Concerns and recommendations of internal medicine residents in HIV patient care in the second decade of the AIDS epidemic in Taiwan

Abstract

內科住院醫師通常擔任愛滋病醫療照護的前線，然而鮮少有研究探討其照護過程可能 有的顧慮，在愛滋病感染者人數持續增加的情況下，內科住院醫師的顧慮及建議更值 得重視，本研究探取質性研究之方式深入了解內科住院醫師對提供此醫療照護所可能 有的顧慮及可能促進愛滋病照護意願之策略。本研究共訪談47位台灣某醫學中心之內 科住院醫師，研究發現受訪者之主要顧慮有七項，即對愛滋病抱持先入為主印象；擔 心被感染；家人、朋友及同事的顧慮；缺乏足夠的臨床經驗；缺乏同事間的支持；缺 乏成就感及缺乏因職務而感染愛滋病之賠償及保障。而受訪者亦提出四項促進愛滋病 照護意願的策略，即教育訓練、臨床訓練、提供安全之工作環境及提供優握之員工福 利；討論中也由社會文化及醫療系統情境的觀點探討此研究結果之意義。Internal medicine residents usually are on the front lines of caring for HIV- infected patients. In the second decade of the AIDS epidemic in Taiwan, a qualitative study was conducted to recognize the concerns of internal medicine residents in caring for HIV/AIDS patients and to identify possible strategies to promote HIV-patient care that have not been addressed in previous research. Individual in-depth interview were conducted with 47 internal medicine residents at a university hospital in Taiwan. Seven factors( stereotypes towards AIDS; fear of transmission; concerns of families, friends and colleagues; lack of clinical expertise; lack of collegial support; lack of a sense of accomplishment; and lack of worker’s compensation if infected) were found to be the chief concerns of participants in providing HIV/AIDS care. Four strategies ( education, clinical experiences, safe working environment, and employment benefits) were voiced as those that could promote health care professionals’ well- being and willingness to provide HIV/AIDS care. The results of this study are explained in light of the historical, social and medical context in Taiwan.