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研究生: 吳佩玲
Wu, Pei-Ling
論文名稱: 台灣醫療通譯現況研究-護理人員觀點
An Exploration of Medical Interpreters in Taiwan from the Perspectives of Nurses
指導教授: 陳子瑋
Chen, Tze-Wei
口試委員: 蘇世斌
Su, Shih-bin
馬淑清
Ma, Shu-Ching
汝明麗
Ju, Ming-Li
陳彥豪
Chen, Yan-Hao
陳子瑋
Chen, Tze-Wei
口試日期: 2023/12/22
學位類別: 博士
Doctor
系所名稱: 翻譯研究所
Graduate Institute of Translation and Interpretation
論文出版年: 2024
畢業學年度: 112
語文別: 中文
論文頁數: 384
中文關鍵詞: 臨時通譯員語言障礙醫療通譯員外籍移工護理人員
英文關鍵詞: ad hoc interpreters, language barriers, medical interpreters, foreign migrant workers, nursing staff
研究方法: 主題分析深度訪談法半結構式訪談法
DOI URL: http://doi.org/10.6345/NTNU202400128
論文種類: 學術論文
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  • 本研究旨在探討護理人員面臨語言隔閡對於照護外籍移工所產生的影響,以及如何因應跨語言溝通。研究者採以半結構式深度訪談三十三位南部地區某醫療體系的護理人員,並參考主題分析法進行文本分析與詮釋。研究結果顯示,受訪者礙於語言隔閡無法與外籍移工互動,也因此避免有言語上的接觸,較少花時間與病人互動,護病互動主要是以治癒身體為主的人際關係。
    此外,也礙於通譯可近性與即時性的侷限,護理人員因應之做法為日常照護就使用Google翻譯、採取肢體動作、衛教單張等溝通策略。此外,也配合醫師的要求,預先安排通譯協助。其他則視臨床有必要,才會尋求臨時通譯員的介入。
    面臨臨床工作的複雜與不確定性,儘管意識到臨時通譯員介入可能帶來的負面影響,護理人員仍覺得通譯有其存在的必要性。整體而言,護理人員對專業通譯有其需求,仍而此需求可能礙於工作忙碌、尋求通譯之不易再加上利益關係者介入等因素,使其使用需求似乎低於預期。基於上述研究發現,醫療通譯是否有其臨床發展的可行性,是值得未來通譯推動者深思的議題。並於最後對未來研究者提出相關建議。

    This study aims to investigate the impact of language barriers faced by nursing staff when providing care to foreign migrant workers and how they cope with cross-language communication. The researcher conducted semi-structured, in-depth interviews with thirty-three nursing staff in a healthcare system in the southern region of Taiwan, and analyzed interpreted the textual data with reference to thematic analysis. The results of the study indicate that interviewees in Taiwan, hindered by language barriers, face difficulties in interacting with foreign migrant workers. Consequently, they tend to avoid verbal interactions and spend less time with patients. The nurse-patient relationship focuses on task-focused care. Due to the limitations of interpreter availability and immediacy, nursing staff resort to various communication strategies. Furthermore, they may prearrange interpreter assistance as requested by physicians to address language barriers. In some cases, they only seek ad hoc interpreters when deemed clinically necessary. Faced with the complexities and uncertainties of clinical work, although nursing staff are aware of the possible negative effects of the intervention of ad hoc interpreters, they still see the value of interpreters. To conclude, they acknowledge the need for professional interpreters. However, due to the difficulty of seeking interpreters, and the involvement of stakeholders, the demand for its use seems to be lower than expected. Bases on the critical finding, the feasibility of medical interpreters for clinical development is an issue that future advocates for interpreter services should consider. Finally, the study provides recommendations for future researchers.

    謝 誌 i 摘 要 ii Abstract iii 目 次 iv 表 次 vii 圖 次 ix 第一章 緒論 1 第一節 研究背景 1 第二節 研究動機與目的 4 第三節 研究問題 9 第四節名詞解釋 10 第二章 文獻回顧 11 第一節 跨文化研究 12 第二節 醫師護理師與病人三方的關係與溝通 43 第三節 醫療通譯的理論與實務 65 第四節 小結-以病人為主體互動之脈絡 83 第三章 研究方法與研究設計 85 第一節 研究架構 85 第二節 研究方法的選擇 86 第三節 研究訪談大綱 98 第四節 研究對象 100 第五節 研究訪談 103 第六節 資料蒐集與分析 104 第七節 研究資料嚴謹度 111 第四章 研究分析與結果 115 第一節 受訪者基本資料分析 115 第二節 護理人員於照護過程中面臨語言隔閡的困境 118 第三節 護理人員如何因應語言隔閡之溝通 148 第四節 語言隔閡如何影響護病關係 172 第五節 通譯員介入護病溝通之不確定性 184 第六節 現實與理想的差距-護理人員反思臨時通譯員對於臨床情境之角色需求與期待 198 第五章 討論 221 第一節 護病溝通障礙重重之樣貌 221 第二節 對應外籍病人語言溝通模式-多元溝通策略 243 第三節 無法提供以人為主互為主體的護病關係 253 第四節 站在天秤的兩端左右為難 261 第五節 現實與理想的差距—護理人員反思臨時通譯員對於臨床情境之角色需求與期待 274 第六章 結論與建議 289 第一節 結論 289 第二節 研究建議 294 第三節 研究限制 298 參考文獻 299 附錄 337 附錄一 2019-2021年度至柳營奇美醫院就醫的東南亞籍病人就醫資料 337 附錄二 受訪者基本資料 338 附錄三 外語人才資料庫 340 附錄四 人體試驗委員會核准函 341 附錄五 受訪者基本資料統計 342 附錄六 受訪者訪談文稿 343

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