台灣醫師與病患對醫病關係看法之差異

The Gap between Viewpoints of Physicians and Patients about the Patient-Physician Relationships in Taiwan

目的：瞭解目前台灣醫師與病患之間對醫病關係之看法有何差異。方法：蒐集文獻歸納製作醫病關係問卷，研究對象為某區域醫院之醫師以及前來此前院就診之病患，問卷發放期間為2013年2月至9月，獲得填答問卷共計病患272份及醫師60份。採用之研究方法包含問卷之信度與效度、敘述統計、Mann-Whitney U檢定以及重要性-績效分析法等。結果：病患問卷得分最高之前三項（亦即超過25分）為：認為醫師會詳細記載病歷、會傾聽病患訴說病情及服務態度良好；又由反向題之分析得知病患認為多數醫師不會因為病患具特殊社經地位或關說送禮而特別照顧該病患。而醫師問卷得分最高之前三項（亦即超過2.8分）為醫師自認對病患之服務態度良好、自認總是抱持視病如親之態度以及病患尚存看病的結果一定會拿到藥或打針這種不正確的觀念。結論：近年來醫師多會仔細詢問病患之病史及藥物過敏史且會傾聽病患訴說病情，如此則可降低醫療處置錯誤率以避免醫療糾紛。建議：醫師應多與病患溝通，採用病患可以理解的方式說明用藥之副作用及吃較多的藥不見得有益於身體之觀念，且針對病況提供適合之治療方式並說明優缺點供病患選擇。

Objectives. The objective of this study was to investigate and analyze the gap in viewpoints regarding patient-physician relationships between patients and physicians in Taiwan. Methods. We collected the related literature to develop a questionnaire to investigate the patient-physician relationships. The subjects included physicians and patients of a regional hospital. During the period from August to September 2013, the questionnaire was issued to the subjects and completed by 272 patients and 60 physicians. The data was analyzed by statistical methods including reliability, validity, descriptive statistics, Mann-Whitney U test and Importance-Performance Analysis. Results. The three items, with highest scores, in patients’ questionnaire (higher than 2.5) were (1) most patients believe that their medical records were well documented, (2) physicians would listen carefully to the patients’ descriptions of their conditions, and (3) physicians’ attitudes towards patients would be very good. Analysis of reverse-coding items shows that most physicians do not take special care of those patients who have higher socioeconomic status, who send gifts to them, or intercede with them. With regard to the physicians’ questionnaire, the three items with highest scores (higher than 2.8) were (1) most physicians consider themselves to have good attitudes towards patients, (2) most physicians consider themselves as treating patients as if they were family members, and (3) most physicians believe that the patients still have the misconceptions that they should get some drugs or injections when each visit. Conclusion. In recent years, most physicians will ask patients about their medical records and drug allergy history, and they will listen carefully to patients’ descriptions of their conditions. This can reduce errors in medical treatment and prevent medical disputes. Suggestions: Physicians should communicate with patients more often in a manner in which patients can understand describing the side effects of medicine and explaining that taking more medicine is not necessarily beneficial to the body. They should provide appropriate treatment and explain the advantages and disadvantages of different treatment options.