醫病對麻醉同意書風險知覺差異之研究

Determinants of the Risk Perception Difference on Anaesthesia Consent Form in the Dyads of Patients and Physicians

齊光彪(Kuang-Piao Chi)

指導教授 ： 劉偉文

中臺科技大學/管理學院/健康產業管理研究所/碩士(2010年)

摘要

知情同意是醫師告知病患病情診斷相關資訊、病患理解消化資訊後作出決定，同意或拒絕診治進行的過程。信任是醫病關係品質的重要元素之一，也是預測醫療服務成效的最佳指標。首先，先論述本研究的動機及目的，主要為瞭解麻醉同意書資訊之病患需求，和麻醉醫師提供之狀況。兼以說明本論文的研究方法和範圍及名詞解釋。再針對麻醉現況、知情同意及病患信任的相關研究做一探討說明。透過個別訪談(personal interviewing)，瞭解各階級代表對醫療機構麻醉同意書風險之說明知覺差異為何。經由專家訪談結果整理，針對麻醉同意書內文、同意書訊息、理想麻醉醫師、術後訪視及術前解釋等相關關鍵字句加以整理說明。最後，總結整理瞭解到病患因對醫師的信任而產生麻醉過程的信心，但對麻醉說明書的內容仍希望能增加其麻醉之合併症、麻醉過程及其風險。同時，也希望麻醉醫師多一點時間給病患及家屬，減少對手術及麻醉的不安。為相關單位於提供麻醉醫療資訊服務時，減少醫病關係之緊張程度，其成果將給予麻醉醫師與手術病患對麻醉醫療資訊有差異瞭解，相關單位於擬定麻醉醫療資訊服務時，可參考本研究之結果予以調整並作長期之追蹤調查，藉此提供使手術病患更滿意之麻醉醫療資訊服務品質。

關鍵字

醫病關係 ； 知覺差異 ； 麻醉同意書

並列摘要

Informed consent is the process constituted by doctors informing the medical information about illness to patients, and patients making decision to accept or refuse the therapy after realizing the information completely. Reliability is an important element of quality of doctor-patient relationship, and the most optimal index of predicting the efficiency of medical service. The purpose of this study is to understand the information requested by patients about consent of anesthesia and the real condition provided by anesthesiologists at present. The method of this study adopts the personal interviewing to realize the perceptional difference about the explanation of the risk of anesthesia in the informed consent between the representatives on various echelons. In addition, the experts of anesthesia in different medical institutes are also interviewed. The results of this study are acquired by the collecting and analyzing the key words concerning the content of informed consent of anesthesia, message of consent, the ideal anesthesiologists, the postoperative visit, and the explanation before operation. In this study, we conclude that the patients have the confidence in the anesthestic procedure owing to the reliability with doctors. However, they hope to know more about the complication, processing, and the risk of anesthesia in the anesthestic informed consent. Besides, they also desire that doctors can pay more time to the patients and their family to reduce the anxiety about operation and anesthesia. The difference exists between the anesthesiologists and the patients about the medical information of anesthesia. Therefore, it is accessible to reduce the tension of doctor-patient relationship when providing the anesthestic information to the patients, if we realize the difference. At last, we anticipate to provide more satisfactory service in the anesthestic information on the basis of this study in the future.

並列關鍵字

Patient-physician relationship ； Perception difference ； Anesthesia consent

參考文獻

余佩燁（2006）。病人權益與麻醉同意書。北市醫學雜誌，3（12），33－39。

李明濱（1997）。病人自主與知情同意。醫學教育，1（4），3－14。

楊秀儀（2005）。告知後同意法則之司法實務發展最高法院九四年台上字第二六七六號判決評釋。台灣本土法學雜誌，73，212－214。

蔡甫昌（2003）。臨床生命倫理學。台北市：醫院評鑑暨醫療品質策進會。

蔡甫昌（2004）。醫師，您獲得病患同意了嗎？－知情同意的倫理與實務。健康世界，222，59－62。