醫病溝通會議之推動：護理觀點

目的：探討以護理長之角度分析推動家庭溝通會議過程中遇到的困難及評價。方法：以北區某區域醫院為收案地點，採立意取樣，運用焦點團體訪談15 位護理長，進行分析與整理。結果：研究結果分為四個面向，在（一）醫師的配合度及溝通技巧上包括1. 醫師的配合度將會影響會議的成效，及2. 醫師的溝通技巧能左右會議的成效；（二）病人與家屬醫療抉擇與自我照護模式包括1. 治療同盟的建立及2. 無法配合的困境；（三）護理長嘗試箇中滋味包括1. 扮演多面人的角色與2. 親臨戰場的震撼；（四）政策與現實之差距包括1. 開會場次背後的困惑~ 數量與品質之拉距戰及2. 團隊作戰機制也很重要。結論：提高醫師配合度與訓練溝通技巧，透過團隊合作與共識，同理與接納病人及家屬之感受與需求，以護理長為啟動者，應可落實常規化家庭溝通會議之照護品質。醫院則扮演管理單位制定政策，縮短與現實之間的差距，讓醫療團隊運作順暢，家庭溝通會議有效進行。

關鍵字

焦點團體；家庭溝通會議

並列摘要

Objective: We explored the difficulties and appraisal in promoting Physician-Family Communication Meetings from the view of head nurses. Methodos: This was a qualitative study. The research subjects were included by purposive sampling in a regional hospital in Taipei. Data were collected with focus group interviewed with 15 head nurses. Results: The results were divided into 4 aspects. First, physician coordination and communication skills could influence the results and outcomes of the family meetings. Second, the patient-family medical decision and self-care models included the establishment of treatment alliance and the plight of dys-coordination. Third, the situations in which the head nurses confronted included playing multiple roles and the shock of real-life battlefield. Fourth, the gap between policy and reality included the confusion behind the meeting frequency-the tug of war between quantity and quality, and importance of team combat mechanism. Conclusion: To implement regular and high quality Physician-Family Communication Meetings, it is needed to improve physician's coordination and communication skills, and team work and consensus, and as such to empathy and accept patient's and family's feelings and needs. Also with head nurses as an initiator, the hospital should stipulate the policy in order to shorten the gap between the expectation and reality so that the medical team can operate smoothly and Physician-Family Communication Meetings to be hold effectively.

並列關鍵字

focus group ； Physician-Family Communication Meetings

被引用紀錄

方琳瑜、林巧惠（2018）。一位肺癌合併骨轉移年輕女性之照護經驗。彰化護理，25(3)，81-93。https://doi.org/10.6647/CN.201809_25(3).0011

宋聖芬、陳煌麒、楊婉萍（2022）。末期醫療抉擇的家庭會議溝通模式之回溯性分析。台灣公共衛生雜誌，41(2)，226-233。https://doi.org/10.6288/TJPH.202204_41(2).110147

游麗瑾、陳蓓蓓、郭巧雯、黃露萩、劉翠瑤、馮容莊（2019）。醫療從業人員對醫病溝通會議之評價。領導護理，20(3)，32-51。https://doi.org/10.29494/LN.201909_20(3).0004

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醫病溝通會議之推動：護理觀點

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