醫師與病患對醫病關係模式之看法分析

Analysis of Viewpoints of Doctors and Patients on the Doctor-Patient Relationship Model

10.29916/JMPP.201409_8(3).0004

劉彩娥(Tsai-Er Liu)；王萬琳(Wan-Lin Wang)；應立志(Li-Chih Ying)

醫病關係模式 ； 醫病互動 ； doctor-patient relationship model ； doctor-patient interaction

管理實務與理論研究

8卷3期（2014 / 09 / 01）

54 - 66

繁體中文

Emanuel, E. and Emanuel, L.（1992）針對「醫病關係」提出四種模式，分別是：父權模式、資訊提供模式、詮釋模式及審議模式。本研究之目的乃探討現今之台灣醫師與病患間之醫病關係是偏向何種模式，且醫師與病患所認知之醫病關係模式是否相同。本研究針對個案醫院共蒐集到272份就醫者以及60份醫師之有效問卷。採用次數百分比及卡方檢定進行資料處理。由研究結果獲知：醫師自認在醫病互動關係中，其扮演的角色多屬詮釋模式或商議模式。然而，病患卻認為多數醫師扮演父權模式或資訊提供模式角色，且不同基本資料之醫師對醫病互動關係模式之看法並無顯著差異，但病患在不同之年齡、職業、宗教信仰上，對醫病互動關係模式之看法有顯著差異。此結果可供醫師未來在面對醫病互動時注意並調整自己的角色，以符合自己認知的方式面對各種病況及具各種特質之病患。

The ＂doctor-patient relationship＂, proposed by Emanuel, E. and Emanuel, L., can be divided into four models, namely, paternalistic model, informative model, interpretive model and deliberative model. The main objective of this study is to investigate what kind of doctor-patient relationship model exists currently between doctors and patients in Taiwan and whether the doctor-patient relationship model recognized by doctors and patients is the same or not. In this study, for the hospital under study, effective questionnaires of 272 copies are collected for patients and 60 copies are collected for doctors. Moreover, frequency distribution and chi-square test are adopted for data processing. From the research results, it is clear that in the doctor-patient interaction, the doctors think that they mostly play the role of interpretive model or deliberative model. However, most patients think that the doctors play the role of paternalistic model or informative model. Doctors of different demographic data show no significant differences on their views of doctor-patient interaction model. However, patients of different ages, occupations and religious beliefs show significant differences on the views of the doctor-patient interaction model. The results can be used by doctors for adjusting their roles of doctor-patient interaction model in the future when they are facing the different situations and different patients.

1. Charles, C.,Gafnv, A.,Whelan, T.(1997).SHARED Decision-Making In The medical encounter: What does it mean? (Or it takes at least two to tango).Soc. Sci. Med.,44(5),681-692.
2. Clarke, G.,Hall, R.,Rosencrance, G.(2004).Physician-Patient Relations: No More Models.The American Journal of Bioethics,4(2),16-19.
3. Emanuel, E.,Emanuel, L.(1992).Four models of the physician-patient relationship.Journal of American Medical Association,267(16),2221-2226.
4. Szasz, T.,Hollender, W.(1956).A Contribution to the Philosophy of Medicine: the Basic Model of Doctor-Patient Relationship.Archive of Internal Medicine,97,585-592.
5. Tsai, D. J.(1996).University of Michigan.
6. Veatch, R.(1972).Models for ethical medicine in a revolutionary age.Hastings Center Report,2,5-7.
7. 李詩應(2008)。碩士論文(碩士論文)。台北市，東吳大學法律學系。
8. 林美伶(2012)。博士論文(博士論文)。台南市，國立成功大學健康照護科學研究所。
9. 張苙雲(1998)。醫療與社會：醫療社會學的探索。台北:巨流。
10. 蔡甫昌(2002)。診療室中的道德議題之一從醫病關係談起。健康世界，321，89-93。
11. 藍巧慧(2007)。碩士論文(碩士論文)。台北市，國立臺灣大學衛生政策與管理研究所。

1. 郝宏恕,匡勝捷(2020)。住院病人與照護主治醫師對於醫病溝通認知差異之研究。醫學與健康期刊，9(1)，61-72。
2. 林耀盛,何雪綾(2020)。末期醫療決策中的病人自主：以病人為中心的思考。應用心理研究，72，91-130。
3. 林耀盛、吳英璋、何雪綾(2017)。末期患者家屬參與「預立醫療計劃」的討論行為。中華心理衛生學刊，30(3)，295-320。
4. 張銀益,林淑瓊,林宣均(2016)。從醫病關係管理觀點探討醫療服務與病人的互動關係。慈濟科技大學學報，3期=總2，67-99。
5. 鍾明憲,黃美娟,陳榮福,陳淑娟(2018)。門診強化照護對血糖控制成效之初探。領導護理，19(4)，41-56。