2009年年會論文 -醫病溝通中的信任邏輯:醫病世界的探索
篇名
醫病溝通中的信任邏輯:醫病世界的探索
The Logic of Trust in Doctor-patient Communication—The Exploration of Doctor’s and Patient’s Worlds
作者
盧安邦
An-Bang, Lu
中文摘要
在台灣傳播領域的研究中,較多將心力集中於大眾傳播層次的研究,人際傳播的面向似乎相對較少受到重視,然而,人際傳播卻是人們生活的基礎,針對這個面向的探索是相當重要的。而在人際傳播中,醫病互動又佔據了一個特殊的角色,醫病互動時雙方基於相異的行動邏輯不斷協調、對話,本研究所欲探索的也就是醫病雙方行動邏輯的形貌。
本研究採用Oevermann的結構詮釋學作為研究方法,採用個案分析的方式,從個案中探求醫生和病人雙方互動時的一般性行動邏輯。本研究對一位女性家醫科醫師以及一位因胃潰瘍就醫的女性病患進行訪談,分析結果發現雙方的行動邏輯在信任這個主題上交會了,信任影響著醫病之間的行動策略,在雙方的信任邏輯中,病患和醫師所共同信任的只有西醫的科學系統,對醫療體制以及體制中的個人則相當不信任。除此之外,我們更發現了市場邏輯以及科層化制度對良好醫病關係的建立產生了相當大的限制。因此,我們必須正視結構上的問題才能夠為現存的醫病溝通問題找到可行的解決之道。
英文摘要
Most researches, of communication field in Taiwan, focus on mass communication. In comparison, less attention is paid to the dimension of interpersonal communication. However, interpersonal communication is the basis of human life. It’s quite important in connection with the exploration of this aspect. In the field of interpersonal communication, doctor-patient interaction plays a unique role. When a doctor and a patient interact, two parties with different action logic coordinate and converse constantly. What this research is about to explore is the appearance of action logic between a doctor and a patient.
This research uses Oevermann’s Objective Hermeneutics as the research method, and introduces the way of case study to explore the general action logic within doctor-patient interaction. This research interviews a female doctor of Family Medicine Department and a female patient who takes medical treatment due to a stomach ulcer. In the analysis consequence, we can find out that both sides’ action logic encounter in the topic of trust. Trust affects the strategy of action between a doctor and a patient. In trust logic of two parties, the common trust of a patient and a doctor is just the scientific system of western medicine. What two parties trust less are the medicine system and the individual in the system. Besides, we even discover that market logic and bureaucracy place many restrictions on establishing the great relationship between a doctor and a patient. Therefore, we must take serious on the problem of the structure, and then we are able to find a workable solution to the problem of the present doctor-patient communication.
中文關鍵詞
醫病溝通,信任,結構詮釋學
英文關鍵詞
doctor-patient communication, trust, objective hermeneutics
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