現代医療に対する「信頼」についての実証的研究
URI | http://harp.lib.hiroshima-u.ac.jp/hkg/metadata/1468 | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
File |
AA114393620627.pdf
( 890.0 KB )
Open Date
:2008-10-22
|
||||||||||||
Title |
現代医療に対する「信頼」についての実証的研究
|
||||||||||||
Title Alternative |
People's trust in contemporary medical care system in Japan : Has it been weathering?
|
||||||||||||
Author |
|
||||||||||||
Subject |
医師
患者
信頼
現代医療
Doctors
patient
trust
contemporary medical care system
|
||||||||||||
Abstract |
変動する現代社会において、専門職の1つの典型としての医師に対する「信頼」、すなわち技術性、威信性、倫理性、および正当性という4つの要件を持つものとしての信頼は、患者の権利意識の増大、情報開示の進行、大きな病院での医療事故の増加、医師(開業医)の脱税の多さ、チーム医療の展開などによって、揺らぎ低下して来ていると考えれるが、このような信頼に関する実態はどのようになっているのかという問題意識のもとで、2004年8月から9月に質問紙調査(配票調査法)を行った。調査対象は、地方都市圏の広島市郊外地域の20歳以上の人々500人(無作為抽出)である。都市化が進んでいるが伝統的意識も残存していると思われる地域の人々が対象である。質問項目は35である。有効回収数は257であり、有効回収率は51.4%である。医師に対する信頼に関しては、揺らぎ低下しているものの、信頼の崩壊には至っていないことが分かった。仮説が検証できたといえる。信頼に関係の深い診療における安心の理由は、「医師の責任感」を挙げる人が最も多く(39.2%)、2番目は「医師の医療知識と技術がすぐれていること」(36.9%) である。医師にとって最も重要なことに関しては、「すぐれた医療知識と高い医療技術」を挙げる人が最も多く(約37%)、2番目は「十分な説明」(約29%)、3番目は「誠実さ」(約18%)である。主に利用する医療機関の医師に対する評価は、「良い」が圧倒的に多かった(約66%)。「良くない」は0.4%で、残りは「どちらともいえない」である。このような評価と関連性の最も大きな要因は、「医師の診療における説明の評価」であり、説明が「十分である」と思っている人は医師に対する評価が高かった。今後の研究課題は、今回の質問紙調査で明らかになったことを、より広範囲の調査対象に対する社会調査で検証すること、要因間の関連性についてより精緻な分析を行うこと等である。 Despite the fact that Japanese health care system has been relatively successful in terms of 'cost-benefit analysis' among developed nations, people's trust in medical care system is said to be deteriorating, notably demonstrated in the sharp increase of malpractice litigation. Media reveal that moral hazards have prevailed in many professional occupations of business and politics, and medicine is no exception, thus eroding people's trust in these institutions. Hypothetically, people's trust in medicine is based on its technical competence,prestige, ethical standing,and legitimacy. It seemed that the Japanese were once thoroughly depending on medical doctors and their institutions, which enjoyed high prestige and respect. Recently,however, due to the changing structure of disease and the stronger claim of rights on the part of patients, the long-established, patriarchal relationship between medical practitioners and patients in this country has radically changed and the latter as the 'subject' of medical care has been arguably recognized. This preliminary study conducted a questionnaire survey among the average Japanese in order to clarify their personal trust in doctors, hospitals, and medical care system according to their different individual and social attributes. 500 random samples (20 years-old and more) were selected from the electorate in a suburban region of Hiroshima city, which is neither highly urbanized nor extremely secluded,thus representing the average social setting of contemporary Japanese society. The questionnaire consists of 35 questions and 51.4% of the sample responded, some with noteworthy comments and opinions of their own concerning a variety of medical care problems in today's Japan. Results. Trust in doctors in general seems to be decreasing as is expected, but various data concerned cannot demonstrate a catastrophic decline of trust in medicine on the part of Japanese public. Particularly in everyday encounter with medical practitioners, they show a very favorable evaluation towards their doctors. Many (as much as 40% of the samples) tell that they trust in doctors as they notice responsible attitude and dependable knowledge and skills in them. In addition,well-informed patients are more likely to trust their doctors. Conclusion. Consistent with theory, we found the general decline of trust in medical care system in Japanese society today. However, in everyday experiences, people still hold a favorable attitude towards their doctors. An extended survey on this topic is our next step to pursue. |
||||||||||||
Journal Title |
現代社会学
|
||||||||||||
Issue |
6
|
||||||||||||
Spage |
27
|
||||||||||||
Epage |
46
|
||||||||||||
Published Date |
2005
|
||||||||||||
Publisher |
広島国際学院大学現代社会学部
|
||||||||||||
ISSN |
1345-3289
|
||||||||||||
NCID |
AA11439362
|
||||||||||||
Language |
jpn
|
||||||||||||
NIIType |
Departmental Bulletin Paper
|
||||||||||||
Text Version |
出版社版
|
||||||||||||
Old URI | |||||||||||||
Set |
hkg
|