Quailty improvement of Home care services -The reciprocity between Customer Satisfaction and Nurse's Job Satisfaction with Home Nursing Care

本研究旨在探讨护理人员工作满意度与居家护理顾客满意度之间是否存在交互作用。本研究以鹿儿岛县公共卫生中心地区的顾客和家庭护理人员为样本，于2001年进行了第一次调查。采用多元逐步回归分析，探讨各顾客满意度（因变量）与护士工作满意度（自变量）的关系。护士工作满意度各构面中，顾客“整体满意度”与“与顾客关系”有显著正相关。结果显示，顾客对居家照护服务的满意度可能取决于顾客（照顾者）与居家照护护士之间的关系。在追踪调查中，再次证实居家护理服务的顾客满意度与工作满意度有相关性。分析了顾客满意度的内部结构。结果显示，顾客的“整体满意度”主要是由护士工作满意度所决定的，包括对来访护士的处理态度及服务成效。分析两次调查前后护士工作满意度和顾客满意度的变化。结果表明，护士对服务质量改进的满意度越高，顾客的“总体满意度”越高。从护理管理的角度提出了互惠解释模型作为干预方法。该模型说明建立良好的顾客关系、改善护理服务环境不仅与顾客满意度有关，而且与护士职业倦怠的控制有关。

The purpose of this research was to detect whether there was any reciprocity between nurse's job satisfaction and customer satisfaction with home nursing care. The sample for this study was drawn from customers and home care nursing staffs within a public health center area in Kagoshima prefecture.The first survey was conducted in 2001. The relationship between each customer satisfaction (dependent variables) and nurse's job satisfaction (independent variables), was explored by stepwise multiple regression analysis. Customer's "Overall satisfaction" was associated positively significantly with "Relationship with customers" among nurse's job satisfaction dimensions. It was suggested that customer satisfaction with home care nursing depended potentially on the relationship between customer (caregiver) and home care nurse.The follow-up survey was conducted in 2002. It was reconfirmed that the customer satisfaction and job satisfaction in home nursing care services are related reciprocally at the follow-up survey. The internal structure about the customer satisfaction was analyzed. It was suggested that customer's "Overall satisfaction" was determined by nurse's job satisfaction on the posture in which a visiting nurse is tackled and the outcome which service brings about. The change of the nurse's job satisfaction and the customer satisfaction between twice surveys was analyzed. It was revealed that the higher degree of nurse's satisfaction to the service quality improvement was related with the higher degree of customer's "Overall satisfaction". As the intervention method from a nursing management viewpoint, the reciprocity explanation model was proposed. The model explain that the construction of the relationship with a good customers, and the improvement of the environment where care service is performed was connected with not only customer satisfaction but also nurses' burnout control.