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研究生: 王可容
Wang, Ko-Yung
論文名稱: 建構加護病房病患家屬產品服務系統之研究—以成大醫院為例
Building a Product Service System for Intensive Care Unit Patients’ Families–Take National Cheng Kung University Hospital as an Example
指導教授: 陸定邦
Luh, Ding-Bang
孔憲法
Kung, Shiann-Far
學位類別: 碩士
Master
系所名稱: 規劃與設計學院 - 創意產業設計研究所
Institute of Creative Industries Design
論文出版年: 2008
畢業學年度: 96
語文別: 英文
論文頁數: 207
中文關鍵詞: 產品服務加護病房休息座病患家屬
外文關鍵詞: Intensive Care Unit, Rest Unit, Product Service System, Patients’ Families
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  • 本研究始於研究生對於加護病房病患家屬現有服務未能滿足家屬需求之親身經驗,以及與國外家屬休息等候區之比較,產生利用創意產業設計改變現況之想法。
    雖然台灣的醫院數量逐年減少,醫院占床率、加護病房住房天數等卻都呈現正面成長。各醫院均想盡辦法在這競爭的市場中永續經營,因此開始重視醫療品質。台灣的醫療技術雖已達到相當的水準,相對的,整體服務品質依然有很多進步的空間。病患與家屬的親身經驗將直接影響醫院整體的醫療服務品質之形象。通常病患無預警地在緊急情況下進入加護病房,他的至親無選擇的必須承擔所有心理的壓力,同時必須堅強,給與病患最好的支持並且完成所有必要的手續。
    這一整體研究為創新加護病房病患家屬服務照護規劃案,由三位研究生共同合作,最後各針對其中之主題在論文中更深入探討。主題包括:產品服務系統、科技自助化服務系統、體驗設計。
    本研究之目的在於提出一能減少院方衝擊並提高病患和家屬互動之系統;利用產品服務化之概念針對病患家屬提供一全方位照護系統。在親自到訪全台八間大醫院之後,成大醫院成為進一步研究之對象。
    首先整理歸納醫療服務、服務系統設計以及產品服務化系統等相關之研究,形成本研究之研究架構。經由文獻探討之後,透過親自訪談與問卷調查現有家屬需求,進一步分析整合成為整體服務設計之依據,並實際將產品服務設計之成果於成大醫院加護病房休息區中進行現況與設計體驗之調查。在研究結論提出一對於設計加護病房病患家屬服務之產品服務系統之標準化程序與相關之操作、調查、分析與歸納之方法論。

    Based on personal experiences of dissatisfaction with the existing services offered by hospitals and the unmet needs as a family member of intensive care unit (ICU) patient at hospitals, compared with pleasant experiences in the waiting rooms of the ICU abroad has transformed into an urge to change the present situation using the concept of creative industry design.
    Even though the number of hospitals in Taiwan has decreased gradually, statistics on occupancy rate of hospital beds and average length of stay in hospital’s ICU beds appear to create positive slopes. Recent years, hospitals are concerned with how to survive within this competitive race and standout. Taiwan’s medical technology have improved gradually, however, there is still a great room for improvement on the overall quality of service. Patients and their families’ personal experience satisfactions directly influence the overall image and medical quality of hospitals. Most of the time, one enters the ICU unexpectedly in critical conditions, his/her loved ones are forced to face the emotional stress and still need to put themselves together to support the patient and perform all the needed procedures.
    The overall innovative ICU patients’ families service system project has been conducted by a team of three, each focuses on one aspect for further in-depth development: Product Service System (PSS), Technology-Based Service-System (TBSS), and experience design.
    The purpose of this research is to introduce a system that brings low impact on the hospital and create high connectivity for patients and their families by developing a comprehensive care system towards its ICU patients with a focus on a caring system for the family members through building of a PSS for the ICU patients’ families. In particular, this research performed an in-depth study of the ICU patients’ families waiting environment at National Cheng Kung University Hospital after naturalistic observations of eight major hospitals in Taiwan.
    Through literature reviews of medical services, service system design, PSS, a research framework was formed. After literature reviews, focus group interviews and questionnaires were conducted in search for the actual needs of the patients’ families. The result was analyzed and used as the base for overall service design. Upon completion of an actual system design, conclusion from formative evaluation was made and a standardized procedure, operational strategies for guideline development, analytic and evaluation methodologies, for designing a PSS for ICU patients’ families is proposed.

