Responsive image
博碩士論文 etd-0715123-140306 詳細資訊
Title page for etd-0715123-140306
論文名稱
Title
以計劃行為理論探討團隊合作對護理人員疾病照護品質認證的看法
Applying the Theory of Planned Behavior to explore Teamwork on nurses' perceptions of quality of Disease Care Certification
系所名稱
Department
畢業學年期
Year, semester
語文別
Language
學位類別
Degree
頁數
Number of pages
65
研究生
Author
指導教授
Advisor
召集委員
Convenor
口試委員
Advisory Committee
口試日期
Date of Exam
2023-07-31
繳交日期
Date of Submission
2023-08-15
關鍵字
Keywords
疾病照護品質認證、計劃行為理論、團隊合作、護理人員、結構方程式模型
Disease Care Certification, Theory of Planned Behavior, Teamwork, Nurses, Structural Equation Model
統計
Statistics
本論文已被瀏覽 36 次,被下載 0
The thesis/dissertation has been browsed 36 times, has been downloaded 0 times.
中文摘要
目的:了解護理人員對疾病照護品質認證的看法,不僅能針對員工的想法改善團隊組織的合作程度,也能作為政策改良的參考。因此本研究探討護理人員對態度、主觀規範、行為控制、團隊合作、意圖對行為的相關性。
方法:本研究採立意取樣方式,以南部某公立醫學中心及與該院合作之醫院之年滿20歲以上、65歲以下護理人員為對象,共收407份問卷,排除重複填寫等無效問卷,共388份有效,有效回收率95.331%,並以SPSS 22及AMOS 28進行效度、信度分析、描述性統計、t檢定、變異數分析、皮爾森相關分析、結構方程式模型及迴歸分析。
結果:根據本研究分析團隊合作對態度、主觀規範、行為控制、行為有正向顯著影響,對意圖無顯著影響;態度、主觀規範、行為控制對意圖有正向顯著影響。
結論:團隊合作的程度能顯著影響成員的態度、主觀規範、行為控制及行為,因此醫院管理者應營造良好的團隊合作氛圍。成員對於參與疾病認證的意圖受到態度、主觀規範以及行為控制的正向顯著影響,在疾病認證的執行實務上應設法強化成員的態度、主觀規範及行為控制,提升成員參與疾病照護品質認證意願。
Abstract
Objective: Understanding nursing personnel's perspectives on disease care quality certification not only allows for improving the level of teamwork within the organization based on employee feedback but also serves as a reference for policy improvement. Therefore, this study aims to explore the association between nursing personnel's attitudes, subjective norms, perceived behavioral control, teamwork, intention, and behavior in relation to Disease Care Certification.
Methods: This study adopted a purposive sampling approach and targeted nursing personnel aged 20 to 65 years from a public medical center in the southern region and its collaborating hospitals. A total of 407 questionnaires were collected, and after excluding invalid responses such as duplicates, 388 valid responses remained, resulting in an effective response rate of 95.331%. Validity and reliability analyses, descriptive statistics, t-tests, analysis of variance (ANOVA), Pearson correlation analysis, structural equation modeling (SEM), and regression analysis were conducted using SPSS 22 and AMOS 28.
Results: According to the analysis of this study, teamwork has a positive and significant impact on attitude, subjective norm, behavioral control, and behavior, but has no significant impact on intention; attitude, subjective norm, and behavioral control have a positive and significant impact on intention.
Conclusion: The degree of teamwork significantly influences members' attitudes, subjective norms, perceived behavioral control, and behavior. Therefore, hospital managers should create a positive team cooperation atmosphere. Attitude, subjective norms, and perceived behavioral control have a significant impact on the intention construct. Members' intention to participate in Disease Care Certification is significantly influenced by positive attitudes, subjective norms, and perceived behavioral control . In the practical implementation of Disease Care Certification, efforts should be made to enhance members' attitudes, subjective norms, and perceived behavioral control, thereby increasing their willingness to engage in Disease Care Certification.
