衝突管理新解──談醫療場域的醫（護）病衝突與溝通

An Alternative Interpretation of Conflict Management: Interpersonal Conflicts and Doctor (Nurse)/Patient Communications

本文期盼透過人際衝突的重新定義，提示人際溝通中意見表達與回應，在衝突管理中長期被忽略的面貌。每一次的沒有衝突，是當事人尚未意識到差異、歧見與不滿前，即由一方或雙方的互動協商，得到當下雙方都能接受的方案與結果。衝突管理的關鍵在於溝通與互動過程中，表達疑問／提問／抱怨／歧見的動機、方式與行動，以及回應疑問／提問／抱怨／歧見的時機與方式。人際衝突管理能力的關鍵在於：溝通者的動機（想不想）、認知（懂不懂）或行為（做不做）是否朝向協商與合作的方向盡力。在醫療場域中，有效管理衝突關鍵在於歧見與差異發生時，醫護方能否覺察歧見的時機點，把握衝突管理的主動權，藉由回應病人的歧見、抱怨或不滿，巧妙扭轉可能造成的衝突僵局。

In this paper, interpersonal conflict is redefined to highlight the conflict dimension, which is ignored in traditional definitions of this term. In this new definition, the“no conflict”situation refers to unnoticed differences, disagreements, or dissatisfaction that are accommodated or negotiated prior to being noticed. An essential element of conflict management is identifying the ideal time to express and respond to questions/complaints/disagreement. Communicative efforts for conflict management include increasing (affective) motives related to expressing and responding to disagreement; increasing (cognitively) confidence and competencies in managing interactive flows, and (behaviorally) engaging in communicative actions.