從整形外科醫療爭議女性患者特性探討醫病溝通之應用

Characteristics of Female Plastic Surgery Patients with Medical Disputes: Implications for Physician-Patient Communication

10.6145/jme.201006_14(2).0004

蔡豐州(Feng-Chou Tsai)；廖俊凱(Chuh-Kai Liao)；蔡尚達(Shang-Ta Tsai)；李明濱(Ming-Been Lee)；孫雷銘(Lei-Ming Sun)；呂淑妤(Shu-Yu Lyu)

醫療爭議 ； 整形外科 ； 醫病溝通 ； medical dispute ； plastic surgery ； physician-patient communication

Journal of Medical Education

14卷2期（2010 / 06 / 01）

115 - 121

繁體中文

目的：從整形美容外科醫療爭議之女性患者特性，探討醫病溝通之加強與改善。方法：以2002年1月至2006年12月，臺北市某區域醫院所有接受過整形美容自費手術的女性患者為研究母體，從病歷資料篩選醫療爭議之患者，並分析其醫療爭議與患者特性。結果：在所有1，735位接受過美容手術的患者中，共有13人曾有醫療爭議，最後進入司法訴訟程序者，共有4人(26.7%)。而13位醫療爭議患者中，有61.5%為離婚者，接受全身麻醉手術者為76.9%，有精神科過去病史者占61.5%，教育程度大專以上占53.8%，接受療程前沒有聽過醫師任何訊息者占46.2%，舉債或借錢來整形者占38.5%，整形病史豐富者占26.7%，之前有過任何醫療糾紛經驗者占15.3%。且2002年至2006年之醫療糾紛的發生呈下降趨勢。結論：醫療爭議發生率為0.74%，醫療訴訟發生率約為0.23%。本研究建議宜考量患者特性以加強手術前醫病溝通。

Objectives: We investigated the characteristics of plastic surgery female patients with medical disputes. This study aims to enhance physician-patient communication and identify any implications that affect clinical practice. Methods: The target population consists of all female patients receiving cosmetic surgery who had medical disputes from a Taipei City District Hospital. The information was collected from January 2002 to December 2006 using medical chart records. Descriptive data was used to analyze the patients' characteristics. Results: A total of 1735 female patients received cosmetic surgery at the chosen hospital and among these individuals, thirteen patients had a medical dispute and four patients (26.7%) sued their plastic surgeon. Of the thirteen patients involved in a medical dispute, 61.5% were divorced; 76.9% received the operations under general anesthesia; 6.5% had a hi story of psychiatric clinic visits; 53.8% had junior college education or above; 46.2% had heard about their doctor before seeking the operation; 38.5% had borrowed money to pay for their surgery; 26.7% had received at least three previous cosmetic operation experiences and 15.3% had a history of medical dispute. Medical disputes showed a decreasing trend from 2002 to 2006. Conclusions: The incidence of medical dispute and litigation during the study period were 0.74% and 0.23%, respectively. Our study revealed that we should take the patient's characteristics into consideration in order to enhance preoperative communication with their health care provider.

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