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

本研究旨在探讨护士的工作满意度与顾客对居家护理的满意度之间是否存在互动关系。这项研究的样本来自鹿儿岛县公共卫生中心地区的顾客和家庭护理人员。第一次调查是在2001年进行的。通过逐步多元回归分析，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。护士工作满意度各维度中，顾客总体满意度与顾客关系呈显著正相关。研究表明，顾客对家庭护理的满意度可能取决于顾客(护理者)和家庭护理护士之间的关系。在后续调查中，再次证实居家护理服务的顾客满意度与工作满意度存在双向相关关系。对顾客满意度的内部结构进行了分析。顾客的“总体满意度”取决于护士对来访护士的工作满意度和服务带来的结果。分析两次调查护士工作满意度和顾客满意度的变化情况。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。从护理管理的角度出发，提出了互惠解释模型作为干预方法。该模型解释了与良好客户关系的构建和护理服务环境的改善不仅与客户满意有关，还与护士的职业倦怠控制有关。

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.