醫療與人文的融合－以草屯療養院之成長軌跡為驗證

Fusion of Medicine and Humanities-A Growth Locus of the Tsaotun Psychiatric Center

張介信(Chieh-Hsin Chang) ； 簡以嘉(I-Chia Chien)

《醫學與健康期刊》 5卷2期 (2016/09) Pp. 103-117

摘要

醫療工作主要的目標在維護人類健康，而健康並非僅止於沒有身體病痛而已，健康是身體心理與社會的良好和諧狀態。因此必須關注疾病的預防、治療到復健等面向，才能達到此目標。醫療工作的性質主要是立基於自然科學的理性邏輯，依據客觀的觀察分析，形成假設，最後經嚴謹的辯證，建立一致性的實證資料，再運用到每日的臨床治療。但病人在罹病時的心理感受與主觀體驗卻有極大的個別差異，因此臨床醫療工作，除了依照標準作業準則外，還須依照個別的需求，提供全方位的照護，著重以人文精神思維建立的照護模式才能達到病人的最佳福祉。而人文精神即是以人為中心，尊重自主，並以人的價值為依歸，在與病人接觸的過程中，感通生命的互動經驗，創造心靈的交流以協助病人獲得健康。同時亦須具備深刻反省的精神，以期再造價值體系，並在社會正義的原則下彌平潛在不平等，創造病人的最佳福祉。本文透過回顧草屯療養院各種醫療模式的發展，從療癒環境的建立，教學制度與人文課程的傳承，以建立良好醫病溝通互動；再依據病人的類型與不同需求，透過垂直整合的醫療模式，從急性治療、復健到社區居家治療等，提供全人照護模式，並依照社區特性深植精神健康營造；另外對於被社會排斥甚或遺忘的一群，亦秉持著尊重，平等的對待方式，創造其恢復健康的契機。因此人文思維是提升照護品質的重要機制與核心價值。在此回顧中，也再度提醒我們，醫療工作是涵化科學與人文，具備真善美精神的一門藝術。

關鍵字

醫療照護 ； 健康 ； 人文精神

並列摘要

The goal of medical practice is to maintain and enhance the health status of patients. Health is a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity. We must pay more attention to the multiple perspectives of medical services which typically consist of prevention, treatment and rehabilitation aimed at helping people attain the goal of health. The essence of medical service is based on scientific logic, the observation of clinical phenomenon, hypothesis formulation, and the results of research, together forming evidence-based data that can be applied in daily medical treatment. Each patient experiences different subjective suffering and has different psychological impacts when they get ill, so we must provide comprehensive care based on individual needs, not just follow up treatment following a guideline suitable for all people. In addition, we should engage with the therapeutic model in concordance with the philosophy of the humanities to help relieve the distress of these patients. Humane medicine is medical practice providing patient-centered service with an attitude of respect towards different individual values and autonomy. Humanity in medicine rises from interpersonal reciprocity creating a resonance between patient and healer together helping the patient regain health. From the point of view of the humanities, medical practitioners can and should view issues from more than one perspective including from a perspective of self and society. When providing medical care, we must consider what is best for our patients taking into account societal justice and equal and fair treatment. This article reviews the growth history of Tsao-tun Psychiatric Center reflecting the essence of humanity as expressed in medical practice. The realization of medical humanity is achieved from the establishment of healing environment in the hospital, implementation of humanities education courses and training systems, and forming healing relationships between doctor and patient in daily practice. Based on individual needs of patients in different stages, we integrate the psychiatric service vertically to provide care from the acute stage to rehabilitation stage. We also conduct outreach services to establish a continuous care system and whole person care. We extend our service to the community focusing on creative preventive medicine to enhance mental health organically to fit the needs of patients in their respective communities. For the patient who has been rejected by society because of a criminal act, we also respect their vulnerability and strength to provide the service to create the opportunity of recovery of health for them. Finally, medical humanities takes as a core value the enhancement of quality of care and utilized a patient's life experiences as its chief mechanism to satisfy the health needs. In this review of different perspectives towards treatment models, we learn to view medical work as the liberal art of healing science.

並列關鍵字

Medical care ； Health ； Humanistic spirit

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