不同醫病角色對輔助與替代療法認知差異之探討

研究顯示輔助與替代療法(Complementary and Alternative Medicine, 簡稱CAM)是癌患普遍合併使用的照護方式。過往文獻指出治療階段使用CAM可能具有潛在風險，且CAM照護體系與主流醫學多缺乏互動與對話，使得多數癌患需自行做專業間的跨界組合，進而衍生許多醫療倫理和安全等問題。因此，本研究主要探討癌症病患與醫療專業服務人員間對CAM的看法與互動經驗，並分析不同醫病角色對於CAM的認知是否有所差異或共識。 本研究使用量化問卷設計探討4種不同醫病角色(中/西醫師、醫事人員、癌友支持團體及癌症病患)，對CAM的使用經驗探討，有效樣本共145份。此外，為求全面深入了解不同角色對於CAM看法和互動經驗，本研究亦針對四種角色以半結構式問卷進行深度訪談，以支持或補充量性問卷不足之處。 研究發現，仍有37％未曾與醫療專業服務人員討論過。而醫療專業服務人員對CAM的認知較癌症病患呈正向顯著差異，然實務上仍擔憂CAM會影響療效或耽誤治療時機，又醫病間的溝通礙於醫療體制的限制而限縮。本研究建議強化CAM實證基礎、醫病間應以開放的態度主動討論CAM議題及建立CAM之標準管理機制，以提升照護品質及強化醫病間信任關係。

Complementary and alternative medicine (CAM) is often used alongside conventional medical care. Despite recent findings that the use of CAM may cause potential risk during cancer treatment, and patients who use CAM choose not to mention this to their physician, and this causes the problem of lack of communication among physician-patient relationships. Therefore, this study focuses on the cognitive difference of CAM among different physician- patient relationships.A questionnaire and in-depth interviews with four participants were used to understand the cognitive difference of CAM use. Results indicate that 37% choose not to mention this to their physicians owning to physician’s disinterest, negative response, or unwillingness or inability to contribute useful information. While the physicians still worry about the practice of CAM will affect the treatment efficiency and might delay the timing of treatment. This study suggests that discussions of patients'' CAM use should be integrated into the medicalencounters and patient themselves to enhance the communication quality of medical care.