| Summary: | 碩士 === 國立臺灣大學 === 醫療機構管理研究所 === 96 === Background and aims：
The Institute of Medicine (IOM) proposes patient-centered care as one of six aims for quality of care in the 21st century. After reviewing literatures, we found that limited studies focused on breast cancer and investigate physicians’ and patients’ beliefs, perceptions and practices simultaneously. This aims of this study are to examine and compare the beliefs and the congruence of perceptions and practices between breast cancer patients and their attending physicians by matched questionnaire. In addition, we would like to find out the relationship between their beliefs and perceptions.
Method：
This study adopted the patient-centered care questionnaire developed by Professor Ogden etc. in Survey University to measure breast cancer patients’ and physicians’ beliefs, perceptions and practices of patient-centered care. The study obtained the authorization directly from Professor Ogden. The modification procedures included dual translation between English version and Chinese mandarin, rated finally by Professor Ogden as gold standard, and modified to Chinese according to her rating. The final version was decided after pretest of the draft. This is a cross-sectional study. After looking for hospitals’ cooperation and approved by the Institutional Review Board procedure later on, six hospitals in Taipei Metropolitan Areas agreed to join this study that included two public medical centers, three private medical centers and one private regional hospital. The participants of this study include breast cancer patients, physicians and nurses in specialty of breast surgery, hematology and radiology oncology at outpatient department. All samples came from convenient samples. There were 284 patients, 28 physicians and 33 nurse valid samples with collection period from March 4th to April 22, year 2008.
Result：
There were 34 questions in the patient-centered care questionnaire with high internal consistency (the coefficient of Cronbach α in belief and perception section is 0.869 and 0.907, separately). From paired-t test, the results found that there are differences between patients’ and physicians’ beliefs toward patient-centered care. Physicians’ beliefs are higher in constructions of ”patient involvement” and “the affective content of the relationship”. However, patient’s beliefs are higher in the constructions of “doctor receptiveness” and “information giving”. Besides, there are differences between patients’ perceptions and physicians’ self-report of practices, which patients’ perceptions are lower in the constructions of “doctor receptiveness”, ”patient involvement” and “information giving”. From multiple regression analysis, patients’ beliefs toward patient-centered care had significant relationship with their perceptions; physicians’ beliefs toward patient-centered care had significant relationship with their practices. All hypotheses are supported from the survey data.
Suggestion：
Suggestions for study in the future include: first, increase the sample size of hospitals or physicians for better representative; second, apply multilevel analysis to elaborate the effect of patient and physician or organization as a whole; third, adopt qualitative approach to verify the findings from quantitative study；finally, link patient-centered care to patient outcome to explore its effects.
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