| 摘要: | 目的：當今台灣保護醫病雙方的權益成為重要的議題，病人對於自身所接受的治療內容也較以往有更高的意願參與及了解。然而，在醫療錯誤方面，對於醫療錯誤事件的處理方式，國內目前並沒一套完整的系統及達成清楚的共識。主動揭露是處理醫療錯誤的重要環節，根據國外的研究顯示，病人一致的希望可以被主動告知醫療錯誤，研究結果顯示，主動告知醫療錯誤可以增進醫病雙方彼此間的信任，也會降低病人對於醫療糾紛的訴訟率。但是台灣的文化背景與社會環境明顯與這些國家不同，醫病雙方是否能接受此項作為仍然具有挑戰性，因此瞭解病人對於主動告知醫療錯誤的態度，對於未來思考規劃相關政策將具有重要的參考價值。
方法：以全國性的病友團體為對象，隨機選取各疾病共三十四個病友團體為研究對象，以單位大小按比例抽樣，以問卷調查方式進行，本研究發放1450份問卷，回收有效問卷1330份，總有效回收率為91.7%。
結果：八成以上的病人都希望被告知醫療錯誤。影響被主動告知意願構面之因素為「過去就醫經驗，我與醫師溝通愉快」、「我曾對醫師採取過法律上的訴訟」、「年齡」、「填答者身分」。影響被告知後個人之負面情緒反應構面之因素為「根據過去就醫經驗，完全信任醫師的治療處置」、「教育程度」、「商業醫療保險」。影響被告知後對醫師的滿意度構面之因素為「過去就診經驗中，習慣上找某位特定醫師就診」、「過去就醫經驗，信任醫師醫療處置」、「我曾對醫師採取過法律上的訴訟」、「疾病約已持續多久」、「性別」。影響被告知後醫病間的信任關係構面之因素為「過去就醫經驗，我與醫師溝通愉快」、「過去就醫經驗，信任醫師醫療處置」、「疾病約已持續多久」、「目前疾病狀況」、「被告知後對醫師的滿意度」。影響被告知後可能對醫師採取不利作為構面之因素為「我曾跟醫師有過行為上的衝突」、「性別」、「家戶月收入」、「被告知之意願」、「被告知後個人之負面情緒反應」、「被告知後對醫師的滿意度」。
結論與建議：醫院應將主動告知醫療錯誤納入醫師教育訓練的ㄧ環，醫院也應於主動告知病人後，建立病人情緒支持的機制。
Objective: According to previous researches, most patients wish to be informed medical mistakes happened to them although doctors are reluctant to do so. The study aims to understand patients’ attitude in disclosing medical errors and analyze its related factors.
Methods: 1450 patients from the associations and clubs of different diseases in the country were invited to the research. Questionnaire is designed to investigate patients’ wishes in being disclosed medical errors, patients’ attitudes to disclosing medical errors, and the factors may influence patients’ attitude in disclosure medical errors.
Result: 1351 questionnaires were received. 1330 are eligible. Most of the respondents wish to be disclosed of medical errors; From Stepwise regression test, “ According to the experience of medical treatment, I am happy to communicate with the doctor. ” , ” I had been taken over legal proceedings to doctor” , ” Age” , ” Respondents identity” are factors to affect the willing of being disclosed medical error. “ According to the experience of medical treatment, I totally trust the medical practice of the doctor done. ”, “ Education”, “ Commercial medical insurance” are factors to affect the negative emotions of being disclosed medical error. “ I usually saw the same doctor in the past six months.” , “ According to the experience of medical treatment, I totally trust the medical practice of the doctor done. ” , “ I had been taken over legal proceedings to doctor. “ Course of disease” , “ Gender” are factors to affect satisfactory of doctor of be disclosed medical error. “ According to the experience of medical treatment, I am happy to communicate with the doctor. ” . “ According to the experience of medical treatment, I totally trust the medical practice of the doctor done. ”, “ Course of disease” , “ Disease condition” , “ Satisfactory of doctor of be disclosed medical error. ” are factors to affect the trust between doctor and patient of be disclosed medical error. “ I have had conflict behavior with the doctor” , “ Gender” , “ The monthly family income of the patient” , “ The willing of being disclosed medical error. ” , “ The negative emotions of being disclosed medical error. ” , “ Satisfactory of doctor of be disclosed medical error.” are factors to affect the probably behavior of be disclosed medical error.
Conclusion: Patients wish to be disclosed of medical errors. The result of this research highlights the gap between patients and doctors in disclosing medical errors. |
