醫療諮商之概念分析

Concept Analysis of Medical Consultation

林咨璇(Tzu-Hsuan Lin)；黃正宜(Cheng-Yi Huang)

醫療諮商 ； 共享決策 ； 概念分析 ； concept analysis ； medical consultation ； shared decision-making

志為護理-慈濟護理雜誌

19卷3期（2020 / 06 / 01）

67 - 74

繁體中文

諮商已經廣泛的被應用在各行各業，如醫療諮商。以往醫療諮商是醫療父權式主導的醫療決策，但隨著近二十年來醫病型態轉變，病人醫療自主權日益受重視，以及醫療訊息可由多元管道獲得，使得醫療諮商過程開始有所改變。當醫療目標與預期結果有所差異時，可能造成醫病關係緊張與醫療糾紛。本文依據Walker和Avant所提出概念分析步驟，歸納出醫療諮詢的定義特徵，分別介紹標準案例、邊緣案例、相反案例及前置因子與後果，藉由此醫療諮商概念分析，瞭解當代病人醫療自主提高與多元化的照護需求，期許能延伸此概念分析提供醫療人員參考，運用於臨床照護或研究上。

Consultation is comprehensively applied in various professions, and medical consultation is particularly frequent. Previously, medical consultation was based on medical professionals' paternalistic approaches and decision-making. However, with the transformation in the doctor-patient pattern in the last 20 years, the practice of medical autonomy and accessibility to medical information from multiple channels have received increasing attention. Consequently, the scenario of medical consultation has changed. Differences between medical goals and expected results lead to a tense doctor-patient relationship, causing medical disputes. This study summarized the definitions and characteristics of medical consultation following the steps of concept analysis proposed by Walker and Avant. We introduced contrary cases, borderline cases, model cases, antecedents, and consequences. The use of concept analysis for medical consultation elucidated the ideas of increased medical autonomy and diversified care needs of contemporary patients. We recommend that medical personnel use concept analysis as reference in clinical care or research.

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