台灣婦女親善就醫環境的省思

Evaluation of Women-Centered Health Care in Taiwan

許多醫院已開始推行婦女親善門診和病房，但缺乏從性別觀點檢視這些宣稱親善的服務模式，是否植基於婦女的需求所規劃，品質的衡鑑又為何。本文將從女性主義觀點評析台灣醫療院所推行的婦女親善就醫服務模式。針對衛生署91年婦女親善就醫環境服務模式計劃之參與醫院進行內容分析，了解醫院的服務方案內容。結果發現方案內容以硬體設備和作業流程改善為主，藉此提高病人隱私與人性化就醫環境。醫病溝通與婦女的諮詢資訊需求、自決權利與身體意識是較被忽略的議題。部分醫院在業務流程管理，創新服務（婦女保健中心、婦女個人健康管理資料庫），成長團體，衛教諮詢室方面，有突破性的改革和顯著性的成效。多數醫院在親善方案介入後，婦女就醫滿意度提昇，但方案成效之維持與持續發展並不理想。普遍的問題是，母嬰親善與婦女親善觀念混淆，缺乏性別主流化思維，缺乏需求評估，成效評價能力不足。

A great number of hospitals have already started to develop women-centered wards and out-patient services, but there has been no evaluation from the perspective of gender of the quality of these so-called women-centered health service models and whether they are truly based on women's needs. This article evaluates these service models from a feminist perspective. We performed content analysis of cases at those hospitals that took part in the Department of Health's women-centered health care program in 2002. The results showed that the program's content was based on improvements in hardware and work flow, and, furthermore, enhanced patient privacy and the humanized nature of the patient environment. Some issues, like the interaction between doctor and patient, women's consultation needs, the right to make one's own decisions, and body awareness, were somewhat neglected. Some of the hospitals, however, had achieved break-through reforms and outcomes in management of procedures, innovative services (e.g., women's health centers and databases of women's health management), growth groups and health consultation rooms In many hospitals, levels of satisfaction among women were raised, but standards of retention and continued development of the effects of the program remain imperfect. Common problems were confusion of the concepts of mother-infant centered and women centered care, lack of consideration of gender mainstreaming, lack of needs assessment, and inadequacy of outcomes evaluation skills.