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題 名 | 醫病互動與醫囑遵循=Doctor-Patient Interaction and Medical Adherence |
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作 者 | 許文耀; 鍾瑞玫; 陳秀卿; | 書刊名 | 公共衛生 |
卷 期 | 24:1 1997.04[民86.04] |
頁 次 | 頁41-49 |
分類號 | 419.47 |
關鍵詞 | 醫病互動; 醫囑遵循; 指涉性互動行為; Doctor-patient interaction; Medical adherence; Referential interaction; |
語 文 | 中文(Chinese) |
中文摘要 | 本研院的主要目的是想了解目前醫生與病人的互動狀態,以及此種互動狀態與醫 囑遵循間的關係。 本研究以 Bijou 等人 (1986 年 ) 發展的「指涉性互動行為辨識與分析 手冊」為依據,了解醫生與病人的「引發話題」、「相關反應」及「未完成反應」的次數及 百分比。由 52 位罹患高血壓或糖尿病的病人看診過程中,發現在醫病互動過程中,大多是 由醫生引發話題,而病人做附應的相關反應。由醫生及病人的反應類別與醫囑遵循的相關結 果發現,病人的「未完成反應」愈多,則其醫囑遵循愈高;與醫生的互動中,醫生引發話題 後,病人附應的相關反應愈多病人的醫囑遵循愈低,相反地,病人回應出未完成反應愈多, 則其醫囑遵循愈高。此種結果說明如果病人僅是一味地跟隨醫生的問話及指示來回應,則其 醫囑遵循的意願降低;反之,如果他主動要求醫生給予反應 (未完成反應的意義 ),則其醫 囑遵循反而提昇。本研究認為醫病互動過程中,不要只強調病人應與醫生配合,而要多注意 病人主動提出或其關心的主題,這可能是處理病人疾病的重要之處。 |
英文摘要 | This study is intended to explore the relationship between medical adherence and doctor-patient interactions in outpatient setting. "The Manual of Instructions for Identifying and Analyzing Referential Interaction" developed by Bijou et al., (1986) is used to rate the frequency and percentile of "initiation of referent", "relevant reaction" and "irrelevant reaction" in the responses of both doctor and patient. Fifty-two patients diagnosed as high blood pressure or diabetes are selected for study. In the doctor-patient interaction, most of the time doctors initiate the referent, then patients make the relevant reactions. According to the doctor/patient response categories, when patients have more relevant reactions, the more their behaviors of medical adherence increase. After the doctor initiates if patients respond with more relevant reactions, then they will tend to have lower medical adherence, whereas if they respond with more irrelevant reactions, then they will tend to have higher medical adherence. The result suggests that if patients only follow the doctor's questions, they are less willing to adhere to the doctor's suggestions; on the other hand, if patients demand relevant reactions from the doctor, their medical adherence increases. This study proposes that doctors should take seriously those issues raised by patients, because they would significantly effect the treatment process. |
本系統中英文摘要資訊取自各篇刊載內容。