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研究生:童小綺
研究生(外文):Hsiao-Chi Tung
論文名稱:胃腸科住院病童家屬之溝通滿意度與疾病知識對遵醫囑行為之影響
論文名稱(外文):The Effects of Caregivers' Communication Satisfaction and Disease Knowledge on Compliant Behaviors in Department of Pediatric Gastroenterology.
指導教授:曾旭民曾旭民引用關係
學位類別:碩士
校院名稱:長庚大學
系所名稱:醫務管理學研究所
學門:商業及管理學門
學類:醫管學類
論文種類:學術論文
論文出版年:2004
畢業學年度:92
語文別:中文
中文關鍵詞:遵醫囑行為溝通滿意度疾病知識兒童胃腸科
外文關鍵詞:Compliant BehaviorsCommunication SatisfactionDisease KnowledgeDepartment of Pediatric Gastroenterology
相關次數:
  • 被引用被引用:3
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  • 收藏至我的研究室書目清單書目收藏:6
研究背景與動機:兒科醫療照護有其特殊性,病童家屬的遵醫囑行為特別重要,兒童胃腸科更是兒童內科中重要的一環。研究目的:本研究目的在探討胃腸科住院病童家屬與醫護人員之溝通滿意度、疾病知識對遵醫囑行為之影響。研究方法:收案對象為北部某醫學中心兒童胃腸科病房住院滿24小時病童之陪病家屬,病童限定0-12歲,家屬限定為女性,以問卷調查方式收集資料,共得有效研究對象200位。研究工具方面,包括家屬與醫護人員溝通滿意度量表、小兒腸胃炎疾病知識量表、及家屬照護行為自評量表。其中家屬與醫護人員溝通滿意度量表經因素分析後三因子命名為「內容及可近性」、「溝通對象信任程度」、及「過程內心感受」。此外亦收集家屬I/O記錄分數、護理人員評分遵從性、及出院返回門診追蹤情形等病童家屬遵醫囑行為指標。研究結果與結論:研究結果發現,影響家屬與醫護人員溝通滿意度之因素包括:是否住於胃腸科次專科病房、醫護人員主動告知資訊項目多寡、及家屬有力人士控制信念,影響疾病知識之因素為家屬教育程度。影響家屬遵醫囑行為之因素分成兩部分討論: (一)影響家屬照護行為自評分數之因素為家屬年齡,41歲以上與31-40歲的家屬之照護行為自評分數較30歲以下的家屬佳,且溝通對象信任程度與照護行為自評呈正相關。(二)影響家屬I/O記錄分數之因素為家屬疾病知識,疾病知識分數較高的家屬,其I/O記錄分數較高。另外在探討家屬遵醫囑行為對病童住院日數的影響時發現,照護行為自評分數較高的家屬,其病童平均住院日較短,但I/O記錄分數較佳的家屬,其病童平均住院天數較長(但皆無統計上顯著差異)。綜合結果說明家屬之溝通滿意度與疾病知識會影響到其遵醫囑行為,因此醫護人員應提昇衛教資訊的利用性並主動告知家屬病童疾病相關資訊,可提高家屬之溝通滿意度與疾病知識,進而增進其遵醫囑行為。

