Phffdng phap nghien cffu dinh Iffdng dffdc thffc hien nham kiem dinh va nhan dien cac nhan td' thdng qua cac gia tri, dp tin cay va mffc dp phu hdp cua cac thang do, kiera dinh md hin[r]
Trang 1QUAN TRj - QUAN LY
^,
MOI LIEN HE VE SU HAI LONG
• • CUA BENH NHAN VA CHAT L U O N G
DOI NGU NHAN LlJC Y TE TAI CAC COf Sd
Y TE CONG LAP TINH GIA LAI
PHAM THI NGOC MAI
TOM TAT:
Dpi ngu nhan life y te' (NLYT) cd trinh dp chuyen radn eao, cd phong each ffng xff van minh, phuc vu chuyen nghiep, tinh than trach nhiera cao se dera lai sff hai long cho ngffdi benh, gdp phan khang dinh thffdng hieu va uy tin cua cd sd kham benh Vi vay, nghien cffu nay dffdc thffc hien nham tao tien de cho viee de xua't eac giai phap nang cao cha't Iffdng dpi ngu NLYT tinh Gia Lai
Tuf khoa: Chat Iffdng nhan lffc y te, sff hai long cua benh nhan, cd sd y te cdng lap, tinh Gia Lai
1 Dat va'n de
Dich vu y te la mot loai hinh dich vu dac biet va
nd dffdc cung cap bdi he thd'ng gdra cac ye'u to
cung ffng dich vu; NLYT; thdng tin; cac san phara
y te, vacxin, dffdc pham; cdng nghe, cap tai chinh
va quan ly dieu hanh (WHO, 2007) Ngay nay,
trong xa hdi hien dai, ngffdi benh ngay cang cd xu
hffdng lffa chpn khat khe eac cd sd cung cap dich
vu y te', dac biet la lifa chpn cd sd y te cd dpi ngu
NLYT chat Iffdng cao Do dd, dpi ngu NLYT trd
thanh mdt yeu td chu ye'u, anh hffdng de'n chat
Iffdng cua dich vu y te, gdp phan dera lai sff hai
long cho ngffdi benh (Khassoum Diallo & ctg
2003) Sff hai long cua ngffdi benh, den Iffdt nd lai
cd tac ddng rat ldn dd'i vdi qua trinh phat trien,
khang dinh thffdng hieu cua cac cd sd y te Vi vay,
xem xet rad'i quan he giffa sff hai long cua benh
nhan va chat Iffdng dpi ngu NLYT se la mot yeu
cau cap thiet Ket qua phan tich se cho phep nha
quan ly xay dffng cac chinh sach cai thien chat
Iffdng dpi ngu NLYT nhara dap ffng kip thdi nhu
cau kham chtta benh eua ngffdi dan
Dffa tren qua trinh he thd'ng hda ly thuyet, md
hinh nghien cffu dffdc xay dffng vdi sff ke thffa va
dieu chinh thang do cua Le Dan & ctg, (2011) va tieu ehl danh gia chat Iffdng benh vien cua Bp Y te (2013) Bang phffdng phap lay mlu thuan tien, 120 bang cau hdi dffdc phat ra de thu thap y kien cua benh nhan tai cac cd sd y te cdng lap tinh Gia Lai
va so' mau thu ve dffdc sang lpc la 98 Ket qua phan tich va kiera dinh rad hinh cho thay cac nhan
td chat Iffdng NLYT cd tac ddng thuan chieu ddi vdi sff hai long cua ngffdi benh Trong dd, ffdc Iffdng cua bien chuyen radn ldn nhat cho thay trinh
dp chuyen mdn cua NLYT la yeu to' quan trpng nha't tac dpng den sff hai long cua ngffdi benh Tie'p den lan Iffdt la cac yeu to y dffe va ky nang giao tie'p Day chinh la cd sd khoa hpc cho viec de xua't cac giai phap nham nang cao chat Iffdng dpi ngu NLYT tai cac cd sd y te cdng lap tinh Gia Lai
2 Cd soT ly thuye't va mo hinh nghien cufu
