現今台灣醫療糾紛層出不窮，對大部分民眾的認知而言，葉克膜為重症醫療最後的救命符，殊不知使用葉克膜有許多限制且須投入大量醫療人員和成本，故本研究欲以葉克膜為例探討健康溝通在醫療環境中可能扮演之角色和對重症醫療決策的影響。本研究以南部醫學中心為主，理論性抽樣十二位醫療團隊相關專業人員，採深度訪談進行質性研究，運用紮根理論進行分析。研究顯示影響健康溝通的因素可分醫療認知方面、人口變項方面、健康溝通內容和外在因素等；而現今臨床上重症醫療決策以共享醫療決策、告知決策和專業的輔導者為主，健康溝通會直接影響重症醫療決策，如信任度和醫療資訊不對稱等因素。
本研究建議醫療認知方面可加強醫療知識的普及化及理解醫療的特性，減少期待與臨床的落差；健康溝通過程務求完整並於時間許可下善盡溝通義務，必要時透過連結相關團隊資源以確保溝通品質。最後，應建立友善醫病文化逐步改善當今相對崩壞的醫療環境與醫病關係，達到病患、家屬與醫療端三贏的局面。 Today the medical disputes in Taiwan have occurred frequently. For most people, ECMO is regarded at a severe medical help symbol. However, there are many restrictions of using ECMO and the investment medical personnel and costs are huge. Therefore, this study tries to take ECMO as an example to explore the role of health communication in a medical environment and on critical care decision-making. This study uses theoretical sampling and selected twelve critical care team professionals as samples and conducted in-depth interviews using qualitative research. Grounded theory analysis was used for data analysis. Studies have shown that factors affecting the health of communication can be divided into the cognitive aspects of medical, demographic variables respect, health communication content and external factors. The models of today's critical care clinical decision-making are shared medical decisions, informed decision-making and professional mentor-based decision-making. Health communication will directly affect the critical care decision-making, such as trust , medical information asymmetry and other factors. The study suggests that cognitive aspects of health care can enhance the popularization of medical knowledge and understand the characteristics of health care can reduce the gap between expectation and clinical; Health communication process in view to complete and time permit to fulfill our obligations to communicate, By linking relevant team resources to ensure the quality of communication when necessary. Finally, we should establish a friendly medical treatment culture gradually improve today's health care environment and the relative collapse of the doctor-patient relationship, Reach patients, families and medical end-win situation.
