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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 陳端容 | |
dc.contributor.author | Hsueh-Min Hsu | en |
dc.contributor.author | 許學旻 | zh_TW |
dc.date.accessioned | 2021-06-17T06:16:23Z | - |
dc.date.available | 2019-09-04 | |
dc.date.copyright | 2018-09-04 | |
dc.date.issued | 2018 | |
dc.date.submitted | 2018-08-31 | |
dc.identifier.citation | Ainsworth-Vaughn, N. (1995). Claiming power in the medical encounter: the whirlpool discourse. Qualitative health research, 5(3), 270-291.
Annas, G. J., & Healey Jr, J. M. (1974). The Patient Rights Advocate: Redefinig the Doctor-Patient Relationship in the Hospital Context. Vand. L. Rev., 27, 243. Anzilotti, G. I. (1982). The rhetorical question as an indirect speech device in English and Italian. Canadian Modern Language Review, 38(2), 290-302. Armstrong, D. (1984). The patient's view. Social science & medicine, 18(9), 737-744. Aronsson, K., & Rundström, B. (1988). Child discourse and parental control in pediatric consultations. Text-Interdisciplinary Journal for the Study of Discourse, 8(3), 159-190. Aronsson, K., & Rundström, B. (1989). Cats, dogs, and sweets in the clinical negotiation of reality: On politeness and coherence in pediatric discourse. Language in society, 18(4), 483-504. Baker, P. S., Yoels, W. C., Clair, J. M., & Allman, R. M. (1997). Laughter in triadic geriatric medical encounters: a transcript-based analysis. Social perspectives on emotion, 4, 179-210. Beck, R. S., Daughtridge, R., & Sloane, P. D. (2002). Physician-patient communication in the primary care office: a systematic review. The Journal of the American Board of Family Practice, 15(1), 25-38. Beisecker, A. E. (1989). The influence of a companion on the doctor-elderly patient interaction. Health Communication, 1(1), 55-70. Bensing, J. (1991). Doctor-patient communication and the qualityof care. Social science & medicine, 32(11), 1301-1310. Bernard, H. R. (2017). Research methods in anthropology: Qualitative and quantitative approaches: Rowman & Littlefield. Binbin, Z. (1999). Asymmetry and mitigation in Chinese medical interviews. Health Communication, 11(3), 209-214. Brown, P., & Levinson, S. C. (1978). Universals in language usage: Politeness phenomena. In Questions and politeness: Strategies in social interaction (pp. 56-311). Cambridge University Press. Brown, R. F., Butow, P. N., Henman, M., Dunn, S. M., Boyle, F., & Tattersall, M. H. (2002). Responding to the active and passive patient: flexibility is the key. Health expectations, 5(3), 236-245. Burgoon, M., Parrot, R., Burgoon, J. K., Birk, T., Pfau, M., & Coker, R. (1990). Primary care physicians' selection of verbal compliance-gaining strategies. Health Communication, 2(1), 13-27. Byrne, P. S., & Long, B. E. (1976). Doctors talking to patients. A study of the verbal behaviour of general practitioners consulting in their surgeries. Candlin, C. N., Maley, Y., & Sutch, H. (1999). Industrial instability and the discourse of enterprise bargaining. Talk, work and institutional order, 323-350. Carroll, J., Frankel, R., Keller, A., Klein, T., & Williams, P. (2012). The medical interview: clinical care, education, and research: Springer Science & Business Media. Cegala, D. J. (1997). A study of doctors' and patients' communication during a primary care consultation: Implications for communication training. Journal of Health Communication, 2(3), 169-194. Chandler, D. (2007). Semiotics: the basics: Routledge. Chapple, A., Campion, P., & May, C. (1997). Clinical terminology: anxiety and confusion amongst families undergoing genetic counseling. Patient Education and Counseling, 32(1-2), 81-91. Charles, C., Gafni, A., Whelan, T., & O’Brien, M. A. (2006). Cultural influences on the physician–patient encounter: the case of shared treatment decision-making. Patient Education and Counseling, 63(3), 262-267. Charles, C., Whelan, T., & Gafni, A. (1999). What do we mean by partnership in making decisions about treatment? Bmj, 319(7212), 780-782. Chatterjee, S., & Choudhury, N. (2011). Medical communication skills training in the Indian setting: Need of the hour. Asian J Transfus Sci, 5(1), 8-10. doi:10.4103/0973-6247.75968 Cheng, L.