醫師對媒體報導醫療爭議事件的態度與行為傾向之研究--以高高屏地區為例

Study of Physicians' Attitude and Behavioral Tendencies toward Medical Controversial Events of the Mass Media Reports —An Example of Kaohsiung - Pingtung Area

林秀美(Hsiu-Mei Lin)

指導教授 ： 張永源

高雄醫學大學/健康科學院/醫務管理學研究所碩士在職專班/碩士(2006年)

摘要

中文摘要
研究目的
近年來媒體爆料風氣盛行，醫療爭議事件在媒體曝光也有增加的趨勢，對醫師名譽、醫院形象及營運都造成不小的衝擊。本研究透過醫師對媒體報導醫療爭議事件的態度與行為傾向之調查，探討醫師在輿論壓力下的反應、各醫療機構因應的差異，以及影響醫師與媒體互動的因素。
研究方法
本研究採用問卷調查法，問卷以自填式結構性設計。調查期間自民國95年元月至3月底止。研究對象為高高屏地區的診所、地區醫院、區域醫院及醫學中心等各層級醫師。問卷共發出960份，結果回收690份，回收率71.88%，其中有效問卷581份，有效回收率60.52%。資料以SPSS for Windows10.0版統計套裝體進行描述性與推論性統計分析。
結果
一、醫師對媒體報導醫療爭議事件的態度傾向負面，行為傾向轉為積極。各變項認同指標分數如下：(1)對「病人投訴(媒體動機)」的認同度為73；(2)對「媒體報導(動機與方式)」的認同度為54；(3)對媒體報導造成「負面影響」的認同度為82；(4)在「媒體經營」的意願上為81。(5)在「媒體回應」的意願上為74。
二、不同醫療機構(含層級別、權屬別)的醫師，對媒體報導醫療爭議事件，除了「負面影響」看法一致外，在「病人投訴」、「媒體報導」、「媒體經營」及「媒體回應」上，都有顯著差異(P<0.05)。
三、不同職務別的醫師，僅在「媒體回應」上有顯著差異(P<0.05)。
四、有無「媒體受訪」經驗的醫師，在「負面影響」、「媒體經營」及「媒體回應」上，都有顯著差異(P<0.05)。
五、在態度與行為傾向的影響因子與預測模式上，醫師部分個人特質的預測力雖達顯著性(P<0.05)，但解釋力偏低(adj.R2=5.7%以下)。
此外，研究還發現，在醫療爭議協調過程中，黑道威脅恐嚇(44%)對醫師造成的壓力，高於媒體爆料(24%)、抬棺抗議(20%)；而在各類媒體中，以電視報導(89%)的負面影響最大。
結論與建議
一、醫師對媒體報導醫療爭議事件的態度傾向負面，但面對媒體的行為傾向反而積極。顯示醫師對媒體報導醫療爭議事件雖感到不滿或沮喪，但仍不放棄溝通；這種既期待又怕受傷害的心理，印證媒體功能如同水能載舟亦能覆舟。
二、醫師普遍認為媒體報導醫療爭議事件會造成負面影響，74.4%擔心影響協調機構的協調結果；49.8%認為會影響司法判決；38.1%既使沒有明顯的醫療疏失，仍可能屈服於病患與其家屬的要求。
三、醫師面對媒體報導大多願正面回應。但對媒體報導的公正、客觀性多表存疑，僅12%認為媒體報導前會進行查證；對於損及個人權益的報導，有50.3%的醫師擬採取法律行動反擊。
四、醫學中心對「媒體報導」較不認同，在「媒體經營」與「媒體回應」上也較不積極，可能與醫學中心專業分工較細，醫師不必直接站到火線上面對病人抱怨與媒體報導的壓力有關。而公立醫院在「媒體回應」上較為保守，可能與受到民代監督有關。
五、區域與地區醫院規模不大不小，比較擔心媒體曝光，願花時間與人力於媒體經營上；診所規模小，經不起媒體報導的衝擊，在媒體曝光後，對醫療糾紛的處理傾向「速戰速決」。
六、院長(副院長)在媒體回應上比較積極，可能與身負醫院決策有關。
七、有過媒體受訪經驗者，對媒體報導的負面影響感受較深，在媒體互動上轉為積極，希望避免再次受到傷害。
綜合本研究結果顯示，醫界與媒體、病患的溝通都有待加強，建議將媒體應對列為員工訓練計畫，並落實病患告知責任，讓資訊透明化，不但有助提升醫院的形象，增進大眾的認同感；一旦發生醫療爭議事件，亦有助在短時間內澄清媒體與外界的疑慮，化危機為轉機。