Cac nha nghien cffu da chi ra rang chat Iffdng cua dpi ngu NLYT cd mdi hen he chat che den sff hai long cua benh nhan (Le Dan & ctg, 2011), (ELvira Nica, 2013), (Sang M Lee & ctg 2011) Theo dd, ngffdi benh ed xu hffdng hai long khi dffdc tiep can vdi dpi ngu NLYT ed trinh dp chuyen mdn cao, cd tac phong, y dffe va cd ky nang giao tiep
So 13 Thdng 10/2018 167
Trang 2tdt De do Iffdng mdi hen he giffa chat Iffdng dpi
ngu NLYT va sff hai long cua ngffdi benh, nghien
cffu dinh tinh dffdc thifc hien bang each ke thffa va
dieu chinh thang do cua cac nghien cffu lien quan
Theo dd, nghien cffu cua Le Dan va cac cdng sif
(2011) da chi ra chat Iffdng cua dpi ngu NLYT can
dffdc xera xet dffa tren 3 nhdra yeu td chu ye'u la
trinh dp chuyen radn, ky nang ffng xff, thai dp cua
dpi ngu NLYT Thang do nay cung phu hdp vdi
thang do chat Iffdng dpi ngu NLYT theo bd tieu chi
danh gia chat Iffdng benh vien cua Bp Y te (2013)
gdm 4 yeu td: trinh dp chuyen mdn, ky nang giao
tiep, ky nang nghe nghiep, y dffe Ben canh do,
nhdm nghien cffu cua Le Dan cung de xua't thang
do sff hai long cua ngffdi benh bao gdm sff tin tffdng
vao trinh dp chuyen mdn cua dpi ngu NLYT (Le
Dan & ctg, 2011) Nhff vay, thang do chat Iffdng dpi
ngu NLYT dffdc de xua't gdm 3 nhdm yeu to dd la:
i) Ky nang giao tiep (3 bien quan sat: ky nang chao
ddn; ky nang trao ddi; ky nang dd'i xff) ii) Y dffe (3
bien quan sat: ddng vien; giup dd; tan tam) iii)
Chuyen mdn (5 bien quan sat: hffdng din day du ve
ndi quy, quyen ldi va nghia vu; giai thich day du
ve tinh trang benh, phffdng phap dieu tri; hffdng din
chi tie^t ve each sff dung thude; hffdng din each tff
theo ddi, cham sdc, phdng benh; thara kham, cap
phat thude day du, kip thdi) Thang do hai long
chung ve NLYT gdm 3 bie^n quan sat la sif tin
tffdng, sff hdp tac, sff gan bd
Phffdng phap nghien cffu dinh Iffdng dffdc thffc
hien nham kiem dinh va nhan dien cac nhan td'
thdng qua cac gia tri, dp tin cay va mffc dp phu
hdp cua cac thang do, kiera dinh md hinh nghien
cffu va cac gia thuye't nghien cffu, xac dinh mffc
dp anh hffdng cua cac nhan td chat Iffdng NLYT
den sff hai long cua ngffdi benh Nghien cffu nay
dffdc thifc hien qua cac giai doan:
Xay dffng md hinh va gia thuyet nghien cffu
* Cac gia thuyet nghien cffu:
(1) Gia thuyet HI: Ky nang giao tiep cua
NLYT dffdc danh gia cao hay tha'p thi mffc dp hai
long cua ngffdi benh cung tang hay giara theo
(2) Gia thuyet H2: Chuyen mdn cua NLYT
dffdc danh gia cao hay tha'p thi mffc dp hai long
cua ngffdi benh cung tang hay giam theo
(3) Gia thuyet H3: Y dffe cua NLYT dffdc danh
gia cao hay tha'p thi mffc dp hai long cua ngffdi
benh eung tang hay giam theo
De xac dinh mffc dp anh hffdng cua cac nhan to thuoc chat Iffdng NLYT den sff hai long cua ngifcii benh, md hinh nghien cffu va cac gia thuyet nghien effu dffdc kiem dinh Md hinh nghien cffu vdi 14 bien quan sat nen kich thffdc mlu tdi thieu la 70 (Hair & ctg 1998 din theo Hoang Trpng & ctg 2008) Dtt lieu dffdc thu thap bang bang cau hoi danh cho ngffdi stt dung dich vu y te cdng theo thang do Likert 5 diem Bang phffdng phap lay mlu thuan tien, 120 bang cau hdi dffdc phat ra va
