多面向远距照护评估量表之发展-技术.docVIP

PAGE PAGE 19 多面向遠距照護評估量表之發展-技術、社會心理、管理的整合觀點 蔡宗宏a莊碧焜b a慈濟技術學院醫務管理系 b竹山秀傳醫院 摘要 近年來，資訊通信科技與生物醫學技術的快速發展，使得全球各國逐漸地重視應用遠距醫療技術以增進或擴展現今病患照護與服務，稱之為遠距照護。然而，近年來有關遠距照護之學術論述，率多注重技術的發展與系統的建構，鮮少以病患或顧客的角度，針對遠距照護的服務過程，進行全面性與通盤性的評估與測量，以致於無法發掘高齡者的真正需求或問題所在，在臨床的應用上有其侷限，並造成知識發展上之障礙。 本研究透過回顧歷來重要之遠距醫療與遠距照護的文獻，簡述其演進過程。並針對效能評估的議題，進行深入的探討，歸納整理評估或測量的面向，界定為三大面向與八個指標，分別為技術面：包括系統品質，社會心理面：體制信任與隱私風險，管理面：服務品質、成本效益、滿意程度、使用意向、健康影響等。本研究之研究對象係以台灣中部曾經使用遠距照護系統的某鄉村社區居民為調查樣本，以訪員面訪方式進行調查，共獲得210份有效問卷。本研究發展之本土中文化多面向評估量表，預試問卷原為29題，經過相關之心理計量考驗之後，刪除3題，最後版本共計26題項。量表經過探索性因素分析與驗證性因素分析後，確定為八個因素，符合原預期之八個指標，並可解釋77.870%的解釋量。本量表證實具有良好信度與效度，確立了量表之適切性與可行性，可做為未來進一步研究之基礎。期望藉由本文之探討，激發學術理論與臨床實務的深入之探究與洞見，共同型塑與創造在地「安全、安心、安老」的照護網絡之美好願景。 關鍵詞：遠距醫療、遠距照護、體制信任、隱私風險 The Development of Multi-Dimensions Scale for Evaluating the Effectiveness of Telecare : Technological-Social Psychological-Managing Perspectives Chung-Hung Tsaia Bi-Kun Chuang b Department of Health Administration, Tzu Chi College of Technologya MD, Medical Deputy Superintendent, Chu Shang Show Chwan Hospital b Abstract Recently, advances in information and communication technology as well as biomedical technology have introduced numerous ways of telemedicine technology to enhance or expand the services and care provided to patients, that is, telecare. However, most telecare studies focused only on the development of technology rather than on comprehensive evaluation of patients’ (or customers’) perception about service processes. Therefore, it’s very difficult to understand the elderly population’s actual needs and problems, limiting the clinical implementation of the findings and presenting barriers to knowledge development. This article reviews important literatures on telemedicine and telecare, discusses deeply the issue of evaluating the effectiveness of such technology. The three key dimensions and eight sub-indictors have been identified. That is, technological dimension, including system quality; social psychological dimension, including institutional trust