由於醫療環境的改變，醫療糾紛的事件數逐年攀高，因此醫療糾紛已經是醫療從業人員不得不面對的課題，而醫療糾紛事件所處的情境，幾乎是醫療機構與家屬各執一詞，在這種情況之下，雙方幾乎很難達成共識，冀能藉此一研究作為將來精神復健機構處理醫療糾紛之參考。本研究主要是探討精神復健機構與受眾的認知落差分析，因此選取深度訪談法來蒐集資訊進行描述與分析，有別於目前國內醫療糾紛的相關研究，大都以醫院的醫療糾紛為主要研究的對象，鮮少以精神復健機構的做為研究對象，另外，大部份的醫療糾紛研究，都是以訪談醫事人員或專家的想法與經驗，故本研究的訪談對象除了工作人員外，也加入家屬訪談，瞭解醫療糾紛的形成原因，研究中發現情境認知落差、期望落差也同樣存在於精神復健機構與家屬兩者之間。本研究根據研究結果，建議精神復健機構在面對醫療糾紛時應降低雙方認知落差，並尋找認知落差的原因、溝通應以降低家屬怒氣為目標、並確實製作紀錄，期望這些建議可以成為醫療相關機構在實務上的應用及研究的依據。

Along with changes in the medical environment, there has been a surge in medical disputes year after year. As a result, medical disputes have practically become issues that medical personnel have to face inevitably. However, medical institutions and patients’ families almost have their own steadfast opinions when it comes to the situation of a medical dispute. Under such circumstances, it is essentially difficult for both p. Study centers on an analysis of the cognitive gap between psychiatric rehabilitation agencies and audiences. In-depth interviews were employed to collect data for arties to reach a consensus. As such, this study aspires to provide a reference for psychiatric rehabilitation agencies in handling medical disputes. further data description and analysis. This study is different from current research of medical disputes in Taiwan, which largely focuses on hospitals whereas psychiatric rehabilitation agencies are hardly the research subjects. Meanwhile, considering that most research of medical disputes only interviewed medical personnel or experts to seek their opinions or experiences, this study includes interviews with patients’ families in addition to that with medical workers in order to understand the causes of medical disputes. This study found that both the situation gap and the expectation gap also exist in psychiatric rehabilitation agencies and patients’ families. Based on research results, this study suggests that psychiatric rehabilitation agencies in a medical dispute should minimize both parties’ cognitive gap, find out the causes of the cognitive gap, target communication at easing patients’ families’ anger, and make detailed records. This study hopes that these suggestions can provide guidance for medical related institutions in practical application and research.

目錄
封面內頁
簽名頁
中文摘要 iii
英文摘要 iv
致謝 vi
目錄 vii
表目錄 ix
圖目錄 x
第一章 緒論 1
第一節 研究背景 1
第二節 研究動機 4
第三節 研究目的 7
第二章　文獻探討 8
第一節 醫療糾紛 8
第二節 情境與認知 11
第三節 溝通策略與認知 15
第四節 期望與認知 18
第三章 研究方法 21
第一節 研究方法的選擇 22
第二節 受訪者 23
第三節 研究工具 26
第四節 研究程序 27
第四章 研究分析 30
第一節 情境認知落差分析 30
第二節 溝通策略分析 35
第三節 期望落差分析 39
第五章 結論與建議 41
第一節 結論與討論 41
第二節 管理意涵 44
第三節 研究限制與未來研究建議 45
參考文獻 47

表目錄

表1-1 受理委託醫事鑑定案件數統計 4
表3-1 受訪者的基本資料 25

圖目錄

圖2-1 危機類型與反應策略之對應Coombs（1999） 12

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