sd mlu khao sat ve dffdc sang lpc la 98
Xera xet ket qua sd bp qua cac bang tan so
- Danh gia sd bd dp tin cay va gia tri cua thang
do bang he so' tin cay Cronbachs alpha va phan tich nhan to khara pha (EFA) thdng qua phan mem xff ly SPSS 11.5, nham danh gia dp tin cay cua cac thang do, loai bd cae bien quan sat khdng giai thich cho khai niera nghien cffu, ddng thdi tai cau tnic cac bie^n quan sat cdn lai vao cac nhan tdphii hdp Sau cung, nghien cffu dung phffdng phap phan tich hdi quy bdi de xera xet rad'i lien he giita chat Iffdng dpi ngu NLYT va sff hai long cua benh nhan
3 Ke't qua nghien cu'u va thao luan Theo Nunnally va cdng sff (1994) din theo Pham The Anh (2013), neu rapt bien cd tffdng quan bien tdng ldn hdn 0,3 va he sd Cronbachs Alpha dat mffc tff 0,6 trd len thi thang do dat yeu cau Ket qua phan tich bp dtt lieu cho thay, cac thang doky nang giao tiep (GT), y dffe (YD), tiinh dp chuyen mdn (CM), sif hai long cua ngffdi benh (HL) deu
dat yeu cau d lan kiem dinh thff 1 (Bdng 1)
Cac thang do dat yeu eau dffdc dffa vao phan tich nhan td kham pha EFA Ke't qua xoay nhan to lan thff nha't cho bie'n giai thich rut trich dffdc 3 nhan td, dd'i vdi bie'n phu thude, rut trich dffdc 1 nhan td Chi sd KMO cua ca 2 nhdm bien deu ldn hdn 0,5 nen phan tich EFA la phu hdp Gia tri Sig trong kiem dinh Bartiett's Test nhd hdn 0,05 nen cac bien cd mdi lien he vdi nhau
Cac nhan to' rut trich dffdc tiep tuc stt dungde thifc hien phan tich hdi quy da bien nham kiem dinh gia thuyet nghien cffu (ed sff tffdng quan thuan gitta chat Iffdng NLYT va sff hai long cua ngffcfist dung dich vu y te)
Ket qua cho tha'y he sd hdi quy eua eac bien deu
cd y nghia thd'ng ke va cd tac dpng cung chieu den bien hai long nen eac gia thuyet nghien cffu dii*
Trang 3QUAN TR! - QUAN LY
Bang 1 Ket qua kiem djnh dp tin cqy thang
do bang he so Cronbachs Alpha
Bang 3 Ket qua phdn tich nhan to EFA doi
vdi bien phu thuoc
Nhan td So
bien
Cronbachs Alpha
Solan kiem d|nh
Danh gia
dd tin c$y
Chat luang NLYT
GT
YD
CiVI
Hai Idng
(HL)
3
3
5
3
0.750 0.769 0.886
0.768
1
1
1
1
Dat Dat Dat
Dat
Nguon: Tong hap td ke't qua phdn tich
Cronbach Alpha
Bang 2 Ket qua phan tich nhan to EFA doi
vdi bien giai thich
CIVIS
CIVI4
CIVI3
Cl\/I2
Civil
GT1
GT2
GTS
YD3
YD2
YD1
Nhan to
1
.875
.832
.812
.786
.722
2
.821 799 762
3
.824 789 718
KMO, Bartiett's Test
Kaiser-Meyer-Olkin Measure of Sampling
Adequacy
Bartiett's Test
of Sphericitv
Approx Chi-Square
df
Sig
.773 501.289
55
.000
HL1 HL2 HL3
Nhan td
1
.886 812 791
KMO, Bartiett's Test
Kaiser-Meyer-Olkin Measure of Sampling
Adequacy
Bartiett's Test
of Sphp*rir:itv
Approx Chi-Square
df
Sig
.657 83.182
3
.000
Nguon: Tong hap td ke't qua phdn tich
EFA vdi bie'n phu thude
Bang 4 Ket qua phdn tich hoi quy
vdi bien hdi long
Bien giai thich
CM
GT
YD
H§ so hoi quy chua chuan hda
B
.238 428 276 390
S a i s d chuan
.297 084 070 084
HSsohoi quy da chuan hoa
Beta
.372 281 359
Thong
k e T
-.801 5.108 3.914 4.662
MQcy nghTa (Sig.)
