探討婦女接受人工生殖之就醫體驗及選擇受術機構的關鍵因素

Abstract

背景：臺灣於聯合國全球生育率排名中敬陪末座。出生率低與少子化的現象顯然已成為國家發展危機。由於現今臺灣社會的適婚族群存在晚婚晚育的現象，且不孕症的男女性患者逐年增加，使得生育需求者對人工生殖治療需求逐年增長。儘管臺灣生殖醫療技術成功率已傲視全球，然而，如何建構一友善的尋求人工生殖治療的服務系統與政策，提升就醫體驗，對於提升生育率至關重要。 目的：本研究目的係以質性研究方式，了解曾尋求人工生殖婦女的就醫體驗與選擇人工生殖機構之重要決定因素；及歸納政府在保障就醫選擇與補助規範修改的政策建議。 方法：研究採半結構式深度訪談法，招募曾至人工生殖機構尋求治療的婦女，並且設計符合研究目的之訪談大綱來進行資料搜集。資料於整理成逐字稿後，再以內容分析方法來組織與萃取資料中的意義以得出實際面的結論或現象。 結果：研究共訪談20位曾接受人工生殖療程之婦女。分析資料顯示，婦女於治療後選擇的人工生殖機構關鍵因素，包含醫師的專業度、醫師的成功率與機構服務品質。而婦女接受人工生殖技術之就醫體驗經驗可歸納為醫病關係溝通、療程費用、用藥安全、機構體驗服務品質、心理情感支持，以及居家照護連續性。婦女對人工生殖就醫選擇與補助規範政策之主要建議，包含建立評鑑制度、人工生殖補助增加與範圍放寬、人工生殖療程費用透明化、建立生殖醫療照護整合平台，以及納入心理諮商服務。 結論：本研究主要探討與瞭解婦女選擇人工生殖機構之重要決定因素、就醫體驗，以及人工生殖補助規範的政策建議。研究結果可提供人工生殖機構擬定策略之建議，以提升團隊的服務品質，並給予政府相關單位提供婦女良好就醫體驗與保障權益政策擬定方向之參考。

Background: Taiwan ranks at the bottom in the United Nations' global fertility rate rankings, and the low birth rate and aging population have emerged as crises for national development. With delayed marriages and childbearing becoming increasingly common in Taiwanese society and a growing number of infertility, there is a rising demand for assisted reproductive technology (ART) treatments. Despite Taiwan's high success rates in ART, the primary challenge lies in establishing a patient-friendly service model and implementing policies to enhance the patient experience and boost fertility rates. Objective: This study aims to employ qualitative methods to understand the patient experience, the critical factors influencing the selection of assisted reproduction institutions, and policy recommendations concerning the selection of such institutions and treatment subsidies. Methods: A semi-structured in-depth interview approach was employed in this study, recruiting women who sought treatment at assisted reproduction institutions. Data collection utilized a tailored interview guide aligned with the aim and applied content analysis to organize and derive meaning, enabling the formulation of realistic conclusions. Results: A total of 20 women participated in the interviews. The results indicated that key factors influencing the selection of assisted reproduction institutions after treatment included the physician's expertise, success rate, and institutional service quality. The women's experiences with ART were categorized into physician-patient communication, treatment costs, medication safety, institutional service quality, psychological and emotional support, and the continuity of home care. The recommendations from these women regarding institution selection and subsidy policies included establishing an accreditation system, expanding subsidies for ART treatments, transparency in ART treatment costs, providing integrated platforms for reproductive medical care, and offering psychological counseling services. Conclusion: This study mainly investigates and understands the key factors influencing women's selection of assisted reproduction institutions, their experiences, and provides policy recommendations for treatment subsidies. This finding can offer suggestions for assisted reproduction institutions to enhance the quality of their services and provide guidance to relevant government agencies in formulating policies that ensure women have a positive experience and protect their rights.