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題名:某醫學中心子宮切除婦女自述醫病溝通之探討
書刊名:中華公共衛生雜誌
作者:張珏張菊惠胡幼慧
作者(外文):Chang, ChuehChang, Chu-huiHu, Yow-hwey
出版日期:1997
卷期:16:1
頁次:頁1-12
主題關鍵詞:子宮切除醫病溝通醫師告知HysterectomyPhysician-patient communicationPhysician's informed
原始連結:連回原系統網址new window
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  • 被引用次數被引用次數:期刊(10) 博士論文(0) 專書(0) 專書論文(1)
  • 排除自我引用排除自我引用:10
  • 共同引用共同引用:10
  • 點閱點閱:216
     本研究欲探討前往某醫學中心求診之非癌症診斷婦女在面臨子宮切除時,醫病溝 通間醫師告知與婦女認知的情形。 訪視 72 位術後 3-9 個月的婦女,結果發現三成的婦女 對疾病診斷、手術範圍認知不正確。88.9% 曾有醫師解釋病情,50.0% 曾與醫師討論病情; 72.2% 曾有醫師說明手術範圍,68.9 % 曾與醫師討論手術範圍。 32.6% 的病人在術前並未 被醫師告知會合併單或雙側卵巢切除,51.7% 的人未被醫師告知子宮切除的範圍涵蓋子宮頸 。75.0% 的婦女被告知「過了生育年齡子宮就沒有用了,拿掉沒有關係」,44.4% 被告知子 宮切除後的好處, 只有 6.9% 與 13.5% 的婦女被告知手術對身體與性生活可能會有影響, 4.2% 被告知可能會有合併症,其餘則是沒有說或說沒影響。 結果得知,醫師告知偏向於手 術的好處,而手術風險與可能影響較少提及,婦女對疾病與手術範圍認知不正確,反映出醫 師告知的不清楚與不充份。根據本研究結果,建議改善醫學教育,建立婦女健康資源網絡, 立法規範醫師告知的責任,敦促醫病溝通中醫師告知的落實。
     Focusing on women of one medical center in Taiwan metropolitan area with non-cancer diagnoses who are faced with hysterectomy, this research investigates the physicians-patients communication about the extent of information provided by physicians, and women's knowledge of hysterectomy. The 72 subjects in this study were women who had a hysterectomy 3-9 months prior to interview. The results showed that 29.2% of the women were unclear of their own diagnosis, 27.8% were unclear of their operations. 72.2%-88.9% of the physicians had explained the operations and disease to their patients, and 50.0%- 68.9% had discussed thedisease and operations. Among the 72 women interviewed, 61.1% had either a unilateral or bilateral oopho-rectomy, 32.6% were not advised by a physician to heave the oophorectomy. In the course of physician-patient communication, 75.0% of the women were told that the uterus is useless beyond childbearing age. 44.4% were told the benefits of hysterectomy. Only 6.9-13.5% were told the possible side effects of the surgery, and 4.2% were told the possible complications of the surgery, the rest of the subjects were not told of the possible negative outcomes. Therefore, physicians prefer to tell women the benefits of surgery rather than the risks, side effects and complications of surgery. The facts that women were unclear of their diagnosis and operations reflect the information of physicians supply were unclear and inadequate. This research implies a need for improving the medical education as well as developing women's health network, legislating the physician's responsibility of informing patients to improve the physicians-patients communication.
