摘要目的：运用服务质量差距模型分析急诊患者期望与感知护理服务之间的差距,制订管理对策以提高急诊护理服务质量水平。方法横断面整群选取2013年3—10月太原市某三级甲等医院114例急诊留观患者,自行设计基于服务质量差距模型的急诊护理服务质量现状测评量表,在入急诊及出急诊2个时间点发放量表,分析期望与感知到的护理服务差距(SQ)来源及分类并排序,同时应用多因素分析方法确定患者一般情况对患者感知服务水平的影响,最终确定急诊留观患者护理服务需求的属性。结果患者对急诊护理服务质量5个维度22个条目的感知均值为6.23,期望均值为6.72,两者得分差异有统计学意义(P <0.05)；5个维度 SQ 均值由大到小排序分别为响应性、保证性、有形性、可靠性及移情性；年龄、年就医次数及自理能力均为影响护理服务感知的因素。结论服务质量差距模型是一种从患者角度评价服务质量的方法,应用此模型分析服务对象期望和实际感受,可以帮助管理者发现引发质量问题的根源,并针对性寻找适当的消除差距的措施。

abstractsObjective To utilize service quality difference model to analyze the gap between expectation of emergency patients and recognition of nursing service, in order to improve the quality of emergency nursing service by making out the management strategy. Methods A total of 114 emergency observed patients were transversely selected by cluster sampling method and investigated by self-designed current status of emergency nursing quality scale which based on service quality difference model in Taiyuan one class A grade three hospital from March to October 2013. We assessed at time of admitted emergency and discharged from emergency, analyzed the gap of nursing service′s source and types between expectation and recognition and reordered. At the same time, we applied multiple factors analysis method to ensure attribute of nursing service requirement for emergency observed patients. Results The average scores of patients to emergency nursing service was 6. 23 including 5 dimensions and 22 items, and the average score of expectation was 6. 72 (P <0. 05); the SQ average score of 5 dimensions sequenced from large to small: reactive mode, guarantee, stylish, reliability and empathetic; the age, annual times of seeking medical advice and ability of self-care all were the influencing factor of nursing service recognition. Conclusions Service quality difference model is one service quality assessment method from patients′ perspective, and we utilize this model to analyze the expectation and real feeling of service object, help administrators to find out the source caused quality issues and suitable measures targeted to minimize gap.