郭鐘隆黃久美Jong-Long GouChiu-Mieh Huang黃妙珍Miao-Jeng Huang2019-08-282015-8-202019-08-282014http://etds.lib.ntnu.edu.tw/cgi-bin/gs32/gsweb.cgi?o=dstdcdr&s=id=%22GN0699050195%22.&%22.id.&http://rportal.lib.ntnu.edu.tw:80/handle/20.500.12235/87993痛經一直是許多女性的健康困擾，我國於1995年健保的開放下，除了普遍的西醫體制，中醫治療痛經成為現代婦女的另一新選擇。本研究欲探討原發性痛經婦女與中醫師在中醫治療中的治療期待與互動經驗。研究方法使用質性研究法，以半結構式訪談法收集20位原發性痛經婦女與10位中醫師的訪談資料，透過「內容分析法」及搭配Atlas.ti 5.2軟體協助分析，研究結果以「原發性痛經婦女與中醫師在磨合中對抗痛經」為主軸，發展出四大主題:「醫病互動中的期待落差」、「醫病間訊息溝通的限制」、「醫病共同面對難以完全配合的醫囑」、和「醫病磨合各自修正策略」。從結果得知目前原發性痛經婦女會採取中醫處理痛經，但在中醫的訊息正確性的辨別仍有所不足，甚至使用錯誤的訊息成為照顧的來源，而中醫師也受限門診時間，難以傳遞完整的正確中醫訊息；此外，醫病雙方存在著治療期程、治療主導者與療效方向上的落差，以及原發性痛經婦女在現實生活中，回歸生活作息調整仍存在著落實的困難，造成治療成效不佳的潛在原因之一。醫病雙方透過不斷互動、磨合，雙方摸索出修正行為的方式下，使之痛經的照顧更加完善。研究結果也顯示中醫師職業經驗中認為強化信任關係、修正溝通方式，以及邀請原發性痛經婦女共同決策治療過程，可有效幫助婦女克服障礙，提升中醫治療遵從性。Exploring the Perceived Physician-Patient Interaction Between　 Traditional Chinese Physicians and Primary Dysmenorrheal Women Dysmenorrhea is a common health problem for women. Both Western medicine and traditional Chinese medical are used to treat menstrual pain. In this study, we explored treatment expectations and interaction experiences between women with primary dysmenorrhea and traditional Chinese physicians. We used a qualitative method involving semistructured interviews to collect data from 20 women with primary dysmenorrhea and 10 traditional Chinese physicians. Content analysis of the data were was performed using Atlas.ti 5.2 software. The results indicated that the main theme of the data was “women with primary dysmenorrhea and traditional Chinese physicians cooperating to treat menstrual pain”, which included 4 themes to describe interactions between physicians and women. The 4 themes were as follows: (a) expectation gap of physician–patient interaction; (b) limited communication between physicians and patients; (c) difficulty of practical application of physicians’ orders; (d) cooperation of patients and physicians during treatment and revision of treatment strategies. We observed that women with primary dysmenorrhea used traditional Chinese medicine to treat menstrual pain; however, women were not fully able to determine the validity of information about Chinese medicine, and occasionally used incorrect information as the basis for their treatment of dysmenorrhea. Moreover, traditional Chinese physicians were unable to provide comprehensive information to women with primary dysmenorrhea because the time that women spent in the OPD was limited. In addition, we observed gaps in treatment period, treatment leader, and treatment content. Women with primary dysmenorrhea experienced difficulty in completing all of the health behaviours required to manage their dysmenorrhea, which may be one of the potential factors that caused unsatisfactory treatment outcomes. The results indicated that when physicians and patients interacted consistently throughout the course of treatment, dysmenorrhoeal care improved. Traditional Chinese physicians stated that strengthening trust, revising communication methods, and encouraging women with primary dysmenorrhea to actively participate in decisions about their treatment can help women overcome obstacles to treatment and enhance medical compliance.痛經中醫師醫病互動遵從性dysmenorrheatraditional Chinese physicianphysician-patient interactioncompliance