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題名：子宮切除術前醫師告知內容之研究
書刊名：婦女與兩性學刊
作者：張菊惠／胡幼慧／張玨
作者(外文)：Chang, Chu-hui／Hu, Yow-hwey／Chang, Chueh
出版日期：1998
卷期：9
頁次：頁115-144
主題關鍵詞：子宮切除；醫師告知；多元方法；婦女健康；Hysterectomy；Physician inform；Multimethod；Women's health
原始連結：連回原系統網址new window
相關次數：
  • 被引用次數被引用次數:期刊(10) 博士論文(2) 專書(0) 專書論文(3)
  • 排除自我引用排除自我引用:10
  • 共同引用共同引用:13
  • 點閱點閱:71
　　　　　本研究探討非癌症診斷婦女面臨子宮切除手術決定時，醫師告知之內容， 以及對 醫師告知之反應。研究場域為某都會區之醫學中心。採用質性方法中的多元方法，交叉檢視 婦女問卷訪談與知情人士訪談資料。研究重要發現如下：(1) 醫師告知乃以醫師為中心的權 威性告知，醫病溝通間的醫病地位不對等。(2) 醫師對手術影響的告知偏頗，僅談手術好處 與不手術的壞處。(3) 醫師對切除子宮告知抱持「無用論」與「癌症預防之道」的態度，並 以此說詞說服病人。(4) 手術決策過程是由醫師隱藏性操弄資訊，進而操控手術的決定權。 (5) 病人對醫師告知是不理性的絕對順從。文中就幾個重要發現進行討論，並綜合研究結果 與國際間醫病溝通或子宮切除的經驗，提出四點政策啟示，分別為制訂衛生監核政策、保障 婦女權益的醫院管理、建立婦女健康網絡與醫學教育的改善。
　　　　　The purpose of this study was to explore the content of physician's inform on hysterectomy when women with non-cancer diagnoses faced the surgical decision-making. The data was collected from a medical center located at an urban area. We used multimethod to triangulate two sources of data: women's questionnaire guided interview and key informants interview. Major findings are as follow: (1) since the physician-patient encounter was doctor-centered, the physician had an asymmetrical power-advantage over the patient; (2) the information provided by the physician was biased, rather beneficial than risky; (3) the physician's attitude toward hysterectomy was " uterus useless" and "preventing cancer"; (4) the physician manipulated the information while women making the surgical decision to control the power of decision making; (5) the patient adhered to the physician's regiment irrationally. It is recommend that women's informed right should be improved through policy reform, hospital management, building of women's health network and the changes of medical education.
期刊論文
1.張珏、張菊惠、顧淑芬、胡幼慧(19951200)。子宮切除盛行率的初探。中華公共衛生雜誌，14(6)，487-493。new window  延伸查詢new window
2.張珏、張菊惠、胡幼慧(19970200)。某醫學中心子宮切除婦女自述醫病溝通之探討。中華公共衛生雜誌，16(1)，1-12。new window  延伸查詢new window
3.Gould, D.(1986)。Hidden problems after a hysterectomy。Nursing Times，82(23)，43-46。  new window
4.Wood, P. J.、Giddings, L. S.(1991)。The symbolic experience of hysterectomy。Nursing Praxis in New England，6(3)，3-7。  new window
5.Santow, G.、Bracher, M.(1992)。Correlates of hysterectomy in Australia。Soc Sci Med，34(8)，929-942。  new window
6.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
7.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
8.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
9.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
10.Travis, C. B.(1985)。Medical decision making and elective surgery: the case of hysterectomy。Risk Analysis，5(3)，241-251。  new window
11.Rose, B. K.(1992)。Informed consent and hysterectomy: enhancing the right to know。Am J Public Health，82(4)，609-610。  new window
12.李聖隆(1984)。病人的權利。消費者報導，2(11)，18-20。  延伸查詢new window
13.Cherkin, D.(1994)。Participation in treatment decision might affecr hysterectomy rates。Am J Public Health，84(2)，319。  new window
14.Bickell, N. A.、Earp, J. A.、Garrett, J. M.、Evans, A. T.、Bernstein, S. J.(1994)。Gynecologists' sex, clinical beliefs, and hysterectomy rates。Am J Public Health，84(10)，1649-1652。  new window
