受限之選擇：選擇性手術病患決定手術經驗

林美伶

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受限之選擇：選擇性手術病患決定手術經驗

Choices within restrictions: Exploring Taiwanese elective surgery patients’ decision-making experiences

林美伶 , Ph.D　　Advisor：陳清惠　　

繁體中文

選擇性手術；尊重病人自主權；知情同意；手術決定； elective surgery ； respect for patients’ autonomy ； informed consent ； surgical decision-making

Abstract │ Reference (127) │ Times Cited (1) │ Altmetrics

Abstract 〈TOP〉

Parallel Abstract 〈TOP〉

To respect patients’ autonomy, health care professionals are obligated to protect and ensure patients’ rights by obtaining informed consent before a treatment starts. Nevertheless, informed consent is only a treatment procedure; it cannot ensure a patient’s autonomy if health care professionals fail to understand the context of the patient’s surgery decision-making. This study explored 17 elective surgery patients’ experiences during their decision-making processes. The research was conducted with a phenomenology method and Colaizzi's method was adopted for the data analysis. The participants were recruited from a teaching hospital in southern Taiwan. Two themes emerged from the data analysis, i.e., “An involuntary yet necessary alternative--a surgery” and “Alternatives constrained by the unalterable decision--the surgery”. Under such constraints, patients are forced to maintain harmony with their physicians in their interactions to ensure their safety during surgery. Therefore, it was asserted that medical professionals’ disregard to their patients’ vulnerability in their decision-making, and their lack of caring attitude toward their patients would render informed consent a mere medical routine. Hence medical professionals should empathize with their patients while they are dealing with their distress, and take the initiative to address their patients’ doubts. In a medical context, nurses can be the best advocators for such a concept and practice, and with their efforts trustful doctor-patient relationships can be facilitated to make the respecting patients' autonomy credence truly meaningful.

Reference ( 127 ) 〈TOP〉

石之瑜 (2003a) ‧社會科學研究的主題與目的：知識論的反思‧哲學與文化，30(3)， 135-154。
連結：
成令方 (2002) ‧醫「用」關係的知識與權力‧臺灣社會學，3，11-70。
連結：
林美伶、吳詠葳、黃美智 (2008)‧由手術知情同意過程談華人社會文化對自主的意涵‧護理雜誌，55(5)，69-72。
連結：
林美伶、葉莉莉、陳清惠 (2009)‧影響病人參與醫療決策之論述‧護理雜誌，56(3)，83-87。
連結：
張玨、張菊惠、胡幼慧 (1997) ‧某醫學中心子宮切除婦女自述醫病溝通之探討‧中華衛誌，16(1)，1-12。
連結：

Times Cited (1) 〈TOP〉

陳凱莉(Kai-Li Chen);陳清惠(Ching-Huey Chen)(2014)。台灣老人醫療自主權的省思。護理雜誌。61(5)。26-32。

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