醫療糾紛的風險控制：風險醫療量表的發展

Risk Control of Medical Disputes-Development of Risk Medical Scale

本研究旨在建構一套減少醫療糾紛的風險醫療量表，協助臨床醫師強化對風險的辨識與控管，降低醫病對立，促進醫病雙贏。本研究採用三角檢證法訪談收集初步資料，分析醫療糾紛風險之主次要構面，進而建立初步量表。建立量表後以德菲法方式，邀集跨專業領域專家進行三輪問卷調查與意見整合，透過統計分析尋求專家們的最大共識。依據訪談專家學者共18位完歸納出四構面，分別為:就醫經驗、醫病關係、個人特質、教育訓練，透過標記、編碼和摘要，將資料整理後發展出初步量表。透過三次德菲法的問卷，最終找出共識的8題建立初步風險醫療量表，M>3.5、Mo≧4、SD<1、CV<0.3和Kendall's W係數0.253。醫療風險主因是資訊不透明與共識不足，導致醫療糾紛頻生。醫護人員應尊重患者自主權，避免不公開行為。透過強化知情同意與共享決策，既能有效降低風險、亦減少訴訟並節省成本。本研究初步風險評估量表可助醫師評估，減少風險，促進醫病雙贏，未來將持續完善。

This study aims to construct a medical risk assessment scale to help clinical physicians enhance risk identification and management, thereby reducing the risk of medical disputes. This study adopts the triangulation method to analyze the main dimensions of medical risk. After establishing the scale, the Delphi method is used to invite experts from various professional fields to participate in a three-round questionnaire survey. Statistical analysis is then used to seek the maximum consensus among the experts. Based on interviews with a total of 18 experts and scholars, a preliminary questionnaire was developed. Through three rounds of Delphi method questionnaires, a consensus was reached on 8 items to establish the initial medical risk scale, M>3.5、Mo≧4、SD<1、CV<0.3 & Kendall's W 0.253. The primary causes of medical risk are a lack of information transparency and insufficient consensus, which frequently lead to medical disputes. By strengthening informed consent and shared decision-making, we can effectively lower these risks, reduce lawsuits, and save costs. This study's preliminary risk assessment scale can help physicians in their evaluations, mitigate risk, and promote a win-win situation for both doctors and patients. We will continue to refine this scale in the future.(J Med Health. 2025;14(3):67-76)