Background:Caregivers’ compliant behaviors are important for young inpatients in the department of pediatric gastroenterology. It is therefore important to understand what factors inlfuence caregivers’ compliant behaviors so that the clinicians can help to improve the quality of care for young inpatients. Objective: The purpose of this study is to investigate how communication satisfaction and disease knowledge of parental caregivers in pediatric gastroenterology relate to their compliant behaviors. It is hypothesized that caregivers with better medical communication satisfaction and equipped with disease knowledge will have more compliant behaviors. Methods: A total of 200 volunteered inpatients’ cargivers were recruited from the department of pediatric gastroenterology in a medical center. Self-administered questionnaires used in this study included Communication Satisfaction Sacle, Acute Gastroenteritis Disease Knowledge Scale, and Compliant Behavior Scale. Factor analyses were applied to reduce the components of these questionnaires. Three components for the communication satisfaction questionnaire were extracted and defined as Communicative Content and Accessibility, Trust Degree of Communicative Object, Feeling in Communicative Process. In addition, objective compliant indicators were collected which included caregivers’ I/O record score, nurse clinical judgment score, and keeping appointment rate. Results and Conclusions: The resutls reveal that caregivers’ communication satisfaction is significantly influenced by enrollement in the gastroenterology ward, the amount of medical information given by medical staffs, and caregivers’ health locus of control in powerful others. The reuslts of factors accounting for caregivers’ compliance behaviors suggest that more compliant behaviors are self-reported by the caregivers aged above 30 and had better trust with medical staffs. The.caregivers’ I/O record score is significantly influenced by disease knowledge. Caregivers with higher compliance behaviors appear to reduce the inpatients’ length of stay, however the difference does not reach statistic significance. In conclusion, caregiver’s communication satisfaction, disease knowledge, and compliant behaviors are interrelated. It is therefore important for healthcare providers and medical staffs to improve how to deliver health education and information to caregivers efficiently.

目 錄
誌謝.......................................................v
中文摘要...................................................vi
英文摘要...................................................vii
第一章 緒論...............................................1
第二章 文獻探討...........................................3
第一節 兒科照護過程中家屬之重要性 3
第二節 遵醫囑行為 5
第三節 兒童胃腸科遵醫囑行為的評估方法 12
第四節 與醫護人員的溝通滿意度 17
第五節 疾病知識 21
第六節 文獻總結 24
第三章 研究方法..........................................25
第一節 研究架構 26
第二節 研究對象 27
第三節 研究工具 29
第四節 研究步驟 36
第五節 資料分析方法 39
第四章 結果..............................................41
第一節 住院病童及陪病家屬的基本資料 41
第二節 家屬與醫護人員的溝通滿意度 42
第三節 家屬的疾病知識 46
第四節 家屬的遵醫囑行為 49
第五章 結論與建議........................................55
第一節 研究結果討論 55
第二節 研究限制 60
第三節 建議 61
參考文獻..................................................63
中文參考文獻 63
英文參考文獻 67
附錄一 知識問卷各題目難易程度分布情形 77
附錄二 家屬參與研究同意書 78
附錄三 兒科病房家屬問卷(正式版) 79
附錄四 問卷使用同意函 83
附錄五 專家效度問卷 84
附錄六 專家效度名單 91
附錄七 專家問卷效度結果 92
圖表目錄
圖一 本研究的研究架構...................................26
圖二 研究步驟及收案流程.................................38
表一 家屬及病童社會人口變項.............................28
表二 溝通滿意度因素的命名及所包含的項目.................31
表三 遵醫囑行為測量工具間的相關性.......................40
表四 住院病童及陪病家屬的基本資料.......................41
表五 社會人口變項對於家屬與醫護人員的溝通滿意度之影響...42
表六 醫護人員告知資訊項目分布情形.......................43
表七 醫護人員告知資訊項目多寡與家屬的溝通滿意度.........44
表八 疾病知識有力人士控制信念及人際支持對溝通滿意度影響.45
表九 社會人口變項對於家屬疾病知識之影響.................46
表十 家屬接受資訊來源是否有幫助.........................48
表十一 資訊來源是否有幫助與家屬疾病知識...................48
表十二 基本變項對家屬照護行為自評分數之影響...............50
表十三 基本變項對家屬I/O記錄分數之影響....................50
表十四 家屬溝通滿意度及疾病知識對家屬照護行為自評分數影響.52
表十五 家屬溝通滿意度及疾病知識對家屬I/O記錄分數之影響....53
表十六 家屬的遵醫囑行為對病童住院日數之影響...............54

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