心臟衰竭患者疾病知覺與自我照顧行為相關性之探討

研究目的：本研究運用自我調節模式理論，旨在探討心臟衰竭患者其疾病知覺與自我照顧行為之相關性。主要目的為：（1）描述心臟衰竭患者疾病知覺（含疾病認同、疾病詮釋與病因解釋）與自我照顧行為；（2）分析心臟衰竭患者疾病認同與自我照顧行為相關性；（3）分析心臟衰竭患者疾病詮釋與自我照顧行為相關性；（4）分析心臟衰竭患者病因解釋與自我照顧行為相關性；及（5）分析心臟衰竭患者自我照顧行為重要預測因子。研究方法：本研究採描述性研究，於北部某醫學中心之心臟內科門診進行收案。研究工具包括「心臟衰竭患者疾病知覺量表」、「心臟衰竭症狀經驗量表」與「心臟衰竭患者自我照顧行為量表」，主要之統計方法為描述性分析、獨立性t檢定、皮爾森相關與階層迴歸統計分析。在階層迴歸統計之模式一選入人口學變項性別、教育程度與NYHA心臟功能分級和疾病認同，模式二選入疾病詮釋變項，模式三再選入病因解釋變項。研究結果：發現與疾病詮釋具顯著相關的有：年齡與時間性急性/慢性（r = .34, p < .001）、個人對疾病的控制（r = .28, p = .005）。在疾病詮釋具差異性者：教育程度與時間性急性/慢性（F =4.93, p = .009）、對疾病認知的一致性（F =3.75, p = .027），教育程度小學以下者，對於疾病狀態的急慢性感受大於其他教育程度的患者，而大學以上的患者則對疾病的了解程度較高；NYHA心臟功能分級與時間性急性/慢性（F =6.93, p = .002）、時間週期循環性（F =4.55 , p = .013），即class III以上的患者對於疾病的急性/慢性和週期循環性之感受高於class I 和class II，其愈感受疾病是慢性的、具週期性的，此外，是否接受過心臟衰竭疾病衛教和對疾病認知的一致性具差異性（t =2.29, p = .025），曾接受衛教的患者對疾病了解程度較高。經階層迴歸分析，模式二選入疾病詮釋可提供整體自我照顧行為27%解釋力，其中又以個人對疾病的控制為唯一獨立預測變項，顯示疾病詮釋之個人對疾病的控制為自我照顧行為之重要預測因子。結論與建議：在疾病知覺中，個人對疾病的控制為自我照顧行為之重要預測因子，因此，建議未來應發展具個別性的心臟衰竭疾病衛教模式，並提供患者正確的認知，以提高其自我照顧行為。

關鍵字

心臟衰竭；疾病知覺；自我照顧行為；自我調節模式

並列摘要

Background and Research Objective: The study was based on self-regulation model and aimed to investigate the relationship between illness perception and self-care behaviors of patients with heart failure. The purposes of the study were to (1) describe the illness perception (illness identity, illness representations, and cause) and self-care behaviors of patients with heart failure, (2) examine the relationship between illness identity and self-care behaviors, (3) analyze the relationship between illness representations and self-care behaviors, (4) analyze the relationship between cause and self-care behaviors, and (5) identify important predictors of illness perception and self-care behaviors patients heart with failure. Subjects and Methods: This study used a descriptive correlational design. The study subjects were patients with heart failure from a teaching hospital in northern Taiwan. Three questionnaires including the illness perception questionnaire revised (IPQ-R), the heart failure symptoms experience questionnaire, and the self-care behaviors questionnaire were administered to the study participants. Independent t-test, Pearson’s correlation and hierarchical regression were used to analyze the results. Results: Univariate analyses revealed that age (r = .34, p < .001), education level (F = 4.93, p = .009), and NYHA functional class (F = 4.93, p = .009) are significant correlates of IPQ-R subscales. Hierarchical regression analyses showed that personal control in the illness representations significantly predicted self-care behaviors. Conclusions: Patients’ illness representations impact self-care behaviors. they believed that the personal control of heart failure. Patients will show a better self-care behavior if they can recognize the signs of heart failure. Results of the study suggest that development of a individuality heart failure disease health education or intervention program is required.

並列關鍵字

heart failure ； illness perception ； self-care behaviors ； self-regulation model

參考文獻

中文部份

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