-F. (1998). En/gendering doctors: gender relations in the medical profession in Taiwan 1945-1995. University of Essex. Claramita, M., Nugraheni, M. D., van Dalen, J., & van der Vleuten, C. (2013). Doctor–patient communication in Southeast Asia: a different culture? Advances in Health Sciences Education, 18(1), 15-31. Claramita, M., Utarini, A., Soebono, H., Van Dalen, J., & Van der Vleuten, C. (2011). Doctor–patient communication in a Southeast Asian setting: The conflict between ideal and reality. Advances in Health Sciences Education, 16(1), 69-80. Clayman, M. L., Roter, D., Wissow, L. S., & Bandeen-Roche, K. (2005). Autonomy-related behaviors of patient companions and their effect on decision-making activity in geriatric primary care visits. Social science & medicine, 60(7), 1583-1591. Coe, R. M., & Prendergast, C. G. (1985). The formation of coalitions: Interaction strategies in triads. Sociology of Health & Illness, 7(2), 236-247. Collins, R. (1990). Changing conceptions in the sociology of the professions. The formation of professions: Knowledge, state and strategy, 11-23. Crowe, M. (1998). The power of the word: some post‐structural considerations of qualitative approaches in nursing research. Journal of advanced nursing, 28(2), 339-344. De Haes, H., & Bensing, J. (2009). Endpoints in medical communication research, proposing a framework of functions and outcomes. Patient Education and Counseling, 74(3), 287-294. DiMatteo, M. R., Taranta, A., Friedman, H. S., & Prince, L. M. (1980). Predicting patient satisfaction from physicians' nonverbal communication skills. Medical care, 376-387. Drew, P., & Heritage, J. (2006). Conversation analysis (Vol. 1): Sage London. Duffy, F. D., Gordon, G. H., Whelan, G., Cole-Kelly, K., & Frankel, R. (2004). Assessing competence in communication and interpersonal skills: the Kalamazoo II report. Academic Medicine, 79(6), 495-507. Edwards, D., & Potter, J. (1992). Discursive psychology (Vol. 8): Sage. Epstein, R., & Street, R. L. (2007). Patient-centered communication in cancer care: promoting healing and reducing suffering: National Cancer Institute, US Department of Health and Human Services, National Institutes of Health Bethesda, MD. Fairclough, N. (1992). Discourse and text: Linguistic and intertextual analysis within discourse analysis. Discourse & Society, 3(2), 193-217. Fisher, S., & Groce, S. B. (1990). Accounting practices in medical interviews. Language in Society, 19(2), 225-250. Fisher, S., & Todd, A. D. (1988). Gender and Discourse the Power of Talk. Flexner, A. (2001). Is social work a profession? Research on social work practice, 11(2), 152-165. Foucault, M. (1980). Power/knowledge: Selected interviews and other writings, 1972-1977: Pantheon. Frank, J. (1990). You call that a rhetorical question?: Forms and functions of rhetorical questions in conversation. Journal of Pragmatics, 14(5), 723-738. Greene, M. G., Adelman, R. D., Friedmann, E., & Charon, R. (1994). Older patient satisfaction with communication during an initial medical encounter. Social science & medicine, 38(9), 1279-1288. Greene, M. G., Majerovitz, S. D., Adelman, R. D., & Rizzo, C. (1994). The effects of the presence of a third person on the physician‐older patient medical interview. Journal of the American Geriatrics Society, 42(4), 413-419. Grice, H. P. (1975). Logic and conversation. Cole et al., Eds. Syntax and Semantics 3: Speech arts. 1975, 41-58. Griffin, S. J., Kinmonth, A.