15.Freidson, E.(1960)。Client control and medical practice。Am J Soc，65，374-382。  new window
16.Luoto, R.、Kaprio, J.、Keskimaki, I.、Pohjanlahti, J. P.、Rutanen, E. M.(1994)。Incidence, causes and surgical methods for hysterectomy in Finland, 1987-1989。Int J Epidemiol，23(2)，348-358。  new window
17.Hang, M. R.、Lavin, B.(1979)。Public challenge of physician authority。Med Care，17，844-858。  new window
18.Mwaba, K.、Letloenyane, E. B.(1994)。Attitudes and knowledge about hysterectomy: a study of women in Mmabtho。Curationis，17(3)，2-3。  new window
19.Shapiro, M. C.、Najman, J. M.、Chang, A.、Keeping, J. D.、Morrison, J.、Western, J. S.(1983)。Information control and the exercise of power in the obstetrical encounter。Sac Sci Med，17(3)，139-146。  new window
20.Riessman, Catherine Kohler(1983)。Women and Medicalization: A New Perspective。Social Policy，14(1)，3-18。  new window
會議論文
1.周雅容(1996)。焦點團體法在調查研究上的應用。第一屆調查研究方法與應用學術研討會。中央研究院調查研究工作室。  延伸查詢new window
研究報告
1.張珏、胡幼慧、張菊慧(1995)。影響子宮切除之相關因素探討。  延伸查詢new window
2.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初探。  延伸查詢new window
3.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.曲同光(1990)。基層醫療醫病關係之研究--著重於醫師態度及行為之探討(碩士論文)。國立臺灣師範大學。  延伸查詢new window
2.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
3.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
4.楊慧鈴(1990)。醫師說明義務之研究(碩士論文)。國立政治大學。  延伸查詢new window
圖書
1.Millman, M.(1977)。The Unkindest Cut。NY：Morrow。  new window
2.National Women's Health Network(1993)。Hysterectomy。Washington。  new window
3.Blue Cross and Blue Shield of Illinois(1990)。Hysterectomy at Illinois hospital: potential for eliminating unnecessary surgery。Blue Cross and Blue Shield of Illinois Health Services Research。  new window
4.Schumacher, Sally、王文科(1990)。質的教育研究法。臺北：師大書苑。  延伸查詢new window
5.胡幼慧、姚美華(1996)。質性研究：理論、方法及本土女性研究實例。巨流。  延伸查詢new window
圖書論文
1.Anderson, W. T.、Helm, D. T.(1979)。The Physician-Patient Encounter: A Process of Reality Negotiation。Patients, Physicians, and Illness。NY：The Free Press。  new window
2.陳瑞堅(1994)。子宮肌瘤要開刀嗎？。婦女醫學。台北：健康世界雜誌。  延伸查詢new window
3.Crowe, M.(1992)。Some common and uncommon health and medical problems。The New Our Bodies, Ourselves。New York：Simon & Schuster。  new window
4.Gilcherist, V. J.(1992)。Key informant interviews。Doing Qualitative Research。London：Sage。  new window
5.Mckinlay, J. B.(1987)。Who is really ignorant-physician or patient?。Encounters between Patients and Doctors。Cambridge, MA：MIT Press。  new window
6.Leibowitz, S.、Rachlin, J.(1992)。Our rights as patients。The New Our Bodies, Ourselves。New York：Simon & Schuster。  new window
7.Hauser, S. T.(1981)。Physician-patient relationships。Social Contexts of Health Illness, and Patient Care。London：Cambridge University Press。  new window
8.Salk, H.、Sanford, W.、Swenson, N.、Luce, J. D.(1992)。The policies of women and medical care。The New Our Bodies, Ourselves。New York：Simon & Schuster。  new window
9.Ruzek, S.(1986)。Feminist visions of health: an international perspective。What is Feminism。Oxford：Basil Blackwell Ltd。  new window
 
 
 
 
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