精神科醫師臨床倫理行為量表之建構

Construction of Clinical Ethical Behavior Scale for Psychiatrists

目的：本研究之目的旨在發展一份精神科醫師臨床倫理行為量表，以作為了解現職精神 科醫師倫理行為之工具。方法：本研究量表初稿編製以美國精神醫學會發佈特別適用於精 神醫學的醫學倫理守則以及馬德里宣言為問卷內容設計的主要參考依據；量表結構分兩部 分，第一部分為基本資料，第二部份為精神科醫師臨床倫理行為量表；經專家效度修改後完 成預試量表，預試量表總計發出1332 份，回收有效量表為150 份，有效回收率11%。預試 所得資料進行項目分析、效度考驗及信度檢定。結果：因素分析結果累計可解釋變異量為 56.35%，信度分析得到總量表α 係數為0.84，再測信度為0.74，具有良好的效度與信度。 結論：本研究發展之精神科專科醫師臨床倫理行為量表正式問卷，其內容計四個因素層面， 分別為切勿傷害、病人自主、行善益人、公平正義共23 題。

Objectives: This study was aimed to develop a clinical ethical behavior scale for psychiatrists as a tool for understanding the ethical behavior of practicing psychiatrists. Methods: The preliminary scale was based on the American Psychiatric Association’s Principles of Medical Ethics with Annotations Especially Applicable to Psychiatry, and World Psychiatric Association’s Declaration of Madrid. The scale consisted of two parts. The fi rst part covered basic information while the second part comprised the clinical ethical behavior scale of psychiatrists. Results: Of mailed 1,332 copies of revised pre-trial questionnaire, 150 copies of valid returns were obtained, achieving a 11% valid response rate. The result of factor analysis showed that explained variance of 56.35%. Cronbach's α of internal consistency was 0.84, Pearson’s correlation coeffi cient for test-retest reliability of the total score was 0.74, demonstrating its validity and reliability. Conclusion: From this clinical ethical behavior scale, an offi cial version was developed. This clinical ethical behavior scale for psychiatrists included 23 questions comprising four factors, namely nonmalefi cence, autonomy, benefi cence, and justice.