醫務社會工作者處理醫療爭議的經驗與對話

Medical social workers' experience and dialogue in dealing with medical dispute

張志豊(Chih-Li Chang)

指導教授 ： 鄭麗珍

國立臺灣大學/社會科學院/社會工作學研究所/碩士(2009年)

https://doi.org/10.6342/NTU.2009.01884

摘要

本研究的目的在了解國內醫務社會工作者介入醫療爭議案件處理的歷程，及可能面臨的衝突與掙扎。針對北部地區區域以上醫院社工部門有介入醫療爭議之主管或專責社工，採立意抽樣，進行2場焦點團體，共有17人參與。
研究發現醫務社會工作者介入處理醫療爭議事件的歷程分成以下階段：社工為局外人、從局外人變局內人、社工逐漸成要角，業務職掌制度化，可以看出醫務社工在醫療爭議案件處理上所扮演的角色越來越重。醫務社工介入高風險的醫療爭議的衝突與壓力包含：趨避的情緒、專業倫理的衝突，角色期待的衝突，角色間的衝突以及角色內的衝突。而醫務社工所能扮演的角色，主要是提供醫病溝通平台、資源提供者角色、病人及家屬情緒安撫。倡導者角色；而社工介入醫療爭議對團隊生存的影響主要包含、在團隊中的專業能見度變高、專業團隊關係更好、
自我成長及自信心增強等三向正向影響、及排擠其他社工專業服務等一項負面影響。
基於以上研究發現，於文末中提出討論，並提出四點建議：「專業團體或教育單位應加強醫療爭議處理的技巧和倫理反省」、「醫務社工專業的省思及倡導，讓該業務能合理化，不偏離社工本質」，「建立處理爭議事件的網絡團體，彼此分享及發展處理爭議的合宜模式」及「單位內的督導制度應加強發揮支持及教育功能，以面對複雜的環境」，以供後續研究者與讀者參考。

關鍵字

醫務社會工作 ； 醫療爭議 ； 醫病關係 ； 焦點團體 ； 角色衝突

並列摘要

The research is intended to understand the process of medical social workers dealing with medical dispute and possible conflicts and struggles medical social workers might face. The sample is aimed at program directors and social workers who work at social work department at region hospital in northern Taiwan. The research take purposive sampling, leading two focus groups and seventeen people attended.

The research had found that several stages are taken place in terms of medical social workers getting involved in dealing with medical dispute: social workers are outsiders; from outsiders into insiders, social workers gradually into key roles and social workers business has been standardized. All of these show that roles social workers play become more and more important.

Conflicts and stresses result from medical social workers getting involved in high-risk medical dispute includes: avoidant emotion, conflicts in ethics, conflicts in role expectation and conflicts between different roles and inside different roles.
And roles medical social workers could play are mainly on providing better communication between clients and doctors, providing resources and pacifying clients and their family’s emotion.

The role of proposer; medical social workers get involved in medical dispute have influences on medical team existence. The three positive influences go as follows. First, medical team is more professional; second, medical team has better relationship; and last but not least, self development and self-esteem have improved. Moreover, there is one negative influence: pushing other social workers’ professional services out from a group.

According to research list above, discussion has been brought up at the end of research; establishment of peer support group, supervision qualification, role normalized, working process standardized, and ethical issues have been proposed. This is to provide references to further researchers and readers.

並列關鍵字

medical social worker ； medical dispute ； Doctor-patient relationship ； focus group ； Role conflict

參考文獻

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