基于Kano模型的养老机构老年人护理服务需求属性分析

Attributes of nursing service needs among the institutionalized elderly based on Kano model approach

目的分析养老机构老年人护理服务需求属性,为制订针对性干预措施提供参考。方法基于Kano模型设计养老机构老年人护理服务需求调查问卷,对天津市7所养老机构共687名老年人进行调查。结果养老机构老年人护理服务需求34个条目中,魅力属性需求10条(29.4%),均位于保留区Ⅳ;期望属性需求10条(29.4%),其中7条位于优势区Ⅰ;必备属性需求11条(32.4%),其中7条位于待改进区Ⅱ;无差异属性需求3条(8.8%),均位于次要改进区Ⅲ。生理健康与医疗需要维度中,魅力属性2条,期望属性4条,必备属性5条,无差异属性1条;安全需要维度中,期望属性1条,必备属性4条,无差异属性2条;尊重需要维度中,魅力属性1条,期望属性3条,必备属性2条;爱与归属需要维度中,魅力属性4条,期望属性2条;自我实现需要维度的3条均为魅力属性。结论养老机构老年人必备、期望属性护理服务需求主要集中在生理健康与医疗、安全及尊重需要,魅力属性需求主要集中在爱与归属、自我实现需要。养老机构应在维持和完善必备、期望属性需求的基础上,发展和创新魅力属性需求,客观分析和优化改造无差异属性需求。

Objective To analyze the attributes of nursing service needs among the institutionalized elderly,and to provide reference for targeted interventions.Methods A total of 687 older people from 7 elder-care institutions in Tianjin were surveyed by using a self-designed nursing service needs questionnaire that was formulated based on Kano′s model of quality attributes.Results Among the 34 items of nursing service needs,10 were attractive attributes(29.4%)and located in reserving zoneⅣ,10 were one-dimensional attributes(29.4%)and 7 of them located in predominance zoneⅠ,11 were must-be attributes(32.4%)and 7 of them located in improving zoneⅡ,and 3 were indifferent attributes(8.8%)and located in secondary improving zoneⅢ.In the dimension of physical health and medical needs,there were 2 attractive attributes,4 one-dimensional attributes,5 must-be attributes and 1 indifferent attribute.In the dimension of safety needs,there were 1 one-dimensional attribute,4 must-be attributes and 2 indifferent attributes.In the dimension of respect needs,there were 1 attractive attribute,3 one-dimensional attributes and 2 must-be attributes.In the dimension of love and belongingness needs,there were 4 attractive attributes and 2 one-dimensional attributes.All of 3 items in the dimension of self-realization needs were attractive attributes.Conclusion The institutionalized elderly reported physical health and medical care,safety and respect as must-be and one-dimensional attributes of nursing service,while love,belongingness and self-realization as attractive attribute.The elder care institutions should maintain and improve must-be and one-dimensional attributes of nursing service,develop and innovate attractive attribute,and objectively analyze and optimize indifferent attributes.