摘要 本研究的目的為探討我國精神科醫師人口統計特質與觀點對精神疾病患者拒絕治療的醫療處理意見有何影響，並分析其可能相關因素。本研究的假設為：精神科專科醫師之人口統計特質與觀點與「精神科專科醫師對精神疾病患者拒絕治療的醫療處理意見」無相關；並針對本研究的結果做一整理與綜合性之探討。 研究之對象是以中華民國精神醫學會精神科專科醫師，進行以郵寄無記名問卷方式進行，問卷之內容「精神科醫師對精神疾病患者拒絕治療的醫療處理項目」分為二部分：「精神疾病患者在自願住院治療與在強制住院治療條件下，精神科醫師是否同意患者拒絕治療的權利」與「精神科醫師對強制鑑定與強制治療制度相關的醫療意見」，有效問卷回收率為24.1%。 本研究之結果，利用因素分析法分析「精神科專科醫師對精神疾病患者拒絕治療的醫療處理意見」變項，萃取出6個相關共同因素構面，經驗證研究假設得知：『自願住院治療醫囑』，因醫師『對於精神疾病患者是否接受精神醫療的觀點』與『對於精神醫療醫病關係互動模式』之差異達到顯著水準。『強制住院治療醫囑』，因醫師『執業醫療院所類別』之差異達到顯著水準。『非為防範暴力之約束與隔離治療』，因醫師『對於精神疾病患者是否接受精神醫療的觀點』之差異達到顯著水準。「非『嚴重病人』之強制治療」，因醫師『精神醫療年資別』與『對於精神醫療醫病關係互動模式』之差異達到顯著水準。「『嚴重病人』之強制鑑定與治療」，因醫師『對於精神醫療醫病關係互動模式』之差異達到顯著水準。『強制鑑定之司法程序』，因醫師『對於精神醫療醫病關係互動模式』之差異達到顯著水準。; Abstract Treatment refusal of psychiatric patient has been a therapeutic dilemma to many psychiatrists in psychiatric services. The purpose of this study is to verify the correlation between the demographic data and their perspectives of treatment right and doctor-patient relationships of psychiatrists and their opinions in management of psychiatric patient''s treatment refusal. By using a structured questionnaire, 147 psychiatric specialists of the Society of Psychiatry, R.O.C. are surveyed for their opinions in treatment refusal of psychiatric patient. The structured questionnaire of opinion in treatment refusal is categorized into two parts. The first part of the questionnaire includes 9 questions concerning with the agreement to psychiatric patient’s right of treatment refusal in voluntarily or compulsory hospitalization in psychiatric services. The second is a 10-item questionnaire of agreement of psychiatric specialists to the regulations in civil commitment system of Mental Health Law of R.O.C. The results discuss what the demographic data and their perspectives of treatment right and doctor-patient relationships interfere in psychiatrist''s opinions to psychiatric patient’s right of treatment refusal in voluntarily or compulsory psychiatric hospitalization and the agreement to the regulations in civil commitment system of Mental Health Law of R.O.C.