-L., Veltman, M. W., Gillard, S., Grant, J., & Stewart, M. (2004). Effect on health-related outcomes of interventions to alter the interaction between patients and practitioners: a systematic review of trials. The Annals of Family Medicine, 2(6), 595-608. Hagihara, A., & Tarumi, K. (2007). Association between physicians’ communicative behaviors and judges’ decisions in lawsuits on negligent care. Health Policy, 83(2-3), 213-222. Hall, J. A., Roter, D. L., & Katz, N. R. (1988). Meta-analysis of correlates of provider behavior in medical encounters. Medical care, 657-675. Harmsen, H., Meeuwesen, L., Van Wieringen, J., Bernsen, R., & Bruijnzeels, M. (2003). When cultures meet in general practice: intercultural differences between GPs and parents of child patients. Patient Education and Counseling, 51(2), 99-106. Harvey, K., & Adolphs, S. (2012). Discourse and healthcare. The Routledge handbook of discourse analysis, 470-481. Helman, C. G. (1984). The role of context in primary care. JR Coll Gen Pract, 34(267), 547-550. Hutchison, S. R., Bomford, R., & Hunter, D. (1956). Hutchison's Clinical Methods: Cassell. Ishikawa, H., Roter, D. L., Yamazaki, Y., & Takayama, T. (2005). Physician–elderly patient–companion communication and roles of companions in Japanese geriatric encounters. Social science & medicine, 60(10), 2307-2320. Jarrett, N., & Payne, S. (1995). A selective review of the literature on nurse‐patient communication: has the patient's contribution been neglected'. Journal of advanced nursing, 22(1), 72-78. Kaplan, S. H., Greenfield, S., Gandek, B., Rogers, W. H., & Ware, J. E. (1996). Characteristics of physicians with participatory decision-making styles. Annals of internal medicine, 124(5), 497-504. Kaplan, S. H., Greenfield, S., & Ware, J. (1989). Impact of the doctor-patient relationship on the outcomes of chronic disease. Communicating with medical patients, 228-245. Karnieli-Miller, O., Werner, P., Neufeld-Kroszynski, G., & Eidelman, S. (2012). Are you talking to me?! An exploration of the triadic physician–patient–companion communication within memory clinics encounters. Patient Education and Counseling, 88(3), 381-390. Kawulich, B. B. (2005). Participant observation as a data collection method. Paper presented at the Forum Qualitative Sozialforschung/Forum: Qualitative Social Research. Keady, J., & Nolan, M. (2003). The dynamics of dementia: Working together, working separately, or working alone. Partnerships in family care, 2003, 15-32. King, A., & Hoppe, R. B. (2013). “Best practice” for patient-centered communication: a narrative review. Journal of graduate medical education, 5(3), 385-393. Kjellgren, K. I., Ahlner, J., & Säljö, R. (1995). Taking antihypertensive medication—controlling or co-operating with patients? International journal of cardiology, 47(3), 257-268. Korsch, B. M., Gozzi, E. K., & Francis, V. (1968). Gaps in doctor-patient communication: I. Doctor-patient interaction and patient satisfaction. Pediatrics, 42(5), 855-871. Kress, G. (1990). Linguistic processes in sociocultural practice. Kuipers, J. C. (1989). “Medical discourse” in anthropological context: views of language and power. Medical Anthropology Quarterly, 3(2), 99-123. Labrecque, M. S., Blanchard, C. G., Ruckdeschel, J. C., & Blanchard, E. B. (1991). The impact of family presence on the physician-cancer patient interaction. Social science & medicine, 33(11), 1253-1261. Laidsaar-Powell, R. C., Butow, P., Bu, S., Charles, C., Gafni, A., Lam, W., . . . Tattersall, M. (2013). Physician–patient–companion communication and decision-making: a systematic review of triadic medical consultations. Patient Education and Counseling, 91(1), 3-13. Lambert, B. L., Street, R. L., Cegala, D. J., Smith, D. H., Kurtz, S., & Schofield, T. (1997). Provider-patient communication, patient-centered care, and the mangle of practice. Health Communication, 9(1), 27-43. Larson, M. S., & Larson, M. S. (1979). The rise of professionalism: A