本研究旨在探討急診就醫病人/家屬與醫護人員所認知與感受的急診人性化照護內涵。採立意取樣，以台南地區兩家醫學中心，以及ㄧ家區域醫院的急診室就醫病人或其家屬，以及急診室工作的醫護人員為研究對象，依Paterson及Zderad發展的人性化護理理論設計訪談大綱進行訪談，蒐集客觀訊息，共收案80名，轉寫成逐字稿後，再以”內容分析法”的歸納方式，加以分析與比對急診就醫經驗中，主體與客體在「人性化照護」概念上的不同認知與感受。
研究結果發現病人/家屬所認知與感受的「急診室人性化照護」內涵，共有五個類型「展現良善的互動」、「滿足需求」、「具備倫理思維」、「體貼的環境與設備」、「獲得健康資訊」，包含13項主題「醫護人員能主動接待並具有親切溫暖的態度」、「醫護人員能時常關切病情、投注關懷、讓我心安」、「醫護人員具備同理(感)心，能傾聽病人家屬的問題與需要」、「能即時找到照顧我的醫護人員解決疑惑並討論病情」、「醫護人員能即時緩解我急迫的生理/病痛症狀，並穩定病情」、「醫護人員能針對我的需求，提供基本生理照護與舒適護理」、「醫護人員能夠提供優質的專業知能與技術」、「醫護人員能充份告知訊息，協助自主同意權利之展現」、「不會被標籤而置之不理」、「醫護團隊能因病人個別性的需要，而調整僵化的制度」、「能提供我舒適安全的物理環境與儀器設備」、「能完全明白醫護人員解釋的即時病情診治訊息」、「醫護人員能夠提供我離院的後續照護措施與必要資源」。其中有3項主題「醫護人員能主動接待並具有親切溫暖的態度」、「能完全明白醫護人員解釋的即時病情診治訊息」、「醫護人員能夠提供我離院的後續照護措施與必要資源」，為全部30名病人/家屬都認知與感受到的急診人性化照護主題。
醫師所認知與感受的「急診室人性化照護」內涵，有六個類型「與病人/家屬良善的互動」「尋求醫療團隊的合作」、「回應及滿足病人/家屬的需求」、「具備倫理思維」、「體貼的環境與設備」、「提供合適的健康照護資訊」，包含16項主題「能在互動中與病人/家屬建立信任與親善關係」、「讓病人/家屬感受到關懷」、「能理解並同理(感)病人/家屬的情緒反應」、「必須傾聽且信任病人的主訴」、「醫療團隊應密切合作、培養默契、互相尊重、互相影響，教學相長」、「能重視並回應病人/家屬的需求與反應：包括生理/病痛與非生理層面」、「決定病人看診順序與診治過程應符合倫理」、「充分告知病人/家屬該有的權利，再行自主權同意」、「不隨意標籤病人/家屬」、「物理環境應符合病人/家屬的舒適與安全」、「能夠突破急診的限制，修改或調整僵化的制度」、「儀器設備使用需符合病人/家屬的舒適與安全」、「提供即時的病情診治訊息與足夠的後續照護措施與方向」、「能給予病人/家屬清楚的口頭與書面衛教」、「能用適當的語言與方式向病人/家屬解釋病情，並展示醫療團隊的盡力」、「能為病人/家屬尋求適當的資源」。其中有8項主題「能在互動中與病人/家屬建立信任與親善關係」、「醫療團隊應密切合作、培養默契、互相尊重、互相影響，教學相長」、「能重視並回應病人/家屬的需求與反應：包括生理/病痛與非生理層面」、「決定病人看診順序與診治過程應符合倫理」、「物理環境應符合病人/家屬的舒適與安全」、「能夠突破急診的限制，修改或調整僵化的制度」、「提供即時的病情診治訊息與足夠的後續照護措施與方向」、「能給予病人/家屬清楚的口頭與書面衛教」為全部19名醫師都認知與感受到的急診人性化照護主題。
護理人員所認知與感受的「急診室人性化照護」內涵，有六個類型「與病人/家屬良善的互動」、「尋求醫療團隊的合作」、「回應及滿足病人/家屬的需求」、「具備倫理思維」、「體貼的環境與設備」、「提供合適的健康照護資訊」，包含18項主題「要讓病人/家屬感受到關懷」、「能在互動中與病人/家屬建立信任與親善關係」、「能理解並同理(感)病人/家屬的情緒與感受」、「必須傾聽且信任病人的主訴」、「醫療團隊應密切合作、培養默契、互相尊重、互相影響，教學相長」、「能重視並回應病人/家屬的問題與反應：包括生理/病痛與非生理層面」、「能執行基本生理需求與舒適護理」、「執行護理技術過程中，減少病人的不適與家屬的焦慮」、「能熟知病人的病情及後續處置」、「決定病人看診順序與照護過程應符合倫理」、「充分告知病人/家屬該有的權利，再行自主權同意」、「不隨意標籤或批評病人/家屬」、「物理環境應符合病人/家屬的舒適與安全」、「能夠按個別病人的需要突破急診的限制，修改或調整僵化的制度」、「儀器設備使用需符合病人/家屬的舒適與安全」、「協助提供即時的病情診治訊息與足夠的後續照護措施與方向」、「能用適當的語言與方式向病人/家屬執行口頭與書面衛教」、「能為病人/家屬尋求適當的資源」。其中有8項主題「要讓病人/家屬感受到關懷」、「醫療團隊應密切合作、培養默契、互相尊重、互相影響，教學相長」、「能重視並回應病人/家屬的問題與反應：包括生理/病痛與非生理層面」、「決定病人看診順序與照護過程應符合倫理」、「物理環境應符合病人/家屬的舒適與安全」、「能夠按個別病人的需要突破急診的限制，修改或調整僵化的制度」、「協助提供即時的病情診治訊息與足夠的後續照護措施與方向」、「能用適當的語言與方式向病人/家屬執行口頭與書面衛教」為全部31名護理人員都認知與感受到的急診人性化照護主題。
同樣身為醫療照護提供者的醫師與護理人員，他們所認知與感受的人性化照護的內涵是ㄧ致的。而病人/家屬與醫護人員皆認同的急診室人性化照護面向有：一、醫(護)病短暫的相遇中要有良善的互動。二、就醫過程中能即時的解釋與了解病人病情診治訊息。三、離院後的居家照護措施及後續返診、資源提供。以上所呈，在急診室短暫的醫（護）病相遇（encounter）過程中，可提供急診醫（護）病間對於人性化照護現況上認知的共識，與彼此間的落差，成為落實與改善急診人性化照護的依據，建構出臨床急診室人性化照護模式，使醫護人員照護病人/家屬時更能展現人性化的關懷。

