人類免疫缺乏病毒感染者就醫經驗之初探

The Health Care Experience of Patients with HIV／AIDS: A Preliminary Investigation

患者的觀點是探討醫療服務品質研究中之重要角度，在國內HIV與AIDS患者（以下簡稱患者）人數日漸增加，而醫療專業人員勢必將面臨激增的患者醫療需求的情境下，醫療人員有必要熟悉患者求醫過程中的主觀經驗以提供患者所需的服務，然而國內缺乏相關的研究，也因此本研究乃採質性研究中現象學之觀點，初步探討患者之求醫經驗。參與研究者為四位患者，患者的平均年齡為30.25歲，而其得知自己為HIV陽性反應的期間平均為2年又11.5個月，研究結果顯示醫療相關人員提供患者訊息、對患者身心的關懷及導正患者的疾病適應歷程均構成讓本研究患者滿意之醫療服務；而令其不滿意之求醫經驗包括了醫療訊息的缺失、不情願提供醫療、無理／禮的待遇及延遲或消極治療。本初探性研究開啟了圍內對患者主觀經驗的了解，藉著了解醫療情境對患者的衝擊，在積扭的方面期能促進醫療人員在醫病互動的過程中提供患者所需的服務，而在消極的方面期能提醒醫療人員避免令患者不滿意之醫療情境。

The increasing numbers of cases of Human Immunodeficiency Virus(HIV)and Acquired immune Deficiency Syndrome(AIDS)implies that health care professional will face increased demands to work with people with HIV/AIDS in the future. In order to provide high-quality care, health care professionals need to be better informed about patients' perspectives , because this is the main dimension in evaluating the quality of health care services. The purpose of this study was to investigate the health care experience of people with HIV/AIDS in Taiwan. Given the lack of related studies in Taiwan, this study used a phenomenological approach. The participants were four patients with an average age of 30.3 years, who had known their positive HIV status for an average of 35.5 months. Patients identified health care professionals' providing information, care for their physical and psychological well being, and facilitating their adaptation as critical aspects of their satisfactory health care experiences. They identified lack of information, professionals' unwillingness to provide services, unreasonable/impolite services, and delayed or passive treatment as major aspects of their dissatisfactory health care experiences. The results of this exploratory study indicate of specific aspects of services that could be improved. The perspectives of these participants' can be used as a tool to remind health care professionals to be sensitive about the negative and positive impacts of their practices on patients' biopsychosocial vulnerability.