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患者感知期望差距分析在心胸外科护理质量管理中的应用

Analysis of the Gap between Patient Perceptions and Expectations of Nursing Quality in Cardiothoracic Surgery
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摘要 目的分析心胸外科患者护理质量的"感知-期望差距"来源,探讨重要性-感知绩效模型在提高护理质量中的应用价值。方法利用护理质量问卷,对160例患者进行调查,分析患者入院时、出院时对相关护理项目评价的差异,采用IPA模型对护理项目进行"重要性-绩效性"划分。结果 (1)入院时,患者对响应性护理质量的总体期望值最高,其次依次为可靠性、保证性、有形性、移情性。(2)患者年龄越大、文化程度越高,移情性期望值就越低;自理程度越低,保证性期望值就越高。(3)出院前,患者对可靠性护理质量的总体感知值最高,其次依次为移情性、保证性、响应性、有形性。(4)女性对保证性护理质量的感知值显著高于男性;20~40岁患者感知值显著高于其他年龄段患者。(5)患者对其余护理项目质量的感知值均显著低于入院时的期望值,表明大多数临床护理项目并未完全达到患者心理预期。结论胸外科患者对护理质量的期望值普遍较高,但目前的护理质量与患者期望仍有一定差距。利用IPA模型可对护理项目进行"重要性-绩效性"评价分层,有助于针对性地提高护理质量。 Objective To analyze the source of"perception-expectation gap"of nursing quality in patients of cardiothoracic surgery,and to explore the effect of Importance-Performance Analysis(IPA)in improving nursing quality.Method A nursing quality scale was conducted on 160 patients.The differences in patients'evaluation of nursing services at admission and at discharge were analyzed.The IPA model was used to stratify the"importanceperformance"of the nursing services.Results(1)At admission,patients had the highest overall expectation of responsive care quality,followed by reliability,assurance,tangibility,and empathy.(2)The older the patient,the higher the level of education,the lower the expectation of empathy.The lower the degree of self-care,the higher the guaranteed expectation.(3)Before discharge,patients had the highest overall perception of reliability care quality,followed by empathy,assurance,responsiveness and tangibility.(4)Women had higher perception of guaranteed care quality than men;the perception of patients aged 20-40 was significantly higher than that of other age groups.(5)Patients'perception of nursing quality of the remaining care services was significantly lower than the expectation at admission,indicating that most clinical care programs did not fully meet the patients'psychological expectations.Conclusion The expectation of quality of care in patients with thoracic surgery is generally at a high level,but there is still a gap between the current quality of care and patients'expectations.The IPA model can be used to stratify the"importance-performance"evaluation of nursing services,which helps to improve the quality of care in a targeted manner.
作者 陈朝红 CHEN Chao-hong(The First Affiliated Hospital of Wenzhou Medical University)
出处 《医院管理论坛》 2018年第11期39-44,共6页 Hospital Management Forum
关键词 服务质量 差距模型 护理管理 心胸外科 Service quality Gap model Nursing management Cardiothoracic surgery
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