以焦慮不確定感管理理論探討身體自我概念與醫病關係對遵醫囑行為之影響

Abstract

病患的醫院焦慮和疾病不確定感是影響醫病關係的重要因素，而不遵從醫囑是一個嚴重的問題。本研究的主要目的是探討身體自我概念對患者去醫院焦慮和得疾病不確定感的影響，使用焦慮和不確定性管理理論來解釋，醫病關係和遵醫囑行為如何影響患者持續去醫院的意圖。本研究問卷調查在COVID-19疫情初期，可預期不少人容易更加緊張，對於醫療的狀態有更多不確定感，問卷採取便利抽樣共回收302份，以統計套裝軟體，使用敘述性統計分析、信效度分析與結構方程模型分析等進行統計量化分析，依據統計結果發現：（1）身體自我概念對於到醫院焦慮與得疾病不確定感具有直接負向影響。（2）到醫院焦慮與得疾病不確定感對於醫病關係具有直接負向影響。（3）醫病關係對於遵醫囑行為具有直接正向影響。（4）遵醫囑行為對於持續去醫院的意圖有直接正向影響。（5）身體自我概念對於持續去醫院的意圖有間接正向相關。

Hospital anxiety and illness uncertainty of patients are important factors that affect the doctor-patient relationship. The main purpose of this study is to discuess the influence of physical self-concept on patients’ anxiety about going to the hospital and the uncertainty of getting illness, using anxiety and uncertainty management theories to explain how the doctor-patient relationship and medical compliance affect patient's intention of continuesly returning to the same hospital. This study started at early stage of the COVID-19 epidemic. It is expected that many people would become more nervous and feel more uncertain about the medical treatment during that time. In this study, a total of 302 questionnaires were collected from convenience sampling by sending to several social networks. After testing reliability and validity of questionnaire items and construct, structural equation modeling was applied to test the research model. According to the statistical analysis, we found that: (1) physical self-concept has a direct negative effect on hospital anxiety and uncertainty of getting illness; (2) hospital anxiety and uncertainty of getting illness has a direct negative effect on the doctor-patient relationship; (3) doctor-patient relationship has a direct positive effect on medical compliance; (4) medical compliance has a direct positive effect on the continuous intention to hospital; (5) physical self-concept has an indirect positive effect on the continuous intention to hospital.