期刊論文
1.張珏、張菊惠、顧淑芬、胡幼慧(1995)。子宮切除盛行率之初探。中華衛誌,14(6),487-493。new window  延伸查詢new window
2.Gould, D.(19860600)。Hidden problems after a hysterectomy。Nursing Times,4,43-46。  new window
3.Wood, P. J.、Giddings, L. S.(1991)。The symbolic experience of hysterectomy。Nursing Praxis in New England,6(3),3-7。  new window
4.Bernhard, L. A.(1992)。Consequences of hysterectomy in the lives of women。Health Care for Women International,13,281-291。  new window
5.Ryan, M. M.、Dennerstein, L.、Pepperell, R.(1989)。Psychologic aspects of hysterectomy a prospective study。British Journal of Psychiatry,154,516-522。  new window
6.張珏、張菊惠、毛家舲(19960400)。子宮切除後的性適應。婦女與兩性學刊,7,97-114。new window  延伸查詢new window
7.Williamson, M. L.(1992)。Sexual adjustment after hysterectomy。Journal of Obstetric, Gynecologic & Neonatal Nursing,21(1),42-47。  new window
8.Wright, R. C.(1969)。Hysterectomy: past, present and future。Obstet Gynec,33,562。  new window
9.Amirikia, H.、Evans, T. N.(1979)。Ten-year review of hysterectomies: trends, indications, and risks。Am J Obstet. Gynecol,134,431-437。  new window
10.Santow, G.、Bracher, M.(1992)。Correlates of hysterectomy in Australia。Soc Sci Med,34(8),929-942。  new window
11.Roos, N. P.(1984)。Hysterectomy: variations in rates across small areas and across physicians' practices。Am J Public Health,74(4),327-335。  new window
12.Haas, S.、Acker, D.、Donahue, C.、Katz, M. E.(1993)。Variation in hysterectomy rates across small geographic areas of Massachusetts。Am J Obstet Gynecol,169(1),150-154。  new window
13.Gambone, J. C.、Reiter, R. C.、Lench, J. B.、Moore, J. G.(1990)。The impact of a quality assurance process on the frequency and confirmation rate of hysterectomy。Am J Obstet Gynecol,163(2),545-550。  new window
14.Cherkin, D.(1994)。Participation in treatment decision might affect hysterectomy rates。Am J Public Health,84(2),319。  new window
15.Coulter, A.、Mcpherson, K.、Vessry, M.(1988)。Do British women under go too many or too few hysterectomy?。Soc Sci Med,27,987-994。  new window
16.Travis, C. B.(1985)。Medical decision making and elective surgery: the case of hysterectomy。Risk Analysis,5(3),241-251。  new window
17.吳就君(1983)。從醫護人員工作行為分析看醫院病人衛生教育實況。公共衛生,10(2),136-145。  延伸查詢new window
18.陳阿教(1976)。病人的權利法案。公共衛生,3(2),81-86。  延伸查詢new window
19.Mwaba, K.、Letloenvane, E. B.(1994)。Attitudes and knowledge about hysterectomy:a study of women in Mmabtho。Curationis,17(3),2-3。  new window
20.Tsoi, M. M.、Poon, R. S. M.、Ho, P. C.(1983)。Knowledge about reproductive organs in Chinese women: some overlooked ‘common sense'。Journal of Psychosomatic Obstetrics and Gynecology,2(2),70-75。  new window
21.Wilcox, L. S.、Koonin, L. M.、Pokras, R.、Strauss, L. T.、Xia, Z.、Peterson, H. B.(1994)。Hysterectomy in the United States, 1980-1990。Obstet Gynecol,83(4),549-555。  new window
22.Rose, B. K.(1992)。Informed consent and hysterectomy: enhancing the right to know。Am J Public Health,82(4),609-610。  new window
23.Riessman, Catherine Kohler(1983)。Women and Medicalization: A New Perspective。Social Policy,14(1),3-18。  new window
24.陳鳳櫻、楊雅玲(19860400)。子宮切除病人的性問題及其調適方法。護理雜誌,33(2),83-86。new window  延伸查詢new window
會議論文
1.張菊惠、張珏。婦女有知的權力嗎?--子宮切除的決定過程。婦女健康政策學術研討會,37-61。  延伸查詢new window
研究報告
1.戴桂英、葉元麗(1996)。全民健康保險子宮切除手術流行病學研究的初探。  延伸查詢new window
2.李玉春(1995)。改進勞工保險殘廢給付標準表之研究。  延伸查詢new window
學位論文
1.鍾國彪(1988)。公保門診醫師與病人互動之研究:病人滿意度和遵醫囑服藥情形的探討(碩士論文)。國立陽明大學。  延伸查詢new window
2.鄭麗寶(1990)。醫療過程中人際互動的社會學分析(碩士論文)。國立臺灣大學。  延伸查詢new window
圖書
1.Lauersen, N.、Stukane, E.(1982)。Listen to your body。New York:Simon and Schuster。  new window
2.Budoff, W.(1980)。No more menstrual cramps and other good news。New York:G.P. Putnam & Sons。  new window
3.丹妮絲佛莉、依蓮妮克絲、預防(Prevention)雜誌編輯群、月旦編譯小組(1994)。女人的健康顧問。台北市:月旦。  延伸查詢new window
4.National Women's Health Network(1993)。Hysterectomy。Washington。  new window
5.Kleinman, Arthur(1980)。Patients and Healers in the Context of Culture: An Exploration of the Borderland between Anthropology, Medicine, and Psychi­atry。University of California Press。  new window
圖書論文
1.National Center for Health Statistics(1989)。Hysterectomy: past, present, and future。Statistical Bulletin。  new window
2.Crowe, M.(1992)。Some common and uncommon health and medical problems。The New Our Bodies, Ourselves。New York:Simon & Schuster。  new window
3.Blue Cross and Blue Shield of Illinois(19900500)。Hysterectomy at Illinois hospital: potential for eliminating unnecessary surgery。Blue Cross and Blue Shield of Illinois Health Services Research。  new window
 
 
 
 
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