初次急性心肌梗塞患者的病痛經驗

本研究之目的是為了解初次急性心肌梗塞患者，在發病過程的病痛經驗。研究對象取自於南部某醫院中心心臟內科病房，經醫生診斷為初次急性心肌梗塞的患者，共有10名參加研究，其中男性7人、女性3人，平均年齡45.3歲±SD 7.42，依循現象學的理論基礎，以深度訪談來收集資料，並透過訪談錄音及札記來完整記錄。訪談資料以內容分析法，共呈現出三個生病經歷及病痛感受的主題：「疾病的起點」、「疾病蛻變的過程」、「轉念：生命與愛的引擎」。七個相關的次主題，包括：(一) 覺查異常、(二)身體失控、(三)穿越生死（四）學習建立身體新秩序、(五)珍惜家人關係、(六)把握當下（七）轉變未來。呈現出急性心肌梗塞患者面對疾所產生的壓力，透過疾病改變自我，期待著未來生活著更好的心境。本研究結果顯示：在生病的歷程中所經歷的病痛感受，因疾病造成衝擊與不安、穿越生死的恐懼和面對身體重新的轉變，他們透過疾病的經驗來重新自我調適、重新看待生命及家人之間的關係，對於未來的生活的改變。提醒醫療人員在照護病患上應有的方向，並非只有藥物治療，而傾聽患者內心表達的生病經驗也很重要，才能真正落實全人的醫療照護。

關鍵字

急性心肌梗塞；病痛經驗；質性研究；現象學

並列摘要

This study aims to understand the experiences and feelings of first Acute Myocardial Infarction (AMI) patients. Research subjects are 10 AMI patients in cardiology wards of a Southern Taiwan hospital, of whom there were seven males and three females, with an average age of 45.3 ±SD 7.42. The research utilized the Phenomenological study which included in-depth interviews for data collection to complete accounts of the patients’ post-treatment experiences based on the interviews recorded onto audio files and the detailed notes taken by the interviewer in the process. The qualitative analysis method was then employed to analyze the data elicited from the interviews, yielding three themes concerning the experiences and feeling of the patients: " The start of disease ", "The process of disease transformation," and "The change of perception: Life and the engine of love." Seven sub-themes were found after the analysis: 1. Experiencing unusual feelings, 2. Losing the control of body 3. Traveling through between life and death, 4. Creating a new order for one’s body, 5. Cherishing family relationships, 6. Seizing the moment one has, and 7. Reversing the future. The results of this study show that the suffering illness experiences including the impact and anxiety caused by the disease, the fear of death, and the uncertainty of facing physical changes. Through the experience of the disease, they re-self-adjustment their lives, re-new the relationships toward themselves and their families. More, they also adjust the expectations of future life. All those subjective illness suffering experiences of AMI patients shed the light of medical as well as nursing care, that physical care only part of their disease encounter. For a holistic care, the total facets of disease, especially subjective illness experience of suffering need to be awared.