博碩士論文 etd-0525114-214226 詳細資訊


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姓名 鄭勝峯(Sheng-Fong Jeng) 電子郵件信箱 E-mail 資料不公開
畢業系所 高階經營碩士班(EMBA)
畢業學位 碩士(Master) 畢業時期 102學年第2學期
論文名稱(中) 醫療從業人員的專業承諾與通報意願之關係
-以自尊為干擾變數
論文名稱(英) The Association among Medical Staffs’ Professional Commitment, Self-esteem and Intention to Report Incident
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    摘要(中) 台灣病人安全通報系統以非強制的,鼓勵的方式導入於各醫療機構,通報過程中,採取匿名、自願、保密、不究責與共同學習五大宗旨鼓勵從業人員,藉由不良醫療事件的統計與分析,可做為臨床單位監控照護品質的指標及避免類似事件重覆發生,以提升醫療服務品質。依據約束力分為強制性通報及自主性通報,方式包括通報自己或通報他人。針對本研究探討醫療從業人員的專業承諾與通報意願的關聯性假設驗證結果,以及加入醫療從業人員的自尊進行調節後專業承諾與通報意願的關聯性假設驗證結果加以彙整說明。
    本研究樣本取自北台灣一家區域醫院,採橫斷面研究設計與問卷調查法收集資料。受測者為院內臨床醫療人員,包含醫師、醫技與護理人員,回收有效問卷170 份。本研究使用SPSS 10 軟體呈現人口統計變數分佈、各構念間相關、及迴歸分析,測量具有足夠的信度。本研究將採用描述性統計、t-test、ANOVA、Pearson相關分析瞭解樣本特徵、研究變項在樣本特徵上是否具有差異,以及運用階層迴歸分析驗證所有假說,藉由階層迴歸模式進行分析。
    本研究顯示,醫療從業人員的專業承諾,對其通報意願為顯著的正向影響,顯示醫院從業人員對自我專業承諾越高,將越有意願進行病人安全通報。加入自尊進行調節後,對於通報意願並不會有無顯著的正向關係。當醫療從業人員的專業承諾加入自尊之後,對其通報自己的意願並不會有顯著的正向關係。從業人員的專業承諾加入自尊之後,對其通報他人的意願為顯著的負向影響,顯示自尊較其他專業人員高,其病人安全通報的意願將比自尊較低的同仁為低。藉以協助醫療機構作為提升醫療從業人員進行病人安全通報參考之依據,除了可以從醫療從業人員的教育訓練方向加強外,亦可以藉由動機激勵的角度,設計病人安全通報流程與獎勵措施。希望對醫療機構及病人安全推動人員在病人安全通報工作上有所幫助,並作為後續研究之參考方向。
    摘要(英) Since 2004, Taiwan Patient’s Safety Reporting System (TPR) was gradually adopted by hospitals. The perspective of individual behaviors such as professional commitment, self-esteem has seldom been adopted in previous studies when addressing the determinants for intention of medical staffs, such as physicians, nurses and technicians to report patient safety events. Furthermore, most previous studies do not distinguish between the intention of reporting self-related events and that of reporting others-related events. Therefore, this study discusses the determinants of the intention to report self-related and others-related patient safety events, and regulated by self-esteem in terms of the theory of reasoned action. The survey questionnaires are from 170 medical staffs. The hierarchical regression modeling will be used to test the research hypotheses. Analytical results indicate that professional commitment is positively linked to the intention to report self-related events. The perceived effect of reporting, self-esteem is positively related to both the intention to report self-related and others-related events. Finally, this study expects to complement the theory of safety climate, and construct the new model of education for safety climate-performance relationship in the adoption of more friendly medical information system. Practically, these hospitals could refine the safety practice based on the condition of TPR usage and safety awareness.
    關鍵字(中)
  • 專業承諾
  • 病人安全
  • 通報意願
  • 自尊
  • 關鍵字(英)
  • Patient’s safety
  • Intention of reporting events
  • Self-esteem
  • Professional commitment
  • 論文目次 論文審定書 i
    誌謝 ii
    摘要 iii
    Abstract iv
    第一章、研究背景與動機 1
    第一節、研究背景與動機 1
    第二節、研究目的 8
    第三節、研究流程 10
    第二章、文獻探討 12
    第一節、專業承諾 12
    第二節、自尊 17
    第三節、通報意願 20
    第四節、專業承諾與通報意願 22
    第五節、專業承諾、自尊與通報意願 23
    第三章、研究設計 24
    第一節、研究架構 24
    第二節、研究模式 25
    第三節、研究方法 26
    第四章、實證分析 29
    第一節、樣本基本資料分析 29
    第二節、人口統計分析 33
    第三節、專業承諾對通報意願之影響 37
    第四節、自尊的干擾效果 42
    第五章、結論與建議 45
    第一節、結論 45
    第二節、研究限制 46
    第三節、管理意涵 46
    參考文獻 49
    附錄-醫院安全相關實務與工作狀況 問卷 49
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    三、網路
    Institute of Medicine. (1999) . To Err Is Human: Building a Safer Health System, Committee on Quality of Health Care in America, http://www.ahrq.gov/, accessed from http://archive.ahrq.gov/news/newsroom/press-releases/2008/psoact.html. at 2014.4.21.
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    財團法人醫院評鑑暨醫療品質策進會,病人安全資訊網,2014,http://www.patientsafety.mohw.gov.tw/,擷取於2014年4月20日。
    www.tpr.org.tw/.../台灣病人安全通報系統2012年度報表
    www.patientsafety.mohw.gov.tw/big5/content/Content.asp?cid.
    台灣病人安全通報系統,2014,http://www.tpr.org.tw,擷取於2014年4月20日。
    口試委員
  • 盧淵源 博士 - 召集委員
  • 郭倉義 博士 - 委員
  • 梁慧玫 博士 - 指導教授
  • 蔡憲唐 博士 - 指導教授
  • 口試日期 2014-05-30 繳交日期 2014-07-08

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