sociological analysis (Vol. 233): Univ of California Press. Levinson, S. C. (1983). Pragmatics. Cambridge textbooks in linguistics. Cambridge/New York. Levinson, W., Lesser, C. S., & Epstein, R. M. (2010). Developing physician communication skills for patient-centered care. Health affairs, 29(7), 1310-1318. Levinson, W., Roter, D. L., Mullooly, J. P., Dull, V. T., & Frankel, R. M. (1997). Physician-patient communication: the relationship with malpractice claims among primary care physicians and surgeons. JAMA, 277(7), 553-559. Maguire, P., Fairbairn, S., & Fletcher, C. (1986). Consultation skills of young doctors: I--Benefits of feedback training in interviewing as students persist. Br Med J (Clin Res Ed), 292(6535), 1573-1576. Maguire, P., & Pitceathly, C. (2002). Key communication skills and how to acquire them. Bmj, 325(7366), 697-700. Makoul, G. (2001). Essential elements of communication in medical encounters: the Kalamazoo consensus statement. Academic Medicine, 76(4), 390-393. Makoul, G., & Clayman, M. L. (2006). An integrative model of shared decision making in medical encounters. Patient Education and Counseling, 60(3), 301-312. Mei-hui, T. (2003). Problems in identifying participant structures in medical triadic conversation. Journal of Taiwanese Languages and Literature, 1, 185-211. Mishler, E. G. (1984). The discourse of medicine: Dialectics of medical interviews (Vol. 3): Greenwood Publishing Group. Noble, L. (2002). Communication skills training: pragmatism versus proof. Medical education, 36(2), 108-109. Oates, J., Weston, W. W., & Jordan, J. (2000). The impact of patient-centered care on outcomes. Fam Pract, 49(9), 796-804. Ong, L. M., De Haes, J. C., Hoos, A. M., & Lammes, F. B. (1995). Doctor-patient communication: a review of the literature. Social science & medicine, 40(7), 903-918. Parsons, T. (1951). Illness and the role of the physician: A sociological perspective. American Journal of orthopsychiatry, 21(3), 452-460. Popay, J., Rogers, A., & Williams, G. (1998). Rationale and standards for the systematic review of qualitative literature in health services research. Qualitative health research, 8(3), 341-351. Potter, J., & Wetherell, M. (1987). Discourse and social psychology: Beyond attitudes and behaviour: Sage. Prohaska, T. R., & Glasser, M. (1996). Patients' views of family involvement in medical care decisions and encounters. Research on aging, 18(1), 52-69. Ramirez, A. J., Graham, J., Richards, M., Gregory, W., & Cull, A. (1996). Mental health of hospital consultants: the effects of stress and satisfaction at work. The Lancet, 347(9003), 724-728. Ranjan, P., Kumari, A., & Chakrawarty, A. (2015). How can doctors improve their communication skills? Journal of clinical and diagnostic research: JCDR, 9(3), JE01. Rider, E. A., & Keefer, C. H. (2006). Communication skills competencies: definitions and a teaching toolbox. Medical education, 40(7), 624-629. Roter, D., & Hall, J. A. (2006). Doctors talking with patients/patients talking with doctors: improving communication in medical visits: Greenwood Publishing Group. Roter, D. L., & Hall, J. A. (2004). Physician gender and patient-centered communication: a critical review of empirical research. Annu. Rev. Public Health, 25, 497-519. Roter, D. L., Hall, J. A., & Katz, N. R. (1987). Relations between physicians' behaviors and analogue patients' satisfaction, recall, and impressions. Medical care, 437-451. Ryn, M. v. (1997). Developing effective helping relationships in health education practice. Health Education & Behavior, 24(6), 683-702. Sakai, E. Y., & Carpenter, B. D. (2011). Linguistic features of power dynamics in triadic dementia diagnostic conversations. Patient Education and Counseling, 85(2), 295-298. Sari, M. I., Prabandari, Y. S., & Claramita, M. (2016). Physicians’ professionalism at primary care facilities from patients’ perspective: the importance of doctors’ communication skills. Journal of family medicine and primary care, 5(1), 56. Schilling, L. M., Scatena, L., Steiner, J. F., Albertson, G. A., Lin, C., Cyran, L., . . . Anderson, R. J. (2002). The third person in the room: frequency, role, and influence of companions during primary care medical encounters. Journal of Family Practice, 51(8), 685-692. Silk, K. J., Westerman, C. K., Strom, R., & Andrews, K. R. (2008). The role of patient-centeredness in predicting compliance with mammogram recommendations: an analysis of the Health Information National Trends Survey. Communication Research Reports, 25(2), 131-144. Silva, G. A., Czeisler, C., Niece, K. L., Beniash, E., Harrington, D. A., Kessler, J. A., & Stupp, S. I. (2004). Selective differentiation of neural progenitor cells by high-epitope density nanofibers. Science, 303(5662), 1352-1355. doi:10.1126/science.1093783 Silverman, D. (1987). Communication and medical practice: Social relations in the clinic: Sage Publications Ltd. Silverman, J., Kurtz, S., & Draper, J. (2016). Teaching and learning communication skills in medicine: CRC press. Smith, A. P., & Beattie, B. L. (2001). Disclosing a diagnosis of Alzheimer’s disease: patient and family experiences. Canadian Journal of Neurological Sciences, 28(S1), S67-S71. Starks, H., & Brown Trinidad, S. (2007). Choose your method: A comparison of phenomenology, discourse analysis, and grounded theory. Qualitative health research, 17(10), 1372-1380. Stern, D. T. (2006). Measuring medical professionalism: Oxford University Press. Stern, D. T., & Papadakis, M. (2006). The developing physician—becoming a professional. New England Journal of Medicine, 355(17), 1794-1799. Stewart, M. (2003). Patient-centered medicine: transforming the clinical method: Radcliffe Publishing. Stewart, M. A. (1984). What is a successful doctor-patient interview? A study of interactions and outcomes. Social science & medicine, 19(2), 167-175. Stewart, M. A. (1995). Effective physician-patient communication and health outcomes: a review. CMAJ: Canadian Medical Association Journal, 152(9), 1423. Stewart, M. E., & Roter, D. E. (1989). Communicating with medical patients: Sage Publications, Inc. Szasz, T. S., & Hollender, M. H. (1956). The basic models of the doctor-patient relationship. The Social Medicine Reader. University of North Carolina, 278-286. Tannen, D. (1987). Remarks on discourse and power. Power through discourse, 3-10. Tannen, D. (1990). Rethinking power and solidarity in gender and dominance. Paper presented at the Annual Meeting of the Berkeley Linguistics Society. Tannen, D. (1994). Gender and discourse: Oxford University Press. Tannen, D., Hamilton, H. E., & Schiffrin, D. (2015). The handbook of discourse analysis: John Wiley & Sons. Tannen, D., & Wallat, C. (1983). Doctor/mother/child communication: Linguistic analysis of a pediatric interaction. The social organization of doctor-patient communication, 203-219. Tates, K., & Meeuwesen, L. (2001). Doctor–parent–child communication. A (re) view of the literature. Social science & medicine, 52(6), 839-851. Ten Have, P. (1989). The consultation as a genre. Text and talk as social practice, 115-135. Teutsch, C. (2003). Patient-doctor communication. Medical Clinics of North America, 87(5), 1115-1146. Tsai, M.-h. (2000). Companions of elderly patients: A sociolinguistic study of triadic medical encounters in Southern Taiwan. Citeseer. Tsai, M.-h. (2005). Opening stages in triadic medical encounters in Taiwan. Communication & medicine, 2(1), 53-68. Tsai, M.-h. (2007a). Where do they stand? Spatial arrangement of patient companions in geriatric out-patient interaction in Taiwan. Journal of Applied Linguistics, 4(2). Tsai, M.