.425 000 000 000
R'=0.603; Adjusted R2=0.591
Ngudn: Tong hap td ket qua phdn tich EFA
vdi bie'n gidi thich
Nguon: Tong hap td ke't qua phdn tich hoi quy
chap nhan Dd'i vdi tap dff heu thu dffdc, cac nhan td nay giai thich dffdc 59,1% sff bien thien cua tap dtt lieu Phan tich hdi quy cho thay yeu td chuyen mdn eua NLYT cd mffc anh hffdng cao nha't den sff hai long cua ngffdi benh/than nhan (ffdc Iffdng cua nhan
td chuyen mdn la 0.372) Sau yeu to chuyen mdn, van de y dffe cua NLYT dffdc ngffdi benh danh gia cao (ffdc Iffdng cua nhan td y dffe la 0.359) va cud'i cung la ky nang giao tie^p (ffdc Iffdng cua nhan td ky nang giao tiep la 0.281)
So 13 Thdng 10/2018 169
Trang 4Den day, cd the ket luan rang chat Iffdng dpi ngu
NLYT se gdp phan gia tang mffc dp hai long cho
ngffdi sff dung dich vu y te De do Iffdng mffc dp hai
long nay, kiem dinh One-Sample Statistics dffdc
thffc hien vdi gia thuyet HO la gia tri cua thang do
mffc dp hai long bang 0 Ket qua cho tha'y gia tri
trung binh cua thang do hai long la 3.26 (mffc y
nghia quan sat Sig = 0 nhd hdn dp tin cay =0.05 nen
gia thuyet HO bi bac bd) Vdi gia tri trung binh cua
thang do hai long dat mffc 3.26 (3.26/5 diem cua
thang do Likert tffdng ffng vdi mffc dp tff Rat khdng
ddng y den Rat ddng y) cho thay rang, mffc dp hai
long cua ngffdi sff dung dich vu y te ve chat Iffdng
dpi ngu NLYT dat mffc trung binh
Bang 5 Ket qua do d a d n g mQc dp hdi long
Bien
HL
Cd
98
Gia tri trung binh
3.2619
Std
Deviation
.46713
Std Error Mean
.04719
t=5.550
Sig.=0.000
Ngudn: Tdng hap tif kit qua do ludng mdc hdi long
4 Ket luan va kidh nghi
Cd the ket luan rang cd sff hen he giffa chat
Iffdng NLYT va sff hai long cua ngffdi sff dung dich
vu y te Ket qua do Iffdng cho tha'y mffc dp hai long
cua ngffdi benh dd'i vdi dpi ngu NLYT cdn kha
"khiem ton" Vi vay, cac giai phap de nang cao chat
Iffdng dpi ngu nhan lffc nganh Y te tinh Gia Lai can
dffdc kip thdi xay dffng va trien khai, trong do tap
trung vao nhttng yeu td tac dpng den sff hai long cua
ngffdi sff dung dich vu, cu the:
Trffde het, tap trung cho cdng tac dao tao hen
tuc ve chuyen mdn nham hffdng den sff phat trien
toan dien cho dpi ngu NLYT Theo dd, nganh Y te
tinh can phdi hdp vdi cac cd sd dao tao uy tin trong
va ngoai nffdc de xay dffng ke hoach md cac Idp
dao tao chuyen mdn; ddng thdi, tang cffdng hdp tac
vdi cac ddn vi y te, vien nghien cffu de thffc hien hd
trd, chuyen giao ky thuat mdi, qua dd xay dffng dpi
ngu NLYT cd tay nghe chuyen mdn ngay cang cao
Ben canh dd, chu trpng den viec thie't ke cac
chffdng trinh dao tao ky nang giao tiep; ky nang
ngoai ngtt, tieng dan tpc; trien khai cac khda thffc
hanh ky nang giao tiep, bdi dffdng y dffe cho
NLYT Khdng the bd qua ke hoach td chffc cac
khda hpc dac biet dao tao ky nang sd'ng cli( NLYT, bdi day la se la nhttng ddi mdi tich ci;( trong chie'n Iffdc phat trien dpi ngu NLYT moi each toan dien Cae khda hpc dien hinh nhff khoa hpc phat trien tri tue cam xuc giup ngffdi lao dpnj biet each tif nhan thffc, tff dieu ehinh cam xuc, biet ddng cam, phat trien ky nang xa hdi; khda hoc quan ly xung dot nham trang bi cho nhan vien Iclia nang giai quyet nhttng vffdng mac trong cuoc song
va cdng viec; khda hpc phat huy nang lffc, sd thlcli cho nhan vien (khieu vu, yoga )
Ngoai ra, xay difng van hda hpc hdi khong ngffng cung la mdt khia canh quan trpng can can nhac Van hda hpe hdi dffdc xay dffng thdng qua
ke hoach phat trien he thd'ng thff vien va tap clii chuyen nganh y te" cua tinh; xay dffng he thong thdng tin chia se kien thffc, kinh nghiem trong linli vffc y te nham ket nd'i dpi ngu NLYT trong toan nganh; td chffc cac budi hdi thao khoa hpc tai cac ddn vi cd sd Van hda sang tao, hpc hdi ciing can dffdc thiet lap difa tren cae cd che khuyen khicli hpc tap, bang ca vat chat va tinh than
