基于结构方程住院患者营养支持护理服务满意度模型的研究

Research on satisfaction model of nutrition support nursing service for inpatients based on structural equations

目的设计住院患者营养支持护理服务满意度量表,构建中心城市区域内住院患者营养支持护理服务满意度结构方程模型并进行检验,形成营养支持护理服务满意度测评工具。方法基于欧洲顾客满意度指数(ECSI)、美国顾客满意度指数模型(ACSI)和中国顾客满意度指数模型,选择18个影响住院患者营养支持护理服务满意度的指标,于2017年9—12月选取某三级甲等医疗机构接受营养支持的住院患者开展方便抽样调查,通过因子分析,将18个影响指标归类为6个维度,即营养支持护理质量感知、营养支持护理期望、营养支持护理品牌、营养支持护理服务满意度、患者营养支持护理忠诚、患者营养支持护理抱怨。结果构建了住院患者营养支持护理服务满意度结构方程模型,共6个维度18个条目。6个维度的Cronbach's α系数均≥0.80,KMO检验测试系数为0.745,Bartlett球形检验结果显示检验χ^2=3402.132,P<0.01;并验证了6个维度的合理性,模型的拟合效果较好(χ^2/df=1.416,残差均方根=0.030,拟合优度指数=0.945,调整拟合优度指数=0.927,规范拟合指数=0.947,增值拟合指数=0.984,比较拟合指标=0.984,近似误差均方根=0.035)。结论借助该模型护理管理者能找出影响接受营养支持患者满意度的因素,提出持续性改进策略,有助于改善护理服务效果,提升住院营养支持患者满意度,为住院患者满意度模型的研究提供参考。

Objective To design a satisfaction scale on nutrition support nursing service for inpatients, and establish a structural equation model of inpatient satisfaction with nutrition support nursing service in central city area to test the scale, so as to construct a tool for evaluating the satisfaction with nutrition support nursing service. Methods This study selected 18 indicators affecting the satisfaction with nutrition support nursing services of inpatients based on the European Customer Satisfaction Index (ECSI), the American Customer Satisfaction Index (ACSI) Model, and the China Customer Satisfaction Index Model. From September to December of 2017, a convenience sampling investigation was carried out among the inpatients receiving nutritional support in a Class?Ⅲ Grade A medical institution. Through factor analysis, the 18 impact indicators were categorized into 6 dimensions, namely, perception of nutrition support nursing quality, nursing expectations, nutrient support nursing brands, nutrient support nursing service satisfaction, patient nutrient support nursing loyalty, patient nutrient support nursing complaints. Results A structural equation model for satisfaction of nursing support services for inpatients was constructed, and the rationality of the 6 dimensions was verified. The Cronbach's α indexes of the 6 dimensions were all equal or greater than 0.80. KMO test coefficient was 0.745. Bartlett spherical test results showed χ2=3 402.132 (P<0.01). The reasonableness of the six dimensions was verified, and the fitting effect of the model was good (χ2/df=1.416, RMS of residual=0.030, goodness of fit index=0.945, adjusting goodness of fit index=0.927, standard fitting index=0.947, value-added fitting index=0.984, comparing fitting index=0.984, root mean square of approximate error=0.035). Conclusions With this model, nurse managers can identify the factors affecting the satisfaction of patients receiving nutritional support, and propose continuous improvement strategies that will help improve the effectiveness of nursing services, and improve patient satisfaction with inpatient nutritional support, so as to provide reference for the research of satisfaction model for inpatients.