-h. (2007b). Who gets to talk? An alternative framework evaluating companion effects in geriatric triads. Communication, 4(1), 37-49. Turner, B. S. (1995). Medical power and social knowledge: Sage. Van Dolmen, A. (1998). Children’s contribution to pediatric outpatient consultations. Pediatrics, 8, 102-563. van Dulmen, A. M. (1998). Children's contributions to pediatric outpatient encounters. Pediatrics, 102(3), 563-568. Virshup, B. B., Oppenberg, A. A., & Coleman, M. M. (1999). Strategic risk management: reducing malpractice claims through more effective patient-doctor communication. American Journal of Medical Quality, 14(4), 153-159. von Friederichs-Fitzwater, M. M., & Gilgun, J. (2001). Relational control in physician-patient encounters. Health Communication, 13(1), 75-87. Waitzkin, H. (1991). The politics of medical encounters: how doctors and patients deal with social problems. New Haven and London, Yale University. Wanzer, M. B., Booth-Butterfield, M., & Gruber, K. (2004). Perceptions of health care providers' communication: relationships between patient-centered communication and satisfaction. Health Communication, 16(3), 363-384. Wolff, J. L., Guan, Y., Boyd, C. M., Vick, J., Amjad, H., Roth, D. L., . . . Roter, D. L. (2017). Examining the context and helpfulness of family companion contributions to older adults’ primary care visits. Patient Education and Counseling, 100(3), 487-494. Wolff, J. L., & Roter, D. L. (2008). Hidden in plain sight: medical visit companions as a resource for vulnerable older adults. Archives of Internal Medicine, 168(13), 1409-1415. Wolff, J. L., & Roter, D. L. (2011). Family presence in routine medical visits: a meta-analytical review. Social science & medicine, 72(6), 823-831. Zaleta, A. K., & Carpenter, B. D. (2010). Patient-centered communication during the disclosure of a dementia diagnosis. American Journal of Alzheimer's Disease & Other Dementias®, 25(6), 513-520. Zolnierek, K. B. H., & DiMatteo, M. R. (2009). Physician communication and patient adherence to treatment: a meta-analysis. Medical care, 47(8), 826. 王德威譯. (1993). 知識的考掘. 台北: 麥田. 成令方. (2002). 醫 [用] 關係的知識與權力. 台灣社會學, 3, 11-71. 莊茂. (2000). 台灣病人人權之研究. 台灣醫學人文學刊, 1(1), 86-101. 陳映燁, &李明濱. (2000). 醫學倫理學之理論與原則. 醫學教育, 4(1), 3-22. 藍采風, &廖榮利. (1984). 醫療社會學: 三民書局. 蘇喜, 李敏禎, &劉嘉玲. (1998). 某醫學中心家庭醫學科病人候診與看診時間之研究. 中華公共衛生雜誌, 17(6), 504-511. | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/71953 | - |
dc.description.abstract | 本研究藉由剖析實際的醫病溝通,提供一個從醫療現場研究醫病關係的觀點,並關注於醫病溝通間醫師、病人與陪同者相互協商與共同建構的溝通過程。由於醫療參與者間知識與權力不對等,導致在看診時,彼此為了達到各自的溝通目的而使用不同的溝通策略。希望能藉由分析臨床上實際的問診過程,反映出台灣現今醫病關係的現況,進而增進醫病溝通的可能。
Armstrong (1984)從社會行為的角度出發,指出病人的觀點、病患的主體性是醫學與社會科學的研究重點。受到行為科學的影響,從七十年代起,醫病溝通的研究在西方已蓬勃發展數十年,雖然台灣的醫學教育與體系承襲西方醫學,但醫病溝通除了受到醫療參與者知識不平等與權力拉鋸的影響,文化與社會的因素也深具影響力。在台灣特殊的醫療環境之下,看診時間相對的短,如何能在一個具有時間壓力的情況下藉由交換資訊來完成有效良好的溝通,替病患正確的診斷,回答病患的擔憂,找到最適切的醫療處置,達到醫病共決,並增加病人遵醫囑的接受度,著實需要醫療參與者的智慧與相互配合。 本研究為觀察型的研究,並採用質化與言談分析的方式來分析門診間的口語溝通策略,藉由剖析醫師、病患與陪同者間共同構築而成的協商,來探究參與者實際的溝通目的。本研究在北部一間醫學中心的眼科門診執行,總共有68位患者參與本研究,28位男性,40位女性,陪同者共有23位,6位妻子、5位先生、9位女兒、1位兒子與1位女性友人。在問診過程中,醫師使用了至少13種口語溝通策略來溝通協商。這些溝通策略主要可以分為三個部分:(1) 提供訊息 (providing information),(2) 醫療決定 (treatment decision-making),(3) 藉由語言表達來弱化嚴重程度,或是拉近與聽者關係的其他口語溝通策略。其中,第三類的口語溝通策略出現的次數最多,佔的比例最高 (57%),其次是治療決策的時候 (26%),較少的是出現在資訊提供的階段,佔總體策略的16%。 本研究的目標是希望能呈現醫師面對不同患者在訊息提供與醫療決策的階段,為了特定的溝通目的,所使用的不同口語溝通策略。透過實際問診過程的分析,在台灣特殊的文化背景下,提供醫療參與者與研究者一個不同的視角,從實際溝通的內涵與醫療現場出發,剖析醫病協商的現況與重要性,以期在未來達到更平等、和諧的醫病溝通與醫病關係。 | zh_TW |
dc.description.abstract | This study investigates face-to-face doctor-patient communication and aims to provide a different viewpoint of doctor-patient relationships. It illustrates doctor-patient communication as a negotiated and co-constructed process between the doctor, patients, and patients’ companions. Due to their power asymmetry, the participants use different verbal strategies to achieve their communicative goals. Through examining the consultations, we hope to demonstrate the doctor-patient relationships in Taiwan and to find a way to improve doctor-patient communication.