目次 Table of Contents
論文審定書 i
摘要 ii
Abstract iii
目錄 v
圖次 vi
表次 vii
第一章 緒論 1
第一節 研究動機與背景 1
第二節 研究目的 2
第三節 研究流程 3
第二章 文獻回顧與探討 4
第一節 疾病照護品質認證 4
第二節 團隊合作 5
第三節 計劃行為理論 7
第三章 研究方法 9
第一節 研究架構 9
第二節 研究假設 10
第三節 問卷設計與研究對象 11
第四節 研究工具 11
第五節 重要變項定義 13
第六節 統計分析方法 15
第四章 研究結果 21
第一節 描述性統計分析 21
第二節 差異性分析 24
第三節 皮爾森相關分析 32
第四節 結構方程式模型分析 33
第五節 迴歸分析 36
第五章 討論與建議 37
第一節 研究討論 37
第二節 研究結論 41
第三節 研究限制 44
第四節 研究建議 44
第五節 研究貢獻 45
參考文獻 47
附錄一 問卷 54
附錄二 人體試驗委員會同意函 57 
參考文獻 References
中文文獻
史佳慧、潘美連、溫信財、何政勳、李麗惠、王大為,2015。影響醫院醫師及資訊主管電子病歷交換意圖之因素,醫療資訊雜誌,24(4),13-26。
李茂能,2006。結構方程模式軟體 Amos 之簡介及其在測驗編製上之應用: An introduction to Amos and its uses in scale development: Graphics & Basic (Vol. 32),台北:心理出版社。
汪秀玲、關皚麗、蕭元哲、黃俊英,2007。醫師主管對醫院總額管理實務態度之探索性研究,醫務管理期刊,8(4),317-337。
亞東醫院慢性阻塞性肺病疾病照護團隊,2021。亞東醫院慢性阻塞性肺病疾病認證經驗分享,醫療品質雜誌,15(2),52-54。
林秀玲、李玟慧,2017。利用層級分析法探討民眾就醫之選擇,創新研發學刊,13(1),16-28。
邱皓政,2011。結構方程模式: LISREL 的理論, 技術與應用,台北:雙葉書廊。
財團法人醫院評鑑暨醫療品質策進會,2023。疾病照護質量認證簡介。http: https://www.jct.org.tw/cp-148-2576-345ed-1.html
陳俐茹、黃泇心、陳建謀,2022。 物業管理公司主管適任性評量指標之研究,物業管理學報,13(1),47-53。
陳冠宇、黃柏豪、董鈺琪、陳哲維、洪聖惠,2021。參與腦中風「疾病照護品質認證」對急性腦中風病人照護成效之探討,醫療品質雜誌,15(5),52-59。
黃馨慧、陳珮郁、陳乃華、吳堯達、江靜楓、黃仲毅、王拔群、2018。疾病照護品質認證-展現醫療照護新價值,醫療品質雜誌,12(4),4-7。
蔡介文、鄭博文、李玟儀,2020。以TPB理論探討護理人員於病歷隱私認知暨保護的行為意圖-中部某教學區域醫院的實證研究,病歷資訊管理,17(2),1-15。
英文文獻
AbuAlRub, R. F., Gharaibeh, H. F., & Bashayreh, A. E. I. (2012). The Relationships Between Safety Climate, Teamwork, and Intent to Stay at Work Among Jordanian Hospital Nurses. Nursing Forum, 47(1), 65-75. https://doi.org/https://doi.org/10.1111/j.1744-6198.2011.00253.x
Ajzen, I. (1985). From Intentions to Actions: A Theory of Planned Behavior. In J. Kuhl & J. Beckmann (Eds.), Action Control: From Cognition to Behavior (pp. 11-39). Springer Berlin Heidelberg. https://doi.org/10.1007/978-3-642-69746-3_2
Ajzen, I. (1991). The theory of planned behavior. Organizational behavior and human decision processes, 50(2), 179-211.
Ajzen, I. (2002). Constructing a TPB questionnaire: Conceptual and methodological considerations.Retrirvrd from https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=0574b20bd58130dd5a961f1a2db10fd1fcbae95d
Ajzen, I., Joyce, N., Sheikh, S., & Cote, N. G. (2011). Knowledge and the prediction of behavior: The role of information accuracy in the theory of planned behavior. Basic and applied social psychology, 33(2), 101-117.