Mot van de quan trpng de thffc hien thanh cong cac ke hoach tren la can xay dffng de an khuyen nghi Nha nffdc tang kinh phi cho dao tao hen tuc, ddng thdi huy ddng ddng gdp kinh phi dao tao cua cac cd sd y te cd ngffdi di hpc Ben canh do, cac chinh sach dpng vien ngffdi lao dpng cung can difdc trien khai ddng bp Theo dd, nganh Y te tinh can quan triet va thifc hien triet de chu trffdng, chinh sach cua Nha nffdc ve che dp dai ngd ddi vdi NLYT; kien toan, cdng khai quy che chi tieu ndi bp tai cac ddn vi y te, hffdng de'n muc tieu cdng bang, hpply, cdng khai; xay dffng va trien khai quy che tra IiiOng, tra thffdng theo ket qua cdng viec; cai thien che dp phu cap nghe va dpc hai tffdng xffng; cd chinh sach
hd trd nha d cho nhan vien; thffdng xuyen td cliiJc cac boat dpng phong trao the thao, van nghe, tham quan, nghi dffdng de giup dpi ngu NLYT tai san xua't sffc lao ddng, cdng hien bet sffc minh cho si( nghiep y te
5 Han ch6' cua nghien cu'u
Do sff gidi ban ve ngudn life, nghien cffu d# thifc hien theo phffdng phap chpn mlu thuan tien
va kich thffdc mSu tffdng dd'i nhd nen tinh dai dien chffa cao Ben canh dd, can cd nhttng nghiencilu dinh tinh tie'p theo de giai thich rd rang cho Ite'i qua nghien cffu •
Trang 5QUAN TR! - QUAN LY
TAI LIEU THAM KHAO:
1 Pham Thi'Anh, Nguyin Thi Hong Ddo (2013), Qudn tri nguon nhdn lUc vd sU gan ket cua ngUdi lao ddng vdi doanh nghiep, Tgp chi Khoa hoc DHQGHN, Kinh ti'vd kinh doanh Tap 29, sd4
2 Bd Y te (2013), Bd tiiu chi ddnh gid chdt luang hinh viin
3 Li Ddn, Nguyin Thi Kim Phuang (2011), Ddnh gid mdc do hdi long cua binh nhdn dd'i vdi chd't luang dich vu khdm chUa binh tgi cdc binh viin Da khoa Dd Ndng, Tgp chi Phdt trien kinh ti'- xd hdi Dd Nang, sd25, tr45-50
4 Hodng Trong, Chu Nguyin Mong Ngoc (2008), Phdn tich dd lieu nghiin cdu vdi SPSS, TrUdng DH Kinh ti'TP HCM, NXB Hong Ddc
5 ELvira Nica (2013), The importance of human resources management to the health care system Economics, Management and Financial
6 Khassoum Diallo, Pascal Zurn, Neeru Gupta, Mario Dal Poz (2003), Monitoring and evaluation of human resources for health: An international perspective Human resources for health
7 Sang M Lee et al (2011), The impact of high-performance work systems in the health-care industry: Employee reactions, service quality, customer satisfaction, and customer loyalty The Service Industries Journal, Vol 32, No
1, January 2012, 17 - 36
8 WHO (2007), Everybodys business: Strengthening health systems to improve health outcomes: WHOs framework for action, Geneva
Ngay nhan bai: 6/9/2018
Ngay phan bien danh gia va sufa chi?a: 16/9/2018
Ngay cha'p nhan dang bai: 26/9/2018
Thdng tin tdc gid:
TS PHAM THI NGOC MAI
Khoa Quan tri kinh doanh - Trrfofng Dai hoc Tai chinh Marketing
THE RELATIONSHIP BETWEEN THE SATISFACTION
OF PATIENTS AND THE QUALITY OF HEALTH WORKFORCE
AT PUBLIC HEALTHCARE UNITS OF GIA LAI PROVINCE
• PhD PHAM THI NGOC MAI
Faculty of Business Administration, University of Finance and IVIarl<eting
ABSTRACT:
A professional health workforce with good manners and high responsibilities would make patients satisfied and contribute to the brand image and the reputation of healthcare units This research was conducted to create the fundamental for proposing solutions that improve the quahty
of health workforce of Gia Lai province
Keywords: Quality of health workforce, the satisfaction of patients, public healthcare unit, Gia
Lai province
So 13 Thdng 10/2018 171