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題名：影響臺灣地區民眾醫療信任相關因素之探討
書刊名：管理實務與理論研究
作者：邱政元／陳冠銘／黃子袁／陳敏郎 引用關係
作者(外文)：Chiou, Jeng-yuan／Chen, Guan-ming／Huang, Zih-yuan／Chen, Min-lang
出版日期：2016
卷期：10:1
頁次：頁113-134
主題關鍵詞：醫療信任；專業信任；制度信任；臺灣社會變遷基本調查；Medical trust；Professional trust；Institutional trust；Taiwan social change survey
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目的：現代醫療科技與管理不斷進展的同時，社會大眾對於醫師與醫療照護的信任程度在下降，但是尋求值得信任的醫師與醫療照護的需求不減。本文的目的在探討影響社會大眾對醫師與醫療體系之信任的相關因素。方法：資料來源為「台灣社會變遷基本調查」計畫，「健康與醫療照顧」議題的次級資料庫。以2,199份完訪樣本為對象，進行次數分配、百分比、卡方檢定、皮爾森相關分析、邏輯斯複迴歸等統計分析。結果與結論：回答信任醫師佔72.35%；信任醫療保健系統佔77.26%。信任醫師與信任醫療保健系統的程度，同時會因為教育程度、每月收入、自覺健康、生活品質、生活快樂的不同而有顯著差異。在迴歸分析中，生活快樂同時是「專業信任」(OR=1.41，p＜0.05)與「制度信任」(OR=1.50，p＜0.05)的顯著相關因子。社會大眾對制度信任的比例高於專業信任。專業信任漸漸依賴於制度信任，對醫師執業與醫療保健體系發展的挑戰，是值得關注的重要議題。在制度信任高於專業信任的醫療信任現象中，強化社會大眾對醫療機構的信任，會是改善醫病關係與增進醫師信任的有效途徑。
Objectives: Although trust in the medical field was declining in the progressive process of managed health care, but the patients’ need for trustworthy care is undiminished. The purpose of this article was to investigate the medical trust in Taiwan. Methods: Data were drawn from the 2011 Taiwan Social Change Survey (TSCS, n=2,199), which included a topical module on Health questionnaire revealed the status of health and medical care issue. Case summary, χ^2 test, Pearson correlation and multiple logistic regression analyses were conducted to investigate the relationship among variables. Results and Conclusions: 72.35% respondents reported trust in physicians and 77.26% trust in medical system. Variables filter by educational level, monthly income, health awareness, life quality and happiness showed statistically significant both in the measurement of trust in physician and medical system. In adjusted analyses, both in trusted physician (OR=1.41, 95% CI=1.06-1.90) and medical system (OR=1.50, 95% CI=1.09-2.06) dimensions, respondents with happiness reported had higher odds of reporting than respondents with unhappiness reported. Respondents reported more trust of medical system than physicians. The rise of managed care often is seen as undermining and lessening the trustworthiness of care. But, whether what circumstances, managed health care might make medical process more trustworthy, not less. In our views, that would be a continually challenge for physicians and health care system which can operate in ways that merit patients’ trust.
期刊論文
1.Hall, M. A.、Dugan, E.、Zheng, B.、Mishra, A. K.(2001)。Trust in physicians and medical institutions: What is it, can it be measured, and does it matter?。The Milbank Quarterly，79(4)，613-639。  new window
2.Hall, M. A.(2006)。Researching medical trust in the United States。Journal of Health Organization and Management，20(5)，456-467。  new window
3.Thom, D. H.、Ribisl, K. M.、Stewart, A. L.、Luke, D. A.(1999)。Further validation and reliability testing of the Trust in Physician Scale。Medical Care，37(5)，510-517。  new window
4.Thom, D. H.(2001)。Physician behaviors that predict patient trust。Journal of Family Practice，50(4)，323-328。  new window
5.Caterinicchio, Russell P.(1979)。Testing Plausible Path Models of Interpersonal Trust in Patient-Physician Treatment Relationships。Social Science & Medicine，13，81-99。  new window
6.Thom, D. H.、Hall, M. A.、Pawlson, L. G.(2004)。Measuring Patients’ Trust in Physicians When Assessing Quality of Care。Quality Of Care，23(4)，124-132。  new window
7.Thom, D. H.、Kravitz, R, L.、Bell, R. A.、Krupat, E.、Azari, R.(2002)。Patient Trust in the Physician: Relationship to Patient Requests。Family Practice，19(5)，476-483。  new window
8.陳秀敏、李尹暘、林麗娟(20130300)。糖尿病患血糖控制的假期效應--醫病關係之影響。醫務管理期刊，14(1)，1-17。new window  延伸查詢new window
9.葉永文(20120500)。醫病關係：一種信任問題的考察。臺灣醫學人文學刊，13(1/2)，77-103。new window  延伸查詢new window
10.黃旭男、張維容(20140600)。病人對醫師與醫院信任、滿意與忠誠之關係。健康管理學刊，12(1)，1-20。new window  延伸查詢new window
11.Bachinger, S. M.、Kolk, A. M.、Smets, E. M.(2009)。Patients’ trust in their physician-psychometric properties of the Dutch version of the ’wake forest physician trust scale。Patient Education and Counseling，76，126-131。  new window
12.Balkrishnan, R.、Dugan, E.、Camacho, F. T.、Hall, M. A.(2003)。Trust and satisfaction with physicians, insurers, and the medical profession。Medical Care，41(9)，1058-1064。  new window
13.Benjamin, M. R.(2006)。Religious influences on trust in physicians and the health care system。International Journal of Psychiatry in Medicine，36(1)，69-83。  new window
