臺灣博碩士論文加值系統

摘 要

風險溝通已成為醫療服務環境不可或缺的工具，一般人對醫療風險的知覺與其風險接受度汲汲相關，了解國人對醫療知覺風險概念，將對醫療業風險管理相關議題有重大的影響。
本研究以問卷方式，針對高雄市300位20歲以上居民為對象，施以調查。主要目的在了解醫療風險溝通與醫療知覺風險之間關係與影響幅度，並進一步探討其可能造成差異的原因。問卷係參考國內外文獻並自擬而成，內容包含消費者對醫療風險溝通接收之頻率與醫療風險的認知與態度，受訪者以直覺來判斷並答覆每一問題，結果使用SPSS for Windows套裝軟體作複迴歸分析。
結果顯示，消費者對於醫療風險溝通訊息來源中之「媒體來源」與「社會風險」有顯著的關係存在，其餘則無顯著相關；風險訊息內容之「教育資訊」與「知覺風險」有顯著的關係存在，其餘皆部份有顯著相關。醫療知覺風險會因受測者之背景如性別、年齡、教育程度、婚姻狀況、家庭收入、醫療經驗等因素不同而有顯著差異。
本研究僅就高雄市地區做調查，結果卻顯示國人醫療風險資訊之不足。建議政府單位及民間團體加強醫療風險訊息內容之傳遞，以培養國人對醫療風險理性溝通的能力，期以避免醫療爭議的發生。

Risk communication has become an important tool in medical service environment.There are significant relealance between medical perception risk acceptability.To understand the domestic medical perception risk concept would be benetical to medical risk manegement.
Questionnaires adapted from literatures were used to study consumer whose frequencies of received medical risk communication, the perception and attitude of medical risk. To send questionnaires focus on three hundred residents, who are over twenty years old living in Kaohsiung region. These questions were designed for intuitive analyses to study the effect of breadth and relationship including medical risk communication and medical perception risk, respondents’ attitude toward and other risk factors. Data collected for this study were analyzed with the Chi-square test using the SPSS program.
Our results show significantly related to medium source and social risk of the source of medical risk communication information, the rest has not related. Between in education information and perception risk contents has significant related, the rest has partial related. Our results also show that consumer had significant differences in gender, age, education level, marital status, household income, medical experience etc.
Although this thesis only investigate Kaohsiung region, the result Results from this case study imply that the public obviously lack knowledge of medical risk information, and suggest that government and folk group enhanced send medical risk information contents. Bring up the ability of medical risk rationality communication of compatriot. To avoid medical dispute comes up.

目 錄
中文摘要　 ---------------------------------------------------------------------------------i
英文摘要 ---------------------------------------------------------------------------------ii
誌謝 ---------------------------------------------------------------------------------iii
目錄 ---------------------------------------------------------------------------------iv
表目錄 ---------------------------------------------------------------------------------v
圖目錄 ---------------------------------------------------------------------------------vii
第一章 緒論 ---------------------------------------------------------------------------1
第一節　研究背景與動機 -----------------------------------------------------------1
第二節 研究目的 --------------------------------------------------------------------3
第三節　相關名詞定義 --------------------------------------------------------------4
第四節　研究流程 --------------------------------------------------------------------6
第二章 文獻探討 -----------------------------------------------------------------------7
第一節　醫病關係與醫療糾紛 ----------------------------------------------------7
第二節 風險及其溝通 --------------------------------------------------------------10
第三節　知覺風險與訊息來源 ----------------------------------------------------14
第四節　風險溝通與知覺風險間之關係 ---------------------------------------28
第三章 研究設計與方法 --------------------------------------------------------------29
第一節　研究架構與研究假設 ----------------------------------------------------29
第二節 變數定義與問卷設計 ----------------------------------------------------33
第三節　問卷之效度信度分析 ----------------------------------------------------41
第四節　研究觀念架構之修正 ----------------------------------------------------51
第五節　抽樣設計與問卷回收 ----------------------------------------------------52
第六節　資料分析方法 --------------------------------------------------------------56
第四章 研究結果與討論 --------------------------------------------------------------59
第一節　醫療風險溝通概況及其評析 -------------------------------------------59
第二節 醫療知覺風險程度及其省思 -------------------------------------------72
第三節 醫療『風險溝通』與『知覺風險』間關係之探討-----------------78
第五章 結論與建議 --------------------------------------------------------------------87
第一節　研究發現之彙整 -----------------------------------------------------------87
第二節 醫療風險溝通相關建議 -------------------------------------------------91
第三節　研究限制及後續研究建議 ----------------------------------------------97
參考文獻 ------------------------------------------------------------------------------------99
附錄一 問卷 ------------------------------------------------------------------------------103
　　　