The aim of this study is to explore patients, their families, as well as medical-nursing staff in emergency department (ED) relative to their perception and awareness of humanized care. We used purposive sampling and selected 80 cases that include medical-nursing staff, patient and their families in ED of two medical centers, and one regional hospital in Tainan Region. According to “Humanistic Nursing Theory”, developed by Paterson and Zderad, we design interview guideline and collect objective information by means of interview then translate into text in order to analyze by “content analysis” inductively. Analysis and comparative different perception and awareness of humanized care concept from Subjective and Objective experience of ED. We therefore expect to establish a culture of humanized care of ED.
There are five categories including thirteen themes that were inducted from patients and their families in ED relative to their perception and awareness of humanized care. The five categories are “to have kindhearted interaction”; “to meet my needs”; “to conform to bioethical thinking”; “to fit within considerate physical environment and equipment”; “to obtain health information”. The thirteen themes are “medical-nursing staff received me with enthusiasm and warm attitude”, “medical-nursing staff are always concerned about me and relieved me”; “medical-nursing staff who have empathy, can listen to my questions and needs”; “I can dispel my doubts and discuss my conditions immediately after looking for medical-nursing staff”; “medical-nursing staff can relieve my life-threatening conditions and suffering immediately”, “medical-nursing staff can provide basic and comfortable care for me adequately “medical- nursing staff can provide highly professional capabilities and techniques”; “medical-nursing staff can give me sufficient information and help me to show autonomy”; “Never be labeled and ignored”; “medical-nursing staff can adjust to rigid regulations according to patient’s needs specifically”; “medical-nursing staff can provide comfortable and safe physical environment and equipment”; “to understand lucid information of diagnosis and therapy explained by medical-nursing staff”; “medical-nursing staff can provide continuous care interventions and resources after discharge from hospital”. 100% patients and the families have three of the themes relative to their perception and awareness of humanized care in ED: “medical-nursing staff received me with enthusiasm and warm attitude”; “to understand lucid information of diagnosis and therapy explained by medical-nursing staff”; “medical-nursing staff can provide continuous care interventions and resources after discharge from hospital”.
