跨文化醫療中台灣醫師與東南亞籍病患之互動-醫師的觀點

The Doctor-Patient Interaction in Cross-Cultural Medical Care-Views from Clinical Physicians

陳惠玉(Hui-Yu Chen)

指導教授 ： 林開忠

國立暨南國際大學/人文學院/東南亞研究所/碩士(2013年)

https://doi.org/10.6837/NCNU.2013.00240

摘要

東南亞新住民及移工已成為台灣人口結構中不可忽視的一群，對於跨文化的醫療狀況，目前多以病人的角度進行研究，但是醫病互動是雙向的，醫師的想法亦不容忽視。本研究旨在探討醫師在跨文化照顧中，面對東南亞籍病患時的感受、醫病互動情形、困難及其因應方式。
本研究採質性研究，以半結構式深度訪談11位臨床醫師，將訪談內容建立逐字稿後進行資料分析，研究結論有：(1) 對新住民的觀點受媒體左右。(2) 新住民的醫療決策難脫第三者的影響。(3) 外籍勞工就醫條件較新住民更為弱勢。(4) 家父長式的醫病溝通。(5) 客氣而疏遠的醫病關係。(6) 語言障礙是醫師看診時的最大困難。(7) 視而不見的文化差異。最後就研究未竟之處，對未來研究者提出相關建議。

關鍵字

東南亞籍病患 ； 跨文化醫療 ； 醫病互動

並列摘要

New residents and migrant workers from Southeast Asia have become a group who can not be ignored in Taiwan's population structure. For cross-cultural medical condition, currently ongoing research is mainly based on the patient’s point of view. But, as a matter of fact, the doctor-patient interaction is a bidirectional relationship. Therefore, the views from the doctors are also important. Hence, the purpose of this research is to study the feelings and viewpoints of the doctors, the interactions between the doctors and the patients, the difficulties they face and measures taken by them when dealing with Southeast Asian patients.
This study uses qualitative research. The researcher carries out a semi-structured depth interviews with 11 clinicians, transcribed into verbatim and analyzes the data. There are seven conclusions in this research:
1.Doctors’ views of the new residents are mostly influenced by the image produced by media.
2.The medical decision makings for the new immigrants are always affected by the third party.
3.Medical conditions for foreign workers are more vulnerable.
4.The doctor-patient interactions are mainly paternalism.
5.The doctor-patient relationship is polite but distant.
6.Language barriers could be the greatest difficulty for physicians.
7.Cultural differences were ignored by physicians.
Finally, there are also some suggestions for future researchers.

並列關鍵字

Southeast Asian patients ； cross-cultural medical care ； doctor-patient interaction

參考文獻

一、中文部分

王玉媚、韓錦樺、黃美智 (2007)〈通譯員-搭起醫護人員與外籍病患溝通的橋樑〉。《護理雜誌》54(4)：73-77。

田健堯、侍台平 (1993)〈建立和諧的醫病關係〉。《國防醫學》17(1)：68-75。

田培英、曾紀芬 、李欣慈 (2010)。〈以文化動力模式照護越南籍女性在台灣的健康需求〉。《志為護理》9(4)：65-70。

成令方（2002）〈醫「用」關係的知識與權力〉。台灣社會學編輯委員會。《台灣社會學第三期》。台北：群學出版有限公司。頁11-71。