基于PZB模型的修订后SERVQUAL量表对社区高血压及2型糖尿病患者健康管理服务质量评价研究  

Service Quality Evaluation of Revised SERVQUAL Scale Based on PZB Model in Health Management Service for Community Hypertension and Type 2 Diabetes Patients

作　　者：何艳宏[1] 徐秦儿[1] 黄铮[1] 丁晶莹[1] 金玫华[1] HE Yan- hong XU Qin - er HUANG Zheng DING Jing - ying JIN Mei - hua(Huzhou Center for Disease Control and Prevention, Huzhou 313000, China)

机构地区：[1]浙江省湖州市疾病预防控制中心,313000

出　　处：《中国全科医学》2016年第29期3601-3606,共6页Chinese General Practice

基　　金：浙江省基层卫生软科学研究项目(2014JC12)

摘　　要：目的建立基于PZB模型的修订后SERVQUAL量表,为社区责任医师团队进行自身医疗服务质量评价,改进服务质量提供工具;了解社区高血压、2型糖尿病患者对健康管理的总体评价,找出影响健康管理服务质量的要素,提出针对性建议,为有效评价服务质量和提高管理水平提供参考依据。方法于2015年选择湖州市吴兴区东林镇辖区社区卫生服务站进行规范健康管理的高血压、2型糖尿病患者360例为调查对象,通过文献法、焦点组访谈、德尔菲专家咨询法、预调查等方法修订SERVQUAL量表,评价修订后SERVQUAL量表信效度,主成分分析法提取公因子。采用Likert 5级评价服务感知、服务期望评分,服务质量评分=服务感知评分-服务期望评分;计算各指标服务质量总体评价得分和百分制得分;比较不同基本情况患者服务质量评分的差异。结果共发放问卷360份,回收有效问卷346份,有效回收率为96.11%。346例患者中单纯高血压患者265例,占76.59%,单纯2型糖尿病患者32例,占9.25%,高血压合并2型糖尿病患者49例,占14.16%。修订后SERVQUAL量表5个维度为有形性、响应性、可靠性、保证性、移情性。修订后SERVQUAL量表Cronbach'sα系数为0.802。KMO值为0.708,Bartlett's球形检验χ2=3 556.00,共提取5个公因子,累计方差贡献率为71.14%。5个因子与指标体系的5个维度基本吻合,问卷具有较好的结构效度。修订后SERVQUAL量表二级指标中的健康知识宣教、干预效果、遵守承诺、服务安全、沟通、信任、尊重的服务质量评分比较,差异均无统计学意义(P>0.05);修订后SERVQUAL量表二级指标中的就医环境、医务人员仪表、优质服务、服务及时、解答疑问、医风医德、考虑患者特殊需要、个性化、适用性、全面、主动关心、便民服务的服务质量评分比较,差异均有统计学意义(P<0.05)。服务质量总体评价得分结果显示,一级指标中移情�Objective To establish revised SERVQUAL scale based on PZB model,to evaluate their medical service quality of physician teams of community responsibility and improve service quality and provide tools; to understand overall evaluation of community hypertension and type 2 diabetes patients on health management, identify factors that affect service quality of health management, put forward specific recommendations and provide references for effectively evaluating service quality and raising management level. Methods 360 hypertension and type 2 diabetes patients,receiving standardized health management in the community health service station that under administration of Donglin Town in Wuxing District of Huzhou,were selected as research objects. SERVQUAL scale was revised by literature review,focus group interviews,Delphi expert consultation,pre- investigation methods. Reliability and validity of revised SERVQUAL scale were assessed, and common factors were extracted by principal component analysis method. 5- point Likert scale was applied to evaluate service expectation,service perception,scores of quality of service = scores of perceived service- scores of service expectation. The score of overall evaluation of service quality of each index and score of hundred- mark system were calculated. The differences between service quality scores of patients with different basic conditions were compared. Results 360 questionnaires were sent out and 346 valid questionnaires were recovered with a response rate of 96. 11%. Among the 346 patients,265 patients with simple hypertension,accounting for 76. 59%,32 with simple type 2 diabetes,accounting for 9. 25%,and 49 with hypertension combined with type 2diabetes,accounting for 14. 16%. The 5 dimensions of revised SERVQUAL scale were tangible,responsiveness,reliability,assurance and empathy. Cronbach＇s α coefficient of revised SERVQUAL scale was 0. 802. KMO value was 0. 708,Bartlett＇s test of sphericity χ2= 3 556. 00,a five common factors were extracted in total,contribution

关 键 词：高血压 糖尿病 2型 健康管理 社区卫生服务 

分 类 号：R544.1[医药卫生—心血管疾病] R587.1[医药卫生—内科学]