[[alternative]]The Construction of Indicators of a Friendly Environment in Hospitals for Hospital Outpatients-An example of CHENG HSIN GENERAL HOSPITAL

[[abstract]]早在1993年臺灣就已達到世界衛生組織（World Health Organizations, WHO）所認定「高齡化社會」的門檻（7%）也就是指65歲以上老人佔總人口的7%，由於長者普遍有慢性病，因此前來就診的機率相對較高；加上開始實施全民健康保險後醫療資源更加廣泛地被使用使得早期的設計已逐漸變得不若當時的友善與方便。依據世界衛生組織所定義高齡友善城市是一個兼容且無障礙，能增進活躍老化的生活環境，加上友善環境一直是政府單位所重視的一環由此可見友善之重要趨勢，因此若藉由世界衛生組織在2007年提出「Global Age-friendly Cities: A Guide」所定義的高齡友善城市中八項構面，加上「通用設計」的理念：為大多數人所使用，且平等的保障所有人的權利。再擷取生活品質QOL（quality of life）裡身、心、社會、環境四個面相，藉文獻回顧篩選出相關候選問題，探討其必須性，經由德爾菲法獲得專家資料，達成共識得出最終相關指標。 本研究目的為探討長者來就醫時對於友善環境的需求，於2019年4月至5月執行共二回合修正式德爾菲法，每次發放問卷21份，回收有效問卷21份，有效回收率 100% ，使用SPSS 20統計軟體進行矩陣分析計算出平均數、標準差、眾數、四分位數作為判別標準。研究結果顯示四項構面裡得出：身（8題）、心（9題）、社會（6題）、環境（13題）總共36題項指標。 研究結果顯示，現有醫院門診友善環境中，患者仍存在身、心、社會、環境需求，例:身-保暖及隱私、心-候診時間及指示清晰、社會-工作人員之溝通態度、環境-侯診資訊及道路設計。但醫院友善環境建構之研究在國內屬少見，且實際參與之專業領域專家人數及研究執行時間均有限，故本研究僅是醫院友善環境指標建構之先驅研究，用以發覺現有不足之處，經歸納整理，期望能成為臨床上參考之指標，提供來診患者更加友善的門診就醫環境。研究結果須進一步進行實務應用並經指標建構相關信效度之檢驗，方能成為醫院管理實務上有用之參考指標。[[abstract]]As early as 1993, Taiwan had reached the threshold of “aged society” (7%) as determined by the World Health Organizations (WHO). It means that the elderly over 65 years old accounted for 7% of the total population. Because the elderly generally have chronic diseases. Therefore, the probability of coming to the clinic is relatively high; coupled with the wider use of medical resources after the implementation of universal health insurance, the early design has gradually become less friendly and convenient. According to the definition from the World Health Organization, the age-friendly city is a compatible and accessible environment that enhances the active and aging environment. The friendly environment has always been an important trend that government agencies have attached to. This is because of the importance of world health. In 2007, the organization proposed eight facets in the age-friendly city defined by the "Global Age-friendly Cities: A Guide", plus the concept of "universal design": used by most people, and equal protection for everyone. right. Then take the life quality QOL (quality of life) body, heart, society, environment four aspects, through the literature review to screen out the relevant candidate questions, explore its necessity, obtain expert information through Delphi method, reach a consensus and finally Related indicators. The purpose of this study was to explore the need for a friendly environment for the elderly to seek medical treatment. From April to May 2019, a total of two rounds of modified Delphi method were implemented. 21 questionnaires were issued each time, and 21 valid questionnaires were collected. The effective recovery rate was 100 %, by using SPSS 20 statistical software for statistical analysis to calculate the mean, standard deviation, mode, quartile as the criteria. The results of the study show that there are a total of 36 items in the four facets: physical (8 questions), psychological (9 questions), social(6 questions), and environment (13 questions). The results of the study show that in the friendly environment of existing hospital outpatients, patients still have physical,psychological, social and environmental needs.Like: body-warmness and privacy, heart-waiting time and clear instructions, social-worker communication attitude, environment-hours information and road design. However, the research on the hospital's friendly environment construction is rare in Taiwan, and the number of experts in the professional field and the research execution time are limited. Therefore, this study is only a pioneering study on the construction of hospital friendly environmental indicators to detect existing deficiencies. Inductively sorted out, it is expected to become an example for clinical reference, and to provid a more friendly outpatient medical environment for visiting patients. The research results must be further applied in practice and tested by the relevant reliability and validity of the indicators to become a useful reference indicator for hospital management practice