Armstrong (1984) pointed out that the patient’s view and their subjectivity should be the focus of medical practice and social science research. Researches related to doctor-patient communication have incredibly increased in the past few decades in the West. Medical education and system in Taiwan have also adapted accordingly. Studies have shown that communication between doctors and patients is influenced by their institutional power asymmetry. In Taiwan, one consultation is relatively short so it needs effort and skills to achieve good communication under the time pressure. How can doctors exchange information, diagnose correctly, answer patient’s questions and relieve their concerns, give medical recommendations, and decide medical treatments with the patients becomes very important. In this study, we analyze qualitatively through Discourse Analysis to show how the doctor, the patients, and their companions co-construct communication during their negotiations. This research is conducted in an eye clinic in a medical center in Northern Taiwan. There are in total 68 patients (28 males and 40 females), and 23 companions (6 wives, 5 husband, 9 daughters, 1 son, and 1 female friend) in this study. The doctor uses at least 13 kinds of verbal communication skills to negotiate with the participants. These communication strategies can be categorized into three parts: (1) providing information, (2) treatment decision-making, and (3) other verbal communication strategies. The frequency of other verbal communication strategies takes up 57% of all the verbal strategies. The strategies in treatment decision-making phase are 26%. In the stage of providing information, the frequency is 16%. The goal of this study is to show how an experienced doctor uses different verbal communication strategies when facing different kinds of patients and for different communicative purposes. Through the analysis of the consultations and under our unique cultural and social background, the study provides a different perspective for us to understand the importance of doctor-patient communication and to create more equal and harmonious doctor-patient relationships in Taiwan. | en |
dc.description.provenance | Made available in DSpace on 2021-06-17T06:16:23Z (GMT). No. of bitstreams: 1 ntu-107-R04850002-1.pdf: 959366 bytes, checksum: 39ecb673871cd71fc935b12c12caffab (MD5) Previous issue date: 2018 | en |
dc.description.tableofcontents | 謝辭 I
中文摘要 II 英文摘要 II 目錄 IV 表目錄 V 第一章緒論 1 第一節研究背景 1 第二節研究動機 3 第三節研究問題 7 第二章文獻探討 8 第一節醫病溝通 8 第二節權力 12 第三節醫療情境中的三方溝通 14 第三章研究方法 17 第一節 資料採集 19 第二節 研究方法 21 第三節 資料分析 23 第四章醫師之溝通策略 26 第一節 醫師資訊提供的溝通策略 33 第二節 醫師治療決策的溝通策略 50 第三節 醫師的其他口語溝通策略 64 第五章結論與建議 85 第一節 研究結論 85 第二節 研究貢獻 91 第三節 研究限制與未來研究方向 93 參考文獻 95 | |
dc.language.iso | zh-TW | |
dc.title | 醫師之溝通策略—以醫學中心之眼科門診為例 | zh_TW |
dc.title | A Physician’s Communicative Strategies in an Ophthalmological Clinic in a Medical Center | en |
dc.type | Thesis | |
dc.date.schoolyear | 106-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 楊長豪,劉宇挺 | |
dc.subject.keyword | 醫病溝通,醫病言談,醫師病人陪同者,權力, | zh_TW |
dc.subject.keyword | doctor-patient communication,medical discourse,doctor-patient-companion communication,power, | en |
dc.relation.page | 104 | |
dc.identifier.doi | 10.6342/NTU201804097 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2018-08-31 | |
dc.contributor.author-college | 公共衛生學院 | zh_TW |
dc.contributor.author-dept | 健康行為與社區科學研究所 | zh_TW |
顯示於系所單位: | 健康行為與社區科學研究所 |
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