| 摘要: | 線上醫病互動的發展與討論方興未艾，儼然是一種全新的醫療模式，然而目前對線上醫病互動的發展與模式仍缺乏探討。本研究旨透過個案場域進行研究。經過初步比較，本研究選取批踢踢實業坊─健康各板作為相對成功的線上醫病互動平台，並作為本研究個案場域。本研究採質性研究方法中的民族誌方式進行觀察及訪談，以行動者網絡理論（Actor-Network Theory，ANT）為指導，透過文獻建構的病人賦權的四種能力來探索轉譯的歷程，共觀察與計訪談12位符合資格者，以詮釋線上醫病互動的發展脈絡、及互動關係的動態建構。台灣最大telnet社群網站─批踢踢實業坊（Ptt），最初是個專為校園所設立的社群互動平台，而其中的健康各板，每天都有固定人次在上面進行大量互動。疾病的出現，緊密的與生命歷程結合在一起；鄉民皆是在自身或家屬歷經罹病經驗之後才開始接觸到健康各板。對場域而言，這裡存在著一套經驗上的使用模式，使用者從一開始經由瀏覽文章獲取更多的經驗知識為起點，開始按文追友，歷經線上、線下、延伸至其他社交媒體的互動討論，最後再以分享自身治病的經驗歷程告一段落，而其間的Ptt板上互動歷程乃積累成為往後使用者搜尋的基礎，形成了知識經驗的共享與傳承。對使用者而言，鄉民藉由在健康各板上得到的資訊嘗試與實際的就醫治療結合，並完成整個治療過程，有些互動更延伸至線下結盟；甚至有些病友經歷了完整的治病經歷，發展出一套屬於自己的完整治病歷程，並在板上進而從病友的身分，轉變成為專家來協助需要的鄉民。這裡所謂的線上醫病互動歷程，是以病人為中心的互動模式，版上的其他使用者（包含使用者本身為該專科醫師）圍繞其主題進行醫病互動。然而，這樣的線上求醫與醫病互動歷程，從未在形式上改變過實體求醫與醫病互動歷程，Ptt儼然是單純延伸了病患的角色，以尋求解決實體醫病互動中的障礙。這樣成功地體現了病人賦權的宗旨。本研究並依此結果提出研究建議，以作為未來發展線上醫病互動的參考依據。
The discussion of online physician-patient interaction is in the ascendant, even forming a whole new healthcare service model. However, it still lacks of the exploration on the development of such service model. That is, the purpose of this research is to explore the patterns on developing online physician-patient interaction service.With the preliminary comparison study, we mark a social platform called “Professional Technology Temple, Ptt” as the remarkable case and choose several healthcare-related discussion boards in Ptt as the research field. Based on the Ethnography, we applied Actor-network theory and patient empowerment theory as guiding us to understand and “translate” the construction of the patterns of the online physician-patient interaction.Ptt is a popular telnet based social platform for Taiwan university campuses. The healthcare related discussion boards in Ptt offer users a health issue focused discussion and multidisciplinary interaction. With the research observation and interview, researchers as the platform user and participant found some interesting results. First of all, users’ involvement of these healthcare related boards reflect the disease experience suffering from oneself or his/her family. That is, it then reflects an unified user-centered using pattern. Next, users always start from the seeking and surveying the disease related knowledge which is composed of much others experiences on curing and caring. Then, they seek for the interaction from the article authors with online, eventually to offline, and to multidisciplinary forms of interaction. Finally, they go back to share their experience to the boards for the ritual of the ending interaction. It becomes a circle for knowledge accumulation for online physician-patient interaction. To patients as users, these boards empowered their understanding facing the disease curing process.To our understanding, this online physician-patient interaction pattern of circle fully represents the patient focused interaction model. Users include physicians, medical professionals, and patients interact with focusing on the core issue of patient’s disease curing. On the other hand, such pattern cannot be called a new service model in any kind of forms, instead of, be called enlarge the role of patient. This pattern successfully represents the patient empowerment. To conclude, This research provide some research suggestions for the future development of online physician patient interaction. |
