| 摘要: | 本研究目的在了解個案醫院病人流失的原因，期能作為醫院決策者及院方團隊了解掌握糖尿病病人之參考，共同提升糖尿病病人照護品質。
本研究為橫斷性研究，以個案醫院之加入糖尿病照護網之病人為對象，研究內容包含質性及量性研究。質性方面，於2009年3月及6月各進行一次焦點團體的訪談，對象分別為流失病人以及糖尿病工作小組人員，深入了解流失病人及糖尿病工作小組對於此個案醫院病人流失看法及因應措施。量性方面，利用郵寄問卷之方式，發放600份問卷，其中包含流失病人300份以及繼續個案醫院就在診病人300份，以電話逐一催收300位流失病人之問卷，而在繼續就診之病人是拜託醫療人員之提醒催收，在多方努力下使總回收問卷份數為97份，其中包含繼續在診病人52份以及流失病人45份。
本研究主要結果分為四方面，個人特質方面，流失病人自認為未領取「糖尿病護照」情形低於繼續在診病人，且流失病人持續至個案醫院其他科別就診情形較低。自我照顧活動方面，流失病人自我照顧活動總分、特殊飲食、運動、未抽菸情形顯著高於繼續參與者。疾病認知方面，流失病人飲食、服用藥物方面疾病認知程度顯著高於繼續參與者。醫療服務滿意度方面，流失病人在醫療服務滿意度方面皆顯著低於繼續參與者，代表流失病人對於此個案醫院有不滿之處可能容易使病人轉換其他醫療院所。
本研究提出下列建議，對於對醫療人員及醫院管理者可加強對參加照護網病人每人皆有發放登入之「糖尿病護照」之重要性說明，以及與病友團體建立合作關係，舉辦相關疾病課程，在流程面可提供「衛教」、「營養」課程採預約制、「衛教」、「營養」課程內容採亦可採需求個別化。對於後續研究者建議可以進一步了解糖尿病人需求、進行糖尿病病人與醫護關係分析以及區域性糖尿病照護網病人流失情形。
The purpose of this study was to find out the reasons of patient drop-out so that they could be the reference for decision makers of hospital and management team in order to improve the care quality of Diabetes patients.
The study was the cross-sectional study and the patients were recruited from the Diabetes Share Care Network (DSCN) of the case hospital. Its content was including qualitative study and quantitative study. In qualitative aspect, focus group interviews were executed in March and June 2009 respectively. The participants were drop-out patients and staff of DSCN providers. The objectives of this task were to greatly find out the opinions of patients and staff toward drop-out as well as its counter actions.
In quantitative study, 600 copies of questionnaire, 300 copies of drop-out patients and the other 300 copies of going-on patients were mailed by post. Drop-out questionnaires were traced one-by-one via the phone call while going-on ones were noticed via the health care providers of the hospital to increase the response rate. Totally 97 copies were collected.
The study had four major findings. When compared with the going-on patients, the drop-out patients themselves stated less“Diabetes passport”alse less visited other departments in the hospital. In self-care activities, the total scores of self-care activities, special diet, exercise and non-smoking, the drop-out group was significantly higher than the going-on one. In the recognition of disease, compared with the going-on group, the drop-out one showed significantly higher recognition in diet and medicine intake. In the satisfaction of healthcare service, the scores of the drop-out group was significantly lower than the going-on one and it implied that the drop-out group could change to other hospitals easily once they were not satisfied by the healthcare service of the hospital.
The following suggestions were concluded by the study. For health care perfessinals, the importance of “Diabetes passport”should be emphasized and improved and the collaboration with the patient groups, like the disease introduction, must be established. In process, health education and nutrition introduction programs are suggested by in-advance registration and their contents can be customized by individual needs. Moreover, it is suggested for the further researchers to understand further more on the needs of Diabetes patients, the analysis of the relationship between Diabetes patients and healthcare provider, and the profile of drop-out patients in different regional Diabetes care networking. |