Appleby, B. E. (2019). Implementing guideline-checklists: Evaluating health care providers intentional behaviour using an extended model of the theory of planned behaviour. Journal of Evaluation in Clinical Practice, 25(4), 664-675. https://doi.org/https://doi.org/10.1111/jep.13075
Armoon, B., Yazdanian, M., Higgs, P., & Nasab, H. S. (2021). Effect of a hospital-based oral health-education program on Iranian staff: evaluating a theory-driven intervention. BMC Medical Education, 21(1), 17. https://doi.org/10.1186/s12909-020-02435-4
Aulawi, H., Sudirman, I., Suryadi, K., & Govindaraju, R. (2009). Knowledge sharing behavior, antecedent and their impact on the individual innovation capability. Journal of Applied Sciences Research, 5(12), 2238-2246.
Baker, D. P., Gustafson, S., Beaubien, J., Salas, E., & Barach, P. (2005). Medical teamwork and patient safety: the evidence-based relation. AHRQ publication, 5(53), 1-64.
Bartlett, M. S. (1937). Properties of sufficiency and statistical tests. Proceedings of the Royal Society of London. Series A-Mathematical and Physical Sciences, 160(901), 268-282.
Bentler, P. M. (1980). Multivariate analysis with latent variables: Causal modeling. Annual review of psychology, 31(1), 419-456.
Bogh, S. B., Blom, A., Raben, D. C., Braithwaite, J., Thude, B., Hollnagel, E., & Plessen, C. v. (2018). Hospital accreditation: staff experiences and perceptions. International Journal of Health Care Quality Assurance, 31(5), 420-427. https://doi.org/10.1108/IJHCQA-06-2017-0115
Cao, Z., Zheng, J., & Liu, R. (2023). Factors Affecting Users’ Continuous Usage in Online Health Communities: An Integrated Framework of SCT and TPB. Healthcare, 11(9), 1238. https://www.mdpi.com/2227-9032/11/9/1238
Chao, C.-T., Chang, C.-I., Wang, P.-C., Chiang, C.-F., Chen, C.-P., Hsu, H.-S., & Hung, K.-Y. (2021). Impact of a kidney-specific disease-specific care certification program on the institutional performance indicators of hospitals caring for patients with chronic kidney disease: A national data analysis [https://doi.org/10.1111/nep.13901]. Nephrology, 26(8), 669-675. https://doi.org/https://doi.org/10.1111/nep.13901
Chau, P. Y. K., & Hu, P. J.-H. (2002). Investigating healthcare professionals’ decisions to accept telemedicine technology: an empirical test of competing theories. Information & Management, 39(4), 297-311. https://doi.org/https://doi.org/10.1016/S0378-7206(01)00098-2
Clements, D., Dault, M., & Priest, A. (2007). Effective teamwork in healthcare: research and reality. HealthcarePapers, 7 Spec No, 26-34. https://doi.org/10.12927/hcpap.2013.18669
Cohen, J. (1992). A power primer. Psychol Bull, 112(1), 155-159. https://doi.org/10.1037//0033-2909.112.1.155
Conner, M., Sandberg, T., & Norman, P. (2010). Using Action Planning to Promote Exercise Behavior. Annals of Behavioral Medicine, 40(1), 65-76. https://doi.org/10.1007/s12160-010-9190-8
Cronbach, L. J. (1951). Coefficient alpha and the internal structure of tests. psychometrika, 16(3), 297-334.
Dionisi, S., Di Simone, E., Franzoso, V., Caldarola, E., Cappadona, R., Di Muzio, F., Giannetta, N., & Di Muzio, M. (2020). The application of the Theory of Planned Behaviour to prevent medication errors: a scoping review. Acta Biomed, 91(6-s), 28-37. https://doi.org/10.23750/abm.v91i6-S.9290
Doll, W. J., Xia, W., & Torkzadeh, G. (1994). A Confirmatory Factor Analysis of the End-User Computing Satisfaction Instrument. MIS Quarterly, 18(4), 453-461. https://doi.org/10.2307/249524
Donaldson, M. S., Corrigan, J. M., & Kohn, L. T. (2000). To err is human: building a safer health system.National Academy Press Washington, D.C.
