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題名:醫病關係之三元效能模式:病患參與、醫病關係滿意度的意涵
作者:陳靜誼 引用關係
作者(外文):Ching-I Chen
校院名稱:國立高雄第一科技大學
系所名稱:管理學院博士班
指導教授:徐世同
學位類別:博士
出版日期:2017
主題關鍵詞:自我效能他人效能關係推論效能醫病關係病患參與relation-inferred self-efficacypatient-physician relationshippatient participationother-efficacyself-efficacy
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病患參與在醫療照護服務過程與結果,扮演著關鍵的角色。近期的理論與實證研究指出,人際關係中所產生的效能信念可能對病患行為具重要意涵。Lent 與 Lopez (2002) 提出的關係效能信念之三元概念模式,說明在特定的成對關係中,個人不僅會發展出對自我能力的評估之外,亦可能對重要他人或合作夥伴產生關係效能信念。近年來,此模式已在體育、運動與教育情境的研究顯示,能促進瞭解人際互動的社會認知與行為結果。然而,過去關係效能信念在醫病關係的研究則付諸闕如,亦甚少同時考量醫病關係間所產生的關係效能信念對病患參與、醫病關係滿意度的影響。故本研究採顧客共創價值的重要概念,結合關係效能信念之三元概念模式,探究其對病患參與、醫病關係滿意度的影響,並驗證病患參與在關係效能信念與醫病關係滿意度間的中介效果。本研究以南部某地區醫院之婦科門診病患及其主治醫師為研究對象,共計117對有效配對樣本;以Smart PLS 2.0 進行模型分析及假說驗證。本研究在整體結構模式顯示,自我效能與他人效能正向影響病患參與;病患參與正向影響醫病關係滿意度。病患參與分別在自我效能、他人效能、關係推論效能與醫病關係滿意度間,具部分中介效果。本研究建議醫療機構管理者在擬定病患參與的策略時,可結合關係效能信念,以提升醫病關係滿意度。
Patient participation in health care is critical to forming the outcomes of a service encounter. Recent theoretical and empirical evidence indicates that the network of efficacy perceptions that exists within interpersonal contexts may have important implications for patient participation. Specifically, in their tripartite efficacy model, Lent and Lopez (2002) articulated that individuals develop a complementary pattern of efficacy beliefs within close interpersonal exchanges, comprising perceptions regarding their significant other as well as themselves.Within sport, exercise, and educational contexts, the tripartite efficacy model has been shown to provide insight into the social cognitions that promote effective interpersonal interactions. To date though, the potential implications of this framework have not received empirical attention in one-to-one patient-physician relationship. Guided by theory (Lent & Lopez, 2002) and existing tripartite efficacy research, this study expects that tripartite efficacy influences patient participation, leading to clinical satifaction. It also examines the mediating effect of patient participation between tripartite efficacy and perceptions of the satisfaction with the patient-physician relationship.
A sample of 117 patient-physician dyads were collected from outpatients of a local hospital in southern Taiwan. The data were analyzed with the partial least squares procedures. Empirical results confirm that self-efficacy and other-efficacy displayed positive direct effects on patient participation, as well as indirect effects in relation to perceptions of the satisfaction with the patient-physician relationship. Higher levels of participation improve patient perceptions of the satisfaction with the patient-physician’s co-produced service experience. Implications of this research focus hospital managers on designing services enhancing efficacy strategies that leveraging the sources of the tripartite efficacy constructs may help bolstering patient participation and thus improve perceptions of the satisfaction with the patient-physician relationship.
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