| Summary: | 碩士 === 中山醫學大學 === 醫學研究所 === 99 === Background and Objectives: Patient-centered medical care is one of the five core values of 21st century practitioners and also one of the goals of post-graduate year one training in Taiwan. For female patients, complete physical examinations include a pelvic examination, but many women ignore or delay a pelvic examination due to its inherent embarrassing nature, a previous terrible experience, or their own misconceptions, which potentially leads to delayed diagnosis and treatment. The aim of this study was to explore the opinion of setting a screen during pelvic examination and the poor pelvic examination experience in Taiwan.
Methods: This observational convenience-sampling survey used a questionnaire administered face-to-face to women 20-64 years of age with pelvic examination experiences while they visited the family medicine out-patient department between June 2008 and May 2009 at a regional teaching hospital in Taichung, Taiwan. 1155 participants were recruited in this study. We analyzed the demographic data, the percentage of agreeing or insisting on screenless pelvic examination and the reason, and the percentage of having poor pelvic examination experience and the scenario and its association with six core competencies.
Results: In the 1155 participants, there were 54 patients(4.7%) who agreed or insisted on screenless pelvic examination. The major reasons for screenless pelvic examination were direct patient-doctor communication and concerns for monitoring doctor behavior. At least, there were 59 patients(5.1%) with poor pelvic examination experience during their course of medical treatment. The scenario of poor pelvic examination included attitude, pain, privacy and hygiene. The poor pelvic examination experience was distributed among both gender physician and different hospital level. Among the six core competencies, professionism and patient care were most related to the poor pelvic examination experience.
Conclusions: There were 4.7%(54 patients) who agreed or insisted on a screenless pelvic examination and at least 5.1%(59 patients) with poor pelvic examination experience during their course of medical treatmen. Based on patient-centered medical care, either during medical education or enforcement of medical practice, it is advised to incorporate the value of patients and provide excellent medical service by professionism and skills. Thus it is believed to eliminate patients’ complaints beforehand.
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