Duthie, C. (1999). Practice based pharmacists: Do patients and primary healthcare teams benefit. Primary Care Pharmacy, 1(1), 20-21.
El-Jardali, F., Jamal, D., Dimassi, H., Ammar, W., & Tchaghchaghian, V. (2008). The impact of hospital accreditation on quality of care: perception of Lebanese nurses. International Journal for Quality in Health Care, 20(5), 363-371. https://doi.org/10.1093/intqhc/mzn023
Finn, R., Learmonth, M., & Reedy, P. (2010). Some unintended effects of teamwork in healthcare. Social Science & Medicine, 70(8), 1148-1154. https://doi.org/https://doi.org/10.1016/j.socscimed.2009.12.025
Francis, J., Eccles, M. P., Johnston, M., Walker, A., Grimshaw, J. M., Foy, R., Kaner, E. F., Smith, L., & Bonetti, D. (2004). Constructing questionnaires based on the theory of planned behaviour: A manual for health services researchers. Newcastle upon Tyne, UK: Centre for Health Services Research, University of Newcastle upon Tyne.
Frost, K., Stafos, A., Barbay, K., & Henderson, K. (2019). Achieving Disease-Specific Care Joint Commission Certification: The Impact of Clinical Nurse Specialist Practice. Clinical Nurse Specialist, 33(6), 273-278. https://doi.org/10.1097/nur.0000000000000483
Gafa, M., Fenech, A., Scerri, C., & Price, D. (2018). Teamwork in healthcare organisations. Pharmacy Education, 5(2). https://pharmacyeducation.fip.org/pharmacyeducation/article/view/151
Hair, J., Anderson, R., Tatham, R., & Black, W. (1998). Multivariate Data Analysis, 5th Edn Prentice Hall International. Upper Saddle River, NJ.
Hall, P. (2005). Interprofessional teamwork: Professional cultures as barriers. Journal of Interprofessional Care, 19(sup1), 188-196. https://doi.org/10.1080/13561820500081745
Harrison, D. A., Peter P. Mykytyn, J., & Riemenschneider, C. K. (1997). Executive Decisions About Adoption of Information Technology in Small Business: Theory and Empirical Tests. Information Systems Research, 8(2), 171-195. https://doi.org/10.1287/isre.8.2.171
Hewitt, A. M., & Stephens, C. (2007). Healthy eating among 10–13-year-old New Zealand children: understanding choice using the theory of planned behaviour and the role of parental influence. Psychology, Health and Medicine, 12(5), 526-535.
Horne, J., Madill, J., & Gilliland, J. (2017). Incorporating the ‘Theory of Planned Behavior’ into personalized healthcare behavior change research: a call to action. Personalized Medicine, 14(6), 521-529. https://doi.org/10.2217/pme-2017-0038
Hwang, J.-I., Kim, S. W., & Chin, H. J. (2019). Patient Participation in Patient Safety and Its Relationships with Nurses' Patient-Centered Care Competency, Teamwork, and Safety Climate. Asian Nursing Research, 13(2), 130-136. https://doi.org/https://doi.org/10.1016/j.anr.2019.03.001
Jöreskog, K. G., & Sörbom, D. (1996). LISREL 8: User's reference guide. Scientific Software International.
Kaiser, H. F. (1960). The application of electronic computers to factor analysis. Educational and psychological measurement, 20(1), 141-151.