    ABSTRACT… i ACKNOWLEDGEMENTS v TABLE OF CONTENTS vi LIST OF TABLES ix LIST OF FIGURES x CHAPTER 1 INTRODUCTION 1 1.1 Motives and Background 1 1.1.1 Motives 1 1.1.2 Background 1 1.1.3 Best practice 6 1.2 Objective and Significance 8 1.2.1 Objective 8 1.2.2 Significance and meaning 9 1.3 Hypothesis 9 1.3.1 Scope 9 1.3.2 Subject 10 1.4 Research Framework 10 1.5 Research Process 12 2 LITERATURE REVIEW 14 2.1 Medical Services 14 2.1.1 The hospital environment 14 2.1.2 Intensive care unit 16 2.1.3 Needs of the ICU patients’ families 18 2.1.4 Needs of patients’ families in Taiwan 23 2.1.5 Interim summary 24 2.2 Service System Design 24 2.2.1 Service concept 24 2.2.2 Service system 26 2.2.3 New service development 28 2.2.4 Functional products 29 2.2.5 Service design 32 2.2.6 Interim summary 36 2.3 Product Service System 37 2.3.1 Definition 37 2.3.2 Characteristics 40 2.3.3 Drivers for PSS 42 2.3.4 Design of a PSS 42 2.3.5 Application of PSSs 44 2.3.6 Benefits and barriers of PSSs 45 2.3.7 Interim summary 46 2.4 Research Strategies 46 2.4.1 Opinion research 48 2.4.2 Empirical research 48 2.4.3 Archival research 49 2.4.4 Analytic research 49 2.4.5 Systematic approach of ideas 50 3 RESEARCH DESIGN 52 3.1 Altered Research Process 52 3.2 Research Method 54 3.3 Research Procedure 55 4 SYSTEM DESIGN 58 4.1 Examination of the Subjects 58 4.1.1 Participant 58 4.1.2 Procedure 58 4.1.3 NCKU Hospital’s ICU statistics 59 4.1.4 Questionnaire result 62 4.1.5 Factor analysis 78 4.2 Building a PSS 78 4.2.1 System integration 78 4.2.2 Scenario, persona, and intention 81 4.2.3 Product 83 4.2.4 Service 87 4.2.5 Product Service System 88 5 System Evaluation 94 5.1 Preliminary formative evaluation 94 5.2 Design Adjustment and Analysis 96 5.2.1 Rest unit 96 5.2.2 Service system 99 5.2.3 Cost analysis 107 5.3 Formative Evaluation 109 5.4 Standardized Procedure 117 5.5 Research Limitations 119 5.6 Suggestions for Future Researches 120 6 CONCLUSIONS AND SUGGESTIONS 121 References 124 Appendix 1. 歷年醫療院所病床數 Number of Hospital Beds, 1992-2006 134 Appendix 2. 歷年醫療院所家數 Number of Hospitals and Clinics, 1992-2006 135 Appendix 3. 加護病房家屬休息室規劃設計計劃紀錄表 136 Appendix 4. NCKU Hospital ICU patients’ families’ rest area 138 Appendix 5. 空間調查記錄表 140 Appendix 6. 成大醫院加護病房醫護人員焦點團體訪談 141 Appendix 7. 醫護人員問卷 144 Appendix 8. 外科ICU醫護人員焦點團體訪談重點整理 147 Appendix 9. 內科ICU醫護人員焦點團體訪談重點整理 149 Appendix 10. 內外科醫護人員焦點團體訪談問卷統計表. 151 Appendix 11. 家屬問卷.. 157 Appendix 12. 基本調查問卷統計表. 159 Appendix 13. 家屬問卷.. 162 Appendix 14. 家屬問卷統計表. 166 Appendix 15. 家屬問卷因素分析 173 Appendix 16. 成大醫院加護病房訪談 179 Appendix 17. 針對家屬流程訪談護理人員之紀錄 181 Appendix 19. 專家訪談.. 184 Appendix 21. 焦點團體訪談大綱 188 Appendix 22. 家屬問卷.. 191 Appendix 23. 家屬問卷統合表. 198 Appendix 24. 成對樣本檢定 202 Appendix 25. 單一樣本檢定 204 Appendix 26. Cost Analysis 205

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