| 摘要: | 本研究旨在於瞭解門診四癌篩檢提示完成率低落的原因及介入改善方案後的成效，本研究以台北市某區域教學醫院門診醫師30名、護理人員84名及門診病人93名為研究對象，進行提升四癌篩檢提示完成率研究，活動期間2015年8月至2015年12月止，及2016年1至2月改善後效果分析研究。
本研究蒐集相關影響四癌篩檢提示完成率的資料，提出影響四癌篩檢提示完成率四大主要構面(1)門診醫師(2)護理師(3)病人(4)環境流程。護理人員部分找出(1) 診間太忙碌，無法顧及太多政策。(2)獎賞得誘因不大，沒有動力。醫師部分找出(1) 擔心推動篩檢影響看診速度(2) 病人太多，無法顧及太多政策。(3) 不熟悉作業方式，常需同仁協助。病人部分找出(1) 自覺已經活夠了不須做檢查。(2) 不方便填寫資料。(3) 擔心篩檢的結果是不好。環境流程部分找出(1) 檢查需要另外約時間再來，病人常忘記或不想出門(2) 夜診缺乏癌症篩檢。(3)需要繞幾個地方檢察，沒人帶很困擾。
研究結果:門診提示完成率由改善前10.75%至改善後15.88%，提升了5.13%，期能提供臨床醫療單位參考，使醫院端四癌篩檢能廣泛被民眾接受。
This study was aimed at understanding the reasons of why four referral cancer screening prompt completion rates (4CSRs) were low, and in further tried to improve the effectiveness after intervention programs implementation. In this study, we took 30 clinicians, 84 nurses, and 93 outpatients as research samples in a regional teaching hospital in Taipei. The period of this study was during in Aug. to Dec., 2015, and analyzed the improvement performance of the project during Jan. to Feb., 2016.
This study collected relevant data about the influence of 4CSRs into 4 dimensions: (1) clinicians; (2) nurse; (3) patients, and (4) process. First, the study found that the main reasons for the nurses were: the process of diagnosis was too busy to take much time following the policy of 4CSRs. Besides, there was too little incentive rewards to motivate complete 4CSRs. Secondly, the main reasons of physician were: (1) trepidation of late medical procedures by 4CSRs; (2) there were so much patients that cannot take too much time following the policy of 4CSRs, and (3) not familiar with the practices of 4CSRs, which require the assistance of co-workers. Third, the main reasons of patient were: (1) had been conscious enough to live and did not have to check; (2) was not convenient to fill in the information, and (3) worried about the bad results of 4CSRs. Finally, the main reasons of process were: (1) need for additional time to come about, the patient often forgot or don’t want to do; (2) lack of evening clinics for 4CSRs, and (3) confused by requiring several places around the prosecution.
The results after improvement by the present study found that 4CSRs from 10.75 to 15.88%, and 5.13% to enhance. The study expected such a result can provide reference clinical units; so that the 4CSRs can be widely accepted by public in hospitals. |