KAYA, N. (2011). Factors Affecting Nurses' Attitudes Toward Computers in Healthcare. CIN: Computers, Informatics, Nursing, 29(2), 121-129. https://doi.org/10.1097/NCN.0b013e3181f9dd0f
Knauder, H., & Koschmieder, C. (2019). Individualized student support in primary school teaching: A review of influencing factors using the Theory of Planned Behavior (TPB). Teaching and Teacher Education, 77, 66-76. https://doi.org/https://doi.org/10.1016/j.tate.2018.09.012
Kupeli, N., Chilcot, J., Schmidt, U. H., Campbell, I. C., & Troop, N. A. (2013). A confirmatory factor analysis and validation of the forms of self-criticism/reassurance scale. British Journal of Clinical Psychology, 52(1), 12-25. https://doi.org/https://doi.org/10.1111/j.2044-8260.2012.02042.x
Liao, H.-H., Wang, P.-C., Yeh, E.-H., Lin, C.-J., & Chao, T.-H. (2020). Impact of disease-specific care certification on clinical outcome and healthcare performance of myocardial infarction in Taiwan. Journal of the Chinese Medical Association, 83(2), 156-163. https://doi.org/10.1097/jcma.0000000000000237
Liberati, E. G., Gorli, M., & Scaratti, G. (2016). Invisible walls within multidisciplinary teams: Disciplinary boundaries and their effects on integrated care. Social Science & Medicine, 150, 31-39. https://doi.org/https://doi.org/10.1016/j.socscimed.2015.12.002
Liu, C.-F., & Kuo, K.-M. (2016). Does information overload prevent chronic patients from reading self-management educational materials? International Journal of Medical Informatics, 89, 1-8. https://doi.org/https://doi.org/10.1016/j.ijmedinf.2016.01.012
McDonald, R. P., & Ho, M.-H. R. (2002). Principles and practice in reporting structural equation analyses. Psychological methods, 7(1), 64.
Morrison, K. (2005). The road to JCAHO disease-specific care certification: a step-by-step process log. Dimens Crit Care Nurs, 24(5), 221-227. https://doi.org/10.1097/00003465-200509000-00009
Mosadeghrad, A. M. (2021). Hospital accreditation: The good, the bad, and the ugly. International Journal of Healthcare Management, 14(4), 1597-1601. https://doi.org/10.1080/20479700.2020.1762052
Pfaff, E., & Huddleston, P. (2003). Does It Matter if I Hate Teamwork? What Impacts Student Attitudes toward Teamwork. Journal of Marketing Education, 25(1), 37-45. https://doi.org/10.1177/0273475302250571
Piccoli, G., & Ives, B. (2003). Trust and the Unintended Effects of Behavior Control in Virtual Teams. MIS Quarterly, 27(3), 365-395. https://doi.org/10.2307/30036538
Polit, D. F., & Beck, C. T. (2006). The content validity index: are you sure you know what's being reported? Critique and recommendations. Research in nursing & health, 29(5), 489-497.
Rosen, M. A., DiazGranados, D., Dietz, A. S., Benishek, L. E., Thompson, D., Pronovost, P. J., & Weaver, S. J. (2018). Teamwork in healthcare: Key discoveries enabling safer, high-quality care. American Psychologist, 73(4), 433.
Ruiz Ulloa, B. C., & Adams, S. G. (2004). Attitude toward teamwork and effective teaming. Team Performance Management: An International Journal, 10(7/8), 145-151. https://doi.org/10.1108/13527590410569869
Şahin, S., & Alp, F. (2020). Agile Leadership Model in Health Care: Organizational and Individual Antecedents and Outcomes. In Agile Business Leadership Methods for Industry 4.0 (pp. 47-68). https://doi.org/10.1108/978-1-80043-380-920201004
Salas, E., Sims, D. E., & Burke, C. S. (2005). Is there a “Big Five” in Teamwork? Small Group Research, 36(5), 555-599. https://doi.org/10.1177/1046496405277134
Sauls, D. J. (2007). Nurses' attitudes toward provision of care and related health outcomes. Nurs Res, 56(2), 117-123. https://doi.org/10.1097/01.NNR.0000263972.54619.4a
Schumacker, R. E., & Lomax, R. G. (2004). A beginner's guide to structural equation modeling. psychology press. .New Jersey London.
Sentosa, I., & Mat, N. K. N. (2012). Examining a theory of planned behavior (TPB) and technology acceptance model (TAM) in internetpurchasing using structural equation modeling. Researchers World, 3(2 Part 2), 62.
Sharma, M. (2021). Theoretical foundations of health education and health promotion. Jones & Bartlett Learning.
Shortell, S. M., O'Brien, J. L., Carman, J. M., Foster, R. W., Hughes, E. F., Boerstler, H., & O'Connor, E. J. (1995). Assessing the impact of continuous quality improvement/total quality management: concept versus implementation. Health Serv Res, 30(2), 377-401.
