2012-08-012024-05-13https://scholars.lib.ntu.edu.tw/handle/123456789/644223摘要：隨著2011 年1 月26 日生效之新版安寧緩和醫療條例賦予撤除無意識病患之維生醫療處置的權利、葉克膜等等高科技的維生設備被更廣泛運用以及近幾個月來不斷出現的「無效醫療」的呼聲，急重症醫療中所可能遭遇的臨床倫理議題、解決臨床倫理爭議的方式以及溝通技巧，逐漸受到更多的重視。提升醫師對臨床倫理議題的敏感度，培養其溝通技巧，並且透過好的溝通方式解決臨床倫理議題，不但可以提升醫療服務品質、也可以降低醫療支出、同時減少醫療糾紛的發生。本計畫為國立台灣大學醫學院附設醫院教學部主任倪衍玄教授所領導之三年期整合型計畫—「臨床核心能力培育—急重症醫療訓練課程發展與總體效益評估」中的第四子計畫—急重症訓練醫病溝通與倫理決策模式及其影響的探討，本子計畫預計將達成下列目標：第一、探討加護病房醫師所遭遇的倫理困境第二、了解醫師在模擬情境中所遭遇溝通的問題第三、探索住院醫師告知病人或其家屬醫療過失的能力與現況第四、分析住院醫師在模擬情境中所呈現的溝通過程對其未來執醫生涯的影響第五、開發急重症核心技能中倫理與溝通技巧訓練課程第六、評估急重症醫療教師培育與訓練課程的效益<br> Abstract: After the revised Hospice Palliative Care Law was enacted on January 26, 2011, the lifesustaining treatments to sustain the lives of unconscious patients now can be legally withdrawn,which was legally allowed before. In addition, the increasing use of ECMO to sustain lives ofcritically ill patients, and the emerging voices of medical futility in Taiwan have attracted thepublic’s and health care professionals’ attentions to clinical ethical conflicts, the resolutions of suchconflicts, and communication skills in critical care medicine. To promote the ethical sensitivity ofhealth care professionals in face of ethical conflicts, and to cultivate the communication skills ofhealth care professionals will not only promote the quality of medical care and lower medialresources consumption, but will also reduce medical malpractice claims for physicians in clinicalpractice.This research proposal (The Influence of Patient-physician Communication And EthicalDecision-making for Critical Care Medicine) is one of the four sub-proposals included in anintegrated proposal (Cultivating Clinical Competence in Critical Care Medicine—The Developmentand Appraisal of a Comprehensive Education Program for Residents) organized by Professor Ni, theChairman of Department of Medical Education, National Taiwan University Hospital. The specificaims that this sub-research proposal will achieve are as the followings:Specific Aim 1: to examine the clinical ethical conflicts encountered by house officers practiced inan intensive care unit.Specific Aim 2: to identify communication difficulties encountered by house officers in a simulatedscenario of intensive care unit.Specific Aim 3: to explore house officers’ disclosures of medical errors to the family members ofpatients in a simulated scenario of intensive care unit.Specific Aim 4: to analyze the influence of the communication skills demonstrated by houseofficers in a simulated scenario of intensive care unit on the carrier of their clinical practice.Specific Aim 5: to develop the educational programs for the core competences of communicationskills and resolving clinical ethical conflicts.Specific Aim 6: to evaluate the effectiveness of educational programs of faculty development forcritical care medicine.急重症醫療臨床倫理溝通Critical Care Medicineclinical ethicscommunication