關鍵字

醫療爭議 ； 媒體報導 ； 態度與行為傾向

並列摘要

Objectives
Due to the popularity of media, the medical controversies are getting more attentions in the society recently. It causes a huge impact and affection on the medical practitioners’ reputations and operations. Under the pressure of mass public opinions, we have wondered what the reactions of these medical practitioners are and how the medical organizations deal with these matters. We have also wondered what factors would affect the relationships between the doctors and the media groups. For this purpose, we surveyed the medical practitioners in Kaohsiung and Ping-Tong area and analyze the attitudes and behaviors of the doctors.
Methods
We did the survey to let the experiments fill in questionnaire by themselves. The survey period is from January, 2006 to March, 2006. The target group is the doctors from clinics, regional hospitals and medical centers in the Kaohsiung and Ping-Tong areas. The total numbers of the questionnaires are 960 and there are 690 (71.88%) replies. From these questionnaires, there are 581 valid replies and we use SPSS for Window version 10.0 to make descriptive and referential analyses.
Results
1.The physicians’ attitude toward mass media reports for medical controversies is negative, but their behavioral tendencies appear aggressive. The index scores eviation are as the followings：(1) The degree of recognition to “patients complain against media” is 73. (2) The degree of recognition to “media reports” is 54. (3) The degree of recognition to “causing negative influence by media reports” is 82. (4) The will to “management of media” is 81. (5) The will to “response to media” is 74.
2. There are significant differences (P<0.05) for physicians of different degreed hospitals to “patients complain against media”, “media reports” , “management of media”, and “response to media”.
3. “The physician with different duty” appears a significant difference (P<0.05) to “response to media” only.
4. “The physician with the experience of been consulted by media or not” has a significant difference (P<0.05) to “negative influence” “management of media” and “response to media”.
5. For the study of affecting factors and predicting models for the attitude and behavioral tendencies of physicians, the predicting ability appears significant (P<0.05) for the “personality of physicians”, but the explanation power is low (adj R2=5.7%).
Besides, based on the research, the doctors feel the most pressures from electronic medium such as TV and radio…etc and then are the newspapers. Moreover, during the compromising process of a medical dispute, the doctors feel the most pressures from the gangsters (48%), then the media (42%), local representatives (4%), government officials (3%), patients’ relatives (2%), and medical improvement associations (1%). In addition, speaking of the forms of interfering, the doctors feel the most pressures from the gangs’ threats (44%), and then the news medium (24%) and the last is the coffin protests (20%).
Conclusion & Suggestions
1. The attitudes of medical practitioners toward the reporting of medical controversy are negative. The research shows that the doctors feel upset and angry about the matter of reporting from the media; however, they don’t give it up to communicate with the public.
2. The tendency and attitudes toward the report of medical controversy are varying from different medical organizations. The attitudes of bigger medical organizations toward the matter of patients’ complaints and news reports of media tend to be more negative than the small ones. Yet, the smaller medical organizations are more willing to corporate with media. Moreover, speaking of media management, the mid-size hospitals involved with this part the most.
3. The tendency and attitudes of different ownerships of hospitals towards the report of medical controversy are varying as well. The reception of public hospitals about the complaints of patients and news reporting are stronger than the private and non-profit medical organizations, nevertheless, their attitudes toward the media strategies are more conservative than those private and non-profit ones.
4. The tendency and the attitudes of medical practitioners at the different positions toward the participations with news media are different as well. The presidents of medical organizations are more active when they face the news media.
5. The research also shows that we can not predict what the doctors’ reactions would be when they deal with news media.

Summarized our study’s conclusion and suggestions are as the followings:
The honesty is the key of solving these kinds of medical predicaments. Covering up the mistakes would only make crisis get worse. The medical groups should tell the truth at crucial time first so that they can prevent the future false speculations from the outsiders and lessen the negative reports from the news media. Right now the channels toward the news media in the hospitals are medical administrators and most of these employees are part time only. They are not from Public Relation (PR) field and are lack of professional knowledge. Therefore, in the future, the spokesman of a hospital should have the both knowledge of Public Relation and medical management and by doing that, they would more understand the characteristics and the needs of the news media and would communicate better with the medical organizations and the news media.
The Public Relation idea of how to deal with the news media should be included into the employees’ training programs. And the medical groups should maintain a good relationship with the news media so that it can help to build up a better image of a hospital and improve on the marketing.

並列關鍵字

medical controversy ； news media report ； attitude and behavioral tendency

參考文獻

參考文獻

一、中文文獻

1. 王晴美，2002，媒體報導精神疾患事件之分析與對策。國立台灣大學衛生政策與管理研究所碩士論文。

2. 王興田，2000，政府危機傳播之研究—以八掌溪事件為例。世新大學傳播研究所碩士論文。

3. 方怡文．周慶祥，1997，新聞採訪理論與實務，正中書局出版。