表目錄
表2-1彙整各學者對風險的定義 ------------------------------------------------------11
表2-2訊息來源之類型 -------------------------------------------------------------------16
表2-3風險訊息之提供者及收訊者 ---------------------------------------------------17
表2-4知覺風險與風險類型之研究彙整表 -----------------------------------------21
表2-5知覺風險與資訊搜尋策略間關係之探討彙整 -----------------------------25
表2-6知覺風險與消費者屬性變數相關文獻 --------------------------------------27
表3-1自變項風險溝通訊息來源之操作型定義 -----------------------------------34
表3-2自變項風險溝通溝通內容之操作型定義 -----------------------------------35
表3-3依變項知覺風險之操作型定義 ------------------------------------------------36
表3-4干擾變項就醫經驗之操作型定-------------------------------------------------37
表3-5衡量變數、相關文獻及問卷題號之設計彙總表 --------------------------41
表3-6醫療風險溝通之「訊息來源」量表之因素分析(前測)---------------------43
表3-7醫療風險溝通之「訊息來源」各向度之定義與相關觀點之學者 -----45
表3-8醫療風險溝通之「訊息內容」量表之因素分析(前測)----------------------45
表3-9醫療風險溝通之「訊息內容」各向度之定義與相關觀點之學者-----46
表3-10醫療知覺風險量表之因素分析(前測)-----------------------------------------47
表3-11知覺風險各向度之定義與相關觀點之學者 --------------------------------48
表3-12風險溝通與知覺風險量表之解釋變異量與累積解釋變異量 ---------49
表3-13問卷量表之Cronbach's α係數信度表 --------------------------------------50
表3-14高雄市各行政區人口數與問卷發放配置表 --------------------------------53
表3-15問卷之回收數與有效數 ---------------------------------------------------------53
表3-16回收樣本之醫療經驗概況次數分配表 --------------------------------------54
表3-17回收樣本之基本資料次數分配表---------------------------------------------55
表4-1醫療風險溝通之訊息來源分析表---------------------------------------------60
表4-2醫療風險溝通之訊息內容分析表---------------------------------------------62
表4-3a醫療風險溝通訊息來源之評量表（全體、性別與婚姻狀況）----------63
表4-3b醫療風險溝通訊息來源之評量表（年齡分佈）-----------------------------64
表4-3c醫療風險溝通訊息來源之評量表（教育程度）-----------------------------65
表4-3d醫療風險溝通訊息來源之評量表（職業背景）-----------------------------65
表4-3e醫療風險溝通訊息來源之評量表（職業背景-續）-------------------------66
表4-3f醫療風險溝通訊息來源之評量表（家庭平均月收入） ------------------66
表4-3g醫療風險溝通訊息來源之評量表（醫療經驗）-----------------------------67
表4-4a醫療風險溝通訊息內容之評量表（全體、性別與婚姻狀況）----------68
表4-4b醫療風險溝通訊息內容之評量表（年齡分佈）-----------------------------68
表4-4c醫療風險溝通訊息內容之評量表（教育程度）-----------------------------69
表4-4d醫療風險溝通訊息內容之評量表（職業背景）-----------------------------69
表4-4e醫療風險溝通訊息-內容之評量表（職業背景-續）------------------------70
表4-4f醫療風險溝通訊息內容之評量表（家庭平均月收入）--------------------70
表4-4g醫療風險溝通訊息內容之評量表（醫療經驗）-----------------------------71
表4-5醫療知覺風險之程度分析表 ---------------------------------------------------73
表4-6a醫療知覺風險之評量表（全體、性別與婚姻狀況）-----------------------74
表4-6b知覺風險之評量表（年齡分佈）------------------------------------------------75
表4-6c知覺風險之評量表（教育程度）------------------------------------------------75
表4-6d知覺風險之評量表（職業背景）------------------------------------------------76
表4-6e知覺風險之評量表（職業背景-續） ------------------------------------------76
表4-6f知覺風險之評量表（家庭平均月收入） -------------------------------------77
表4-6g知覺風險之評量表（醫療經驗）------------------------------------------------77
表4-7「風險溝通訊息來源─知覺風險」Pearson相關係數矩陣 --------------79
表4-8風險溝通訊息來源對知覺風險各向度間的複迴歸分析 ----------------79
表4-9「風險溝通訊息內容─知覺風險」Pearson相關係數矩陣 --------------81
表4-10風險溝通訊息內容對知覺風險各向度間的複迴歸分析 ----------------81
表4-11風險溝通對知覺風險各向度間的複迴歸摘要表 -------------------------82
表4-12干擾變項對風險溝通訊息來源各向度間的複迴歸分析 ----------------84
表4-13干擾變項對風險溝通訊息內容各向度間的複迴歸分析 ----------------85
表4-14樣本特徵對各因素評估之干擾整理表 --------------------------------------86
表5-1本研究假設之支持與實證結果 ------------------------------------------------90
表5-2風險溝通對知覺風險間之整體關聯表 --------------------------------------90




圖目錄
圖1-1本研究之流程圖 -------------------------------------------------------------------6
圖2-1醫療糾紛發生的原因圖 ---------------------------------------------------------9
圖2-2風險溝通模式的連續構面圖 ---------------------------------------------------13
圖3-1本研究之觀念性架構-------------------------------------------------------------29
圖3-2本研究之修正後觀念性架構 ---------------------------------------------------51
圖3-3本研究統計分析流程 ------------------------------------------------------------58

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