Department of Nursing, National Taiwan University Hospital, No. 7 Zhongshan South Road, Taipei, 10002, Taiwan.
Department of Nursing, National Taipei University of Nursing and Health Science, No. 365, Ming-Te Road, Pei-Tou District, Taipei, 11219, Taiwan.
BMC Health Serv Res. 2020 Sep 29;20(1):908. doi: 10.1186/s12913-020-05764-8.
Assessing patients' expectations and perceptions of health service delivery is challenging. To understand the service quality in intensive care units (ICUs), we investigated the expected and perceived service quality of ICU care.
We conducted this study at an ICU of a university-affiliated medical center in Taiwan from April to September 2019. Admitted patients or their family members responded to a questionnaire survey adopted from the SERVQUAL instrument consisting of 22 items in five dimensions. The questionnaire was provided on ICU admission for expectation and before ICU discharge for perception. We analyzed the quality gaps between the surveys and applied important-performance analysis (IPA).
A total of 117 patients were included (62.4% males, average age: 65.9 years, average length of stay: 10.1 days, and 76.9% survival to ICU discharge). The overall weighted mean scores for the surveys were similar (4.57 ± 0.81 and 4.58 ± 0.52, respectively). The 'tangibles' dimension had a higher perception than expectation (3.99 ± 0.55 and 4.31 ± 0.63 for expectation and perception, respectively, p < 0.001). IPA showed that most of the items in 'reliability,' 'responsiveness' and 'assurance' were located in the quadrant of high expectation and high perception, whereas most of the items in 'tangibles' and 'empathy' were located in the quadrant of low expectation and low perception. One item (item 1 for 'tangibles') was found in the quadrant of high expectation and low perception.
The SERVQUAL approach and IPA might provide useful information regarding the feedback by patients and their families for ICU service quality. In most aspects, the performance of the ICU satisfactorily matched the needs perceived by the patients and their families.
评估患者对医疗服务提供的期望和看法具有挑战性。为了了解重症监护病房（ICU）的服务质量，我们调查了 ICU 护理的预期和感知服务质量。
我们于 2019 年 4 月至 9 月在台湾一家大学附属医院的 ICU 进行了这项研究。入住患者或其家属回答了一份从 SERVQUAL 工具中采用的问卷，该问卷包含五个维度的 22 个项目。问卷在 ICU 入院时用于期望调查，在 ICU 出院前用于感知调查。我们分析了调查之间的质量差距，并应用了重要绩效分析（IPA）。
共纳入 117 例患者（62.4%为男性，平均年龄为 65.9 岁，平均住院时间为 10.1 天，76.9%存活至 ICU 出院）。调查的总体加权平均得分相似（分别为 4.57±0.81 和 4.58±0.52）。“有形性”维度的感知得分高于期望得分（期望和感知分别为 4.31±0.63 和 3.99±0.55，p<0.001）。IPA 显示，“可靠性”、“响应性”和“保证性”大部分项目位于期望和感知均较高的象限，而“有形性”和“同理关怀”大部分项目位于期望和感知均较低的象限。一个项目（“有形性”的第 1 项）位于期望和感知均较高的象限。
SERVQUAL 方法和 IPA 可能为患者及其家属提供有关 ICU 服务质量的反馈信息。在大多数方面，ICU 的表现符合患者及其家属感知到的需求。