There are six categories including sixteen themes that were inducted from doctors in ED relative to their perception and awareness of humanized care. The six categories are “to emerge kindhearted interaction”; “to seek medical team to cooperate”; “to respond and to meet their needs”; “to have bioethical thinking”; “to fit within considerate physical environment and equipment”; “to provide fit health care information”. The sixteen themes are “can establish trust and rapport in our interaction”; “Let patients and their families feel they are being cared”; “can perceive and empathize emotional reaction of patients and their families”; “to have to listen and trust patients”; “medical team would collaborate, respect, affect, and teach each other”; “can respect and respond to the needs and reaction of patients and the families: includes physical and non-physical perspectives”; “to dispose patients based on bioethics”; “can sufficient to inform patients and their families about rights and help them to show autonomy”; “Never labeling patients and their families”; “can provide comfortable and safe physical environment”; “can break through limitation of ED, and adjust to rigid regulations”; “can provide comfortable and safe equipment”; “can provide lucid information of diagnosis and therapy ,and continuous care interventions after discharge from hospital”; “can provide verbal and written patient instructions”; “to explain about patient’s condition adequately that ware trying our best at the interest of the patient”; “can provide adequate resources for patient and their families”. 100% doctors have eight of the themes relative to their perception and awareness of humanized care in ED: “can establish trust and rapport in our interaction”; “medical team will collaborate, respect, affect, and teach each other”; “can respect and respond to the needs and reaction of patients and their families: includes physical and non-physical perspectives”; “to dispose patients based on bioethics”; “can provide comfortable and safe physical environment”; “can break through limitation of ED and adjust to rigid regulations”; “can provide lucid information of diagnosis and therapy ,and continuous care interventions after discharge from hospital”; “can provide verbal and written patient instructions”.
There are six categories including eighteen themes that were inducted from nurses in ED relative to their perception and awareness of humanized care. The six categories are the same as doctors’: “to emerge kindhearted interaction”; “to seek medical team to cooperate”; “to respond and to meet their needs”; “to have bioethical thinking”; “to fit within consideration of physical environment and equipment”; “to provide fit health care information”. The eighteen themes are “Let patients and their families feel they are being cared”; “can establish trust and rapport in our interaction”; “can perceive and empathize emotional reaction of patients and their families”; “to have to listen and trust patients”; “medical team will collaborate, respect, affect, and teach each other”; “can respect and respond to the needs and reaction of patients and their families: including physical and non-physical perspectives”; “can perform nursing care of basic physical needs and comfort”; “to decrease the discomfort and anxiety of patients and their families while we perform nursing care”; “to know intimately patient’s condition and disposition”; “to dispose patients based on bioethics”; “can sufficiently to inform patients and their families about rights and help them to show autonomy”; “Never labeling patients and their families”; “can provide comfortable and safe physical environment”; “can break through limitation of ED and adjust to rigid regulations according to patient’s needs”; “can provide comfortable and safe equipment”; “can assist in giving lucid information of diagnosis and therapy ,and continuous care interventions after discharge from hospital”; “can provide verbal and written patient instructions adequately”; “can provide adequate resources for patients and their families”. 100% nurses have eight of the themes relative to their perception and awareness of humanized care in ED: “Let patients and their families feel they are being cared”; “medical team will collaborate, respect, affect, and teach each other”; “can respect and respond to the needs and reaction of patients and their families: including physical and non-physical perspectives”; “to dispose patients based on bioethics”; “can provide comfortable and safe physical environment”; “can break through limitation of ED, and adjust to rigid regulations according to patient’s needs specifically”; “could assist in giving lucid information of diagnosis and therapy ,and continuous care interventions after discharge from hospital”; “could provide verbal and written patient instructions adequately”.
Doctors and nurses are health care providers, they are consistency between perception and awareness of humanized care in ED. All of the patients, their families, and medical-nursing staff have the same perception and awareness of humanized care in ED in three perspectives: (1) Patients, their families, and medical-nursing staff have kindhearted interaction in brief ED encounters. (2) medical-nursing staff could explain about patient’s condition adequately and provide lucid information of diagnosis and therapy for patients and their families (3) medical-nursing staff could provide home care interventions and return resources after discharge from hospital. From the result of this study, we compared different perception and awareness of humanized care concept from Subjective and Objective experience of ED encounters. Thereby able to structure a more humanistic approach to the care of ED patients.

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