAS) care model throughout the surgical period, and can serve as a reference for providing surgical care for the elderly in the future.
目 錄
謝誌 I
中文摘要 III
ABSTRACT IV
目 錄 V
表 次 VIII
圖 次 IX
第壹章 緒論 1
第一節 研究背景與動機 1
第二節 研究目的 4
第三節 研究假說 4
第四節 名詞定義 5
第貳章 文獻探討 8
第一節 高齡病患麻醉與手術的風險與復原力 8
第二節 手術全期照護與ERAS照護模式發展現況 11
第三節 醫療消費體驗與其影響因素 17
第四節 醫療滿意度與其影響因素 21
第五節 醫療消費體驗與醫療滿意度之相關研究 23
第參章 研究方法 26
第一節 研究設計與架構 26
第二節 研究對象 27
第三節 研究工具 29
第四節 信度與效度 30
第五節 研究流程 32
第六節 資料處理與分析 33
第七節 研究倫理 34
第肆章 研究結果 35
第一節 接受ERAS照護模式之高齡者特質 35
第二節 高齡者的醫療消費體驗 37
第三節 高齡者的醫療滿意度 41
第四節 高齡者個人特質與醫療消費體驗的差異性 43
第五節 高齡者個人特質與醫療滿意度的差異性 47
第六節 高齡者醫療消費體驗與醫療滿意度的相關性 48
第伍章 討論 49
第一節 高齡者在ERAS照護模式之醫療消費體驗 49
第二節 高齡者在ERAS照護模式之醫療滿意度 52
第三節 高齡者醫療消費體驗與醫療滿意度之相關性 54
第陸章 結論與建議 57
第一節 研究結論 57
第二節 研究應用與建議 59
第三節 研究限制 64
參考資料 66
一、 中文部分 66
二、 英文部分 70
附錄 76
附錄一 研究問卷 76
附錄二 專家效度名單 81
附錄三 IRB研究計畫許可書 82

表 次

表3-1問卷之信效度分析 31
表3-2資料統計方法 33
表4-1受訪者之個人特質 36
表4-2醫療消費體驗得分及排序 40
表4-3醫療滿意度得分及排序 42
表4-4個人特質與醫療消費體驗總得分之差異分析 45
表4-5個人特質與醫療消費體驗各構面之分析 46
表4-6個人特質與醫療滿意度總分之差異分析 47
表4-7醫療消費體驗與醫療滿意度之相關性 48


圖 次

圖 3-1研究架構圖 26
圖 3-2 G*POWER VERSION統計軟體推估計算樣本數 27
圖 3-3 研究流程 32
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