Thomas, E. J., Sexton, J. B., & Helmreich, R. L. (2003). Discrepant attitudes about teamwork among critical care nurses and physicians*. Critical Care Medicine, 31(3), 956-959. https://doi.org/10.1097/01.Ccm.0000056183.89175.76
Vabø, M., & Hansen, H. (2016). Purchase intentions for domestic food: a moderated TPB-explanation. British Food Journal, 118(10), 2372-2387. https://doi.org/10.1108/BFJ-01-2016-0044
Wang, H., Zhang, J., Luximon, Y., Qin, M., Geng, P., & Tao, D. (2022). The Determinants of User Acceptance of Mobile Medical Platforms: An Investigation Integrating the TPB, TAM, and Patient-Centered Factors. International Journal of Environmental Research and Public Health, 19(17), 10758. https://www.mdpi.com/1660-4601/19/17/10758
Wang, S., Wang, J., Yang, S., Li, J., & Zhou, K. (2020). From intention to behavior: Comprehending residents’ waste sorting intention and behavior formation process. Waste Management, 113, 41-50. https://doi.org/https://doi.org/10.1016/j.wasman.2020.05.031
Weinberg, D. B., Cooney-Miner, D., Perloff, J. N., Babington, L., & Avgar, A. C. (2011). Building collaborative capacity: promoting interdisciplinary teamwork in the absence of formal teams. Medical care, 716-723.
Weller, J., Boyd, M., & Cumin, D. (2014a). Teams, tribes and patient safety: overcoming barriers to effective teamwork in healthcare. Postgraduate Medical Journal, 90(1061), 149-154.
Weller, J., Boyd, M., & Cumin, D. (2014b). Teams, tribes and patient safety: overcoming barriers to effective teamwork in healthcare. Postgraduate Medical Journal, 90(1061), 149. https://doi.org/10.1136/postgradmedj-2012-131168
White Baker, E., Al‐Gahtani, S. S., & Hubona, G. S. (2007). The effects of gender and age on new technology implementation in a developing country: Testing the theory of planned behavior (TPB). Information Technology & People, 20(4), 352-375.
White, K. M., Starfelt, L. C., Jimmieson, N. L., Campbell, M., Graves, N., Barnett, A. G., Cockshaw, W., Gee, P., Page, K., Martin, E., Brain, D., & Paterson, D. (2015). Understanding the determinants of Australian hospital nurses’ hand hygiene decisions following the implementation of a national hand hygiene initiative. Health Education Research, 30(6), 959-970. https://doi.org/10.1093/her/cyv057
Wu, I.-L., Li, J.-Y., & Fu, C.-Y. (2011). The adoption of mobile healthcare by hospital's professionals: An integrative perspective. Decision Support Systems, 51(3), 587-596. https://doi.org/https://doi.org/10.1016/j.dss.2011.03.003
Zaheer, S., Ginsburg, L., Wong, H. J., Thomson, K., Bain, L., & Wulffhart, Z. (2021). Acute care nurses’ perceptions of leadership, teamwork, turnover intention and patient safety – a mixed methods study. BMC Nursing, 20(1), 134. https://doi.org/10.1186/s12912-021-00652-w
電子全文 Fulltext
本電子全文僅授權使用者為學術研究之目的,進行個人非營利性質之檢索、閱讀、列印。請遵守中華民國著作權法之相關規定,切勿任意重製、散佈、改作、轉貼、播送,以免觸法。
論文使用權限 Thesis access permission:自定論文開放時間 user define
開放時間 Available:
校內 Campus:開放下載的時間 available 2026-08-15
校外 Off-campus:開放下載的時間 available 2026-08-15

您的 IP(校外) 位址是 18.191.211.66
現在時間是 2024-04-29
論文校外開放下載的時間是 2026-08-15

Your IP address is 18.191.211.66
The current date is 2024-04-29
This thesis will be available to you on 2026-08-15.

紙本論文 Printed copies
紙本論文的公開資訊在102學年度以後相對較為完整。如果需要查詢101學年度以前的紙本論文公開資訊,請聯繫圖資處紙本論文服務櫃台。如有不便之處敬請見諒。
開放時間 available 2026-08-15

QR Code