14.Bova, C.、Fennie, K. P.、Watrous, E.、Dieckhaus, K.、Williams, A. B.(2006)。The Health Care Relationship (HCR) Trust Scale: Development and Psychometric Evaluation。Research in Nursing and Health，29，477-488。  new window
15.Eveleigh, R. M.、Muskens, E.、van Ravesteijn, H.、van Dijk, I.、van Rijswijk, E.、Lucassen, P.(2012)。An overview of 19 instruments assessing the doctor-patient relationship: different models or concepts are used。Journal of Clinical Epidemiology，65(1)，10-15。  new window
16.Fiscella, K.、Meldrum, S.、Franks, P.、Shields, C. G.、Duberstein, P.、McDaniel, S. H.、Epstein, R. M.(2004)。Patient trust: is it related to patient-centered behavior of primary care physicians。Medical Care，42(11)，1049-1055。  new window
17.Gray, Bradford H.(1997)。Trust and trustworthy care in the managed care era。Health Affair，16(1)，34-49。  new window
18.Gudzune, K. A.、Bennett, W. L.、Cooper, L. A.、Bleich, S. N.(2014)。Patients who feel judged about their weight have lower trust in their primary care providers。Patient Education and Counseling，97(1)，128-131。  new window
19.Guffey, T.、Yang, P. Q.(2012)。Trust in doctors: Are African Americans less likely to trust their doctors than white Americans。Sage Open，2(4)，1-8。  new window
20.Jones, D. E.、Carson, K. A.、Bleich, S. N.、Cooper, L. A.(2012)。Patient trust in physicians and adoption of lifestyle behaviors to control high blood pressure。Patient Education and Counseling，89(1)，57-62。  new window
21.Kao, A. C.、Green, D. C.、Davis, N. A.、Koplan, J. P.、Cleary, P. D.(1998)。Patients' trust in their physicians。Journal of General Internal Medicine，13(10)，681-686。  new window
22.Keating, N. L.、Gandhi, T. K.、Orav, E. J.、Bates, D. W.、Ayanian, J. Z.(2004)。Patient characteristics and experiences associated with trust in specialist physicians。Archives of Internal Medicine，164(9)，1015-1020。  new window
23.Mechanic, D.(1998)。The functions and limitations of trust in the provision of medical care。Journal of Health Politics, Policy and Law，23(4)，661-686。  new window
24.Mechanic, D.(1996)。Changing medical organization and the erosion of trust。Milbank Quarterly，74(2)，171-189。  new window
25.Puhl, R. M.、Gold, J. A.、Luedicke, J.、DePierre, J. A.(2013)。The effect of physicians' body weight on patient attitudes: implications for physician selection, trust and adherence to medical advice。International Journal of Obesity，37(11)，1415-1421。  new window
26.Ratanawongsa, N.、Karter, A. J.、Parker, M. M.、Lyles, C. R.、Heisler, M.、Moffet, H. H.、Adler, N.、Warton, E. M.、Schillinger, D.(2013)。Communication and Medication Refill Adherence: The Diabetes Study of Northern California。JAMA Internal Medicine，173(3)，210-218。  new window
27.Rolfe, A.、Cash-Gibson, L.、Car, J.、Sheikh, A.、McKinstry, B.(2014)。Interventions for improving patients' trust in doctors and groups of doctors。Cochrane Database of Systematic Reviews，4(3)，1-64。  new window
28.Zheng, B.、Hall, M. A.、Dugan, E.、Kidd, K. E.、Levine, D.(2002)。Development of a scale to measure patients' trust in health insurers。Health Services Research，37(1)，187-202。  new window
29.Hosmer, Larue Tone(1995)。Trust: The Connecting Link between Organizational Theory and Philosophical Ethics。Academy of Management Review，20(2)，379-403。  new window
30.蔡宗宏、洪陵鎧(20080900)。病人知覺醫師行為與組織因素對其醫病關係滿意之影響。醫務管理期刊，9(3)，222-242。new window  延伸查詢new window
31.Anderson, Lynda A.、Dedrick, Robert F.(1990)。Development of the Trust in Physician Scale: A Measure to Assess Interpersonal Trust in Patient-Physician Relationships。Psychological Reports，67(suppl.3)，1091-1100。  new window
32.Mechanic, D.、Meyer, S.(2000)。Concepts of trust among patients with serious illness。Social Science & Medicine，51(5)，657-668。  new window
33.Pearson, S. D.、Raeke, L. H.(2000)。Patients' Trust in Physicians: Many Theories, Few Measures, and Little Data。Journal of General Internal Medicine，15(7)，509-513。  new window
34.Thom, D. H.、Campbell, B.(1997)。Patient-physician trust: an exploratory study。Journal of Family Practice，44(2)，169-176。  new window
研究報告
1.章英華、杜素豪、廖培珊(2012)。台灣社會變遷基本調查計畫：第六期第二次調查計畫執行報告。臺北：中央研究院社會學研究所。  延伸查詢new window
學位論文
1.何怡婷(2008)。探討乳癌病患對醫師之信任與照護評價間關係(碩士論文)。國立臺灣大學。  延伸查詢new window
圖書
1.Luhmann, Niklas(1979)。Trust and Power。John Wiley & Sons。  new window
2.Illingworth, Patricia(2005)。Trusting Medicine: the Moral Costs of Managed Care。New York：Routledge。  new window
3.Giddens, Anthony(1991)。The Consequences of Modernity。Polity Press。  new window
 
 
 
 
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