臨床醫師的醫病溝通技巧之質性分析

A Qualitative Study of Clinicians' Communication Skills

李錦虹(Gin-Hong Lee) ； 邱浩彰(Hou-Chang Chiu) ； 陳亭君(Ting-Chun Chen)

《台灣醫學》 19卷6期 (2015/11) Pp. 569-580

https://doi.org/10.6320/FJM.2015.19(6).02

摘要

本研究昌在探討臨床醫師實際採用的有效醫病溝通技巧。研究參與者為台灣北部某一家醫學中心的17位臨床醫師，分別來自10個不同科別。研究者透過方便取樣招募志願受訪的醫師，以一對一半結構訪談法蒐集資料，並以編碼、發展有意義的分類及詮釋分類問關聯之程序進行資料分析。研究結果發現「好的表達」、「關注病人」、「與家屬建立良好關條」、以及「團隊運作」四個主題及與其對應之溝通技巧。除了醫師－病人面的技巧，本研究也發現醫師會應用醫師－家屬及醫師－團隊的技巧來輔助醫病溝通，且兼用理性與風性的技巧能讓表達更有效。本研究從醫師的實務經驗中分析出醫師重視的原則與技巧，可供臨床醫師參考及應用，應有助於解決醫病溝通的困境。

關鍵字

醫病關係 ； 溝通技巧 ； 臨床醫師 ； 質性研究

並列摘要

This study aimed to explore clinicians' effective communication skills with patients and their families. The participants were seventeen clinicians across ten specialties in a medical center in northern Taiwan. The researchers used convenience sampling to recruit participants and collect primary data through one-on-one semi-structured interviews. The data was analyzed through the procedure of coding, developing meaningful themes, and constructing the connections among themes. The results showed there were four themes concerning communication skills: ＂good expressions＂, ＂pay attention to patients＂, ＂connections with the patient's family＂, and ＂team work＂. In addition to clinician-patient communication skills, the skills of clinician-family and clinician-medical team were also applied to assist communication. Furthermore, the clinician utilized intellectual and emotional skills of good expressions to achieve effective communications. The results derived from clinicians' experience may be practical and helpful to other clinicians to solve communication problems.

並列關鍵字

physician-patient relationship ； communication skills ； clinician ； qualitative research

參考文獻

潘恆嘉、蔡甫昌、陳慶餘：醫病溝通。當代醫學2014;371:753-60。[Pan HC, Tsai FC Chen CY: Physician patient communication. Medicine Today 2014;371:753-60.]"

張天鈞：醫護人員與病患及其家屬的溝通技巧。當代醫學2004;371:695-96。[Chang TC: Medical professionals’ communication skills with patients and their families. Medicine Today 2004;371:695-96.]"

蔡宗宏、楊朝堂、黃暉庭等：影響醫病信任前置因素之研究。健康管理學刊 2007;5:83-95。[Tsai CH, Yang TT, Huang HT, et al: The research of physician behaviors and organizational factors influence patient trust. Journal of Health Management 2007;5:83-95.]"

潘怡如、李明濱：同理心的心身醫學觀。北市醫學雜誌2004;1;385-392。[Pan YJ, Lee MB: Psychosomatic Aspects of Empathy. Taipei City Medical Journal 2004;1;385-392.]"

李玉嬋：常用的醫病溝通技巧。諮商與輔導2008;269:51-58。[Lee YC: Commonly used doctor-patient communication skills. Counseling & Guidance 2008;269:51-58.]"