2026-11-092026-11-09https://scholars.csmu.edu.tw/handle/123456789/38776The main goal of this grant is to confer the patient-involvement of the health services industry in a critical stakeholder analysis for patient shared decision-making under risk for providing the health services industry’s reference of practical design and management in Taiwan. Paternalistic made that the tradition cures and concerns for doctor's leading medical care and makes policy. Recently, the movement of the patient-centered and patient-involvement: The patient is absorbed in disease symptom, and the doctor is absorbed in the relevant diseases detail. According to the literatures review, it still remain a lot of difference explanation to the patient participates in and lack of the standard of measurement. In recent years shared decision making has been advocated as an appropriate approach for patient physician communication and decision making. With the changes of the medical environment, the cognition of patient for medical service produced changing at the same time. This 3-year grant is “a critical stakeholder analysis for patient shared decision-making under risk”. The grant is well-organized through analyzing the developing trend and present situation of shared decision model (first year), theory developing and establishment for questionnaire (second year), in addition to the literature review, it can know the potential incident well by investigate into the risk cognition of stakeholders more in detail. Since, test/verified the theory and model which the study established in the previous year (third year). Finally, the result of study will can as the policy of relevant personnel helping patients to participate in medical decision in the future.本計畫的主要目的係探討醫療服務產業以決策利害關係人觀點分析參與共同醫療 決策制定過程風險態度、認知與意向之研究，以提供我國醫療服務產業實務管理之參考 依據。傳統醫病關係為醫師主導醫療照顧和決策制訂的家長政治(paternalistic)，近年來 在以病患為中心(patient-centered)與病患參與醫療服務(patient-involvement)的趨勢下：病 患專注於疾病症狀、偏好；醫師則專注於有關疾病細節、治療的引導。根據文獻回顧， 對於病患「參與」仍存在許多分歧的定義與解釋，相對地產生實務上仍缺乏一套衡量病 患參與目標、過程與結果的標準，因而形成醫療品質不一致的狀況。愈來愈多的文獻將 研究重心放在關心病患應參與醫療決策，並視醫師和病患為平等的伙伴，此決策方式已 被理想的共同決策(shared decision-making)方式所取代。隨著醫療環境的變遷，病患對醫 療服務行為的認知也同時產生變化，就醫療服務提供者而言，從單純的生物醫學到心 理、社會醫學的延伸的同時，也應當瞭解病患的共同醫療決策制定過程態度、認知與意 向以健全醫病關係與確保醫療品質。因此本研究參考國外有關於病患自主權、控制權偏 好、參與治療認知、風險溝通與醫療決策結果等指標為基礎，規劃以三年時間，有系統 地從共同醫療決策制定發展趨勢與現況之分析（第一年）、共同醫療決策制定各子計畫 之理論發展與建置（第二年），綜觀風險管理的文獻顯示，若能深入調查個別利害關係 人對於風險認知的態度就可以掌握不同階段潛在的風險因素，即使有非預期危害事件發 生亦可以將風險損失加以轉移與控制，進而達成風險管理的目標，因此在第三年本研究 將針對共同醫療決策制定所發展之理論進行驗證。最後，期望研究結果可作為未來協助 病患參與醫療決策之相關人員的政策參考依據。利害關係人分析病患參與共同醫療決策制定醫病關係Stakeholder analysisPatient-involvementShared decision-makingPatientclinicianrelationshipProject