兩性醫病溝通於線上醫療諮詢之初探

早期由於資訊科技不發達，一般民眾較難有取得健康醫療相關資訊，多依靠醫療專業從業人員給予資訊，屬於較為被動式的資訊取用者。而今現代人民生活水準提高的影響，國人越來越注重自身健康狀況，也逐漸積極欲了解與自己相關之健康醫療資訊，例如慢性疾病、保健養身……等議題。因為網路科技的發達，以及近年來幾乎人人皆有個人電腦，且隨著上網的行動裝置越來越普及，使得人們能夠輕易透過網路的查詢資料，了解與自身相關的健康醫療資訊，進而衍伸出「消費者健康資訊」一詞。本研究目的在於探討兩性面對醫療情境時之溝通方式及特徵，探討兩性之間於線上醫療問診之提問架構、提問類型、提問策略、提問時機等四個面向之差異情形，以達到提升有效溝通的目的。本研究首先將以文獻探討之方式了解兩性溝通以及醫病溝通相關理論與模式，建立本研究進行內容分析法編碼之用，資料處理方式則使用卡方同質性檢定以及標準化殘差，藉由統計檢定方式判斷兩性之間是否有顯著差異，同時也以質化分析為輔。經分析後發現，藉由針對提問進行內容分析以及統計檢定所得之結果了解到，兩性在使用線上醫療諮詢服務時，其之間的溝通方式整體而言並無明顯差異。而本研究也發現了以下較特殊之現象：男性在提問情緒揭露部份，反而較女性易表露出欲博取同情或是取得認同等情緒，但提問時之情緒為理性者，較女性多出一些。「提問時機」分析中，發覺女性和男性相較之下，並無具有顯著差異是較為注意健康保健或是疾病預防。透過統計檢定顯著差異部份，兩性在使用線上醫療諮詢服務時，「提問篇幅」中兩性提問具有顯著差異之醫療科別共有14科，「條列狀況」共有2科、「問題數」僅有1科、「提問型態」共有3科、「提問目的」共3科、「情緒揭露」共3科、「身份揭露」共6科，以及「提問時機分析」共有3科。根據本研究結果發現，歸納出以下五項結論：提問特例往往是因不同醫療科別有差異而非性別、兩性在表達型態上並無明顯差異、兩性之提問身份無明顯差異、男性較女性易表露出情緒低落狀態及尋求同情、女性無較明顯注重養身保健或疾病預防。並且也提出兩點實務建議：（一）建議網路維護管理人員可以新增網站提問格式引導，讓使用者得以有較清楚的介面進行提問；（二）建議使用者增進資訊素養能力，以有效於網路環境中保護個人資料。最後本研究也期許未來相關研究可往下列面向進行更深入的探究：使用「線上醫療諮詢服務」之使用者訪談、「線上醫療諮詢服務」之醫師回覆分析、現實中之性別與醫病溝通模式和線上醫療諮詢溝通模式差異探討。

關鍵字

兩性溝通；醫病溝通；線上醫療諮詢；內容分析法

並列摘要

Due to the lack of mature information technology in the past, it was difficult for the general public to access health and medical information. People had to rely on medical professional practitioners if they needed related information. However, current society provides better living standards, and people are more concerned about health-related issues. The public go online and actively research health and medical information by themselves. Since the internet is becoming more popular than before, and almost everyone has a PC or mobile device now. The trend also gave birth to the term “Consumer Health Information”. This study aims to investigate the differences between and characteristics of the methods utilized by the two genders when they use online medical consultation by analyzing four aspects: consulting architecture, consulting type, consulting strategies and consulting timing. This study will first look into gender communication and physician-patient communication theories and models. The review was conducted to establish content analysis coding purposes. For data analysis, the chi-square test of homogeneity and standardized residuals was used; then statistics was used to explore whether there are significant differences between different genders. This part of the study was supplemented by qualitative analysis. The analysis, the contents of consultation and the results of statistical analysis of the test results showed that how different genders use online medical consultation services did not have any significant difference in overall terms. However, this study also found some specific phenomena, for example, males are more likely to reveal the emotion and desire to gain sympathy or obtain identity than females. However, the number of males who ask questions in a rational manner is slightly higher than females. Females and males show no significant differences in "consulting timing" analysis, and females do not focus more on health care or disease prevention. Through the statistical significant difference test part of the difference genders using online medical information services, the questions of gender differences have significant differences in 14 medical divisions in "consulting length". Significant differences in 2 medical divisions in "bullet point status", only 1 medical division in "questions amount", 3 medical divisions in "consultation patterns", 3 medical divisions in “consulting purpose", 3 medical divisions in “consulting emotions revealed", 6 medical divisions in “consultation identity”, and 3 medical divisions in “consultation timing. The results of this study can be summarized into the following five conclusions: 1) question exception is often due to the different medical divisions rather than gender differences; 2) no significant gender differences were revealed in consulting emotions; 3) there were no significant gender differences in consultation identity; 4) more males revealed depression status and sought sympathy; 5) females do not focus on promoting good health or disease prevention. The study also makes two substantive recommendations: (a) recommend network maintenance and management personnel can add a consulting guide or format so that users can have a clearer interface to ask medical questions; (b) users may enhance information literacy to effectively protect personal information in the internet environment. Finally, future research can be oriented towards the following topics for more in-depth inquiry: interview the users of online medical consultation services, the reply on online medical consultation by doctors, and the differences of gender and medical communication models in real life and online.