開放性肺結核病人的生病經驗

Illness experience in patients with open pulmonary tuberculosis

周阿綢(A-Chou Chou)

指導教授 ： 周傳姜

長榮大學/健康科學學院/護理學系(所)/碩士(2011年)

https://doi.org/10.6833/CJCU.2011.00165

摘要

本研究目的為瞭解開放性肺結核病人生病之主體感受及行為反應。採質性研究之深度訪談法進行。研究者以立意取樣的方式於南部某地區教學醫院進行收案，於民國九十九年五月至九月之間共訪得九位開放性肺結核病人。
訪談資料以內容分析法分析，結果呈現四個主題：肺結核診斷前後的混沌；治療歷程的考驗；面對社會烙印的反應；人助自助對抗結核。
本研究結果將有助於護理人員及醫療人員瞭解開放性肺結核病人的生病經驗，以便提供病人真正想要及需要的醫療照護。依研究結果提出以下建議：1.行政方面：由衛生主管機關或專科醫院集結具教學案例編輯成衛教手冊、拍攝抗結核勵志影片，於全國宣導，以利導正肺結核帶給病人負面的社會烙印，使病人可正常維持人際互動與確保生計。2.臨床方面：個案報告、護理專案及研究議題宜強化病人生病經驗之探討；成立病友支持團體；強化家庭及社會支持系統運作；促進醫病與護病訊息溝通之充分性。 3.教育方面：學校或醫院應當規劃醫護人員接受人類文化學、文化關懷照護及關懷技巧等訓練課程，以利提供病人真正想要的照護。4.研究方面：本研究結果獲得開放性肺結核病人生病的主體感受與行為反應，共有四個主題及十三個類組，可提供發展量性研究量變項之參考。

關鍵字

開放性肺結核 ； 生病經驗 ； 質性研究

並列摘要

The purpose of this study was to explore the illness experience and illness-related behaviors in patients with open pulmonary tuberculosis. Data were collected through a qualitative research design, in-depth interview, and mining semi-structured interview. This study recruited nine open pulmonary tuberculosis patients of a regional teaching hospital in southern Taiwan from May 2010 to September 2010.
The findings include four themes and thirteen clusters:(1) The chaos of pulmonary tuberculosis before and after diagnosis; (2) suffering from the treatment process; (3) facing social stigma of pulmonary tuberculosis; (4) fighting tuberculosis by heaven and themselves.
The findings will not only help medical and nursing professionals to understand open pulmonary tuberculosis patients’ illness experience and inner world, but also provide adequate medical and necessary care to the patients. Several recommendations are made for medical care personnel. (1)Administrative aspects: to maintain patients’ interpersonal relationships and to ensure their livelihood, it suggests that the government institutions and relative hospitals may apply those results to publish health education handbooks, films, as well as videos to correct the negative impressions of social stigma in patients with pulmonary tuberculosis. (2)Clinical aspects: Future case reports, nursing projects and research can more focus on illness experience of open pulmonary tuberculosis patients. It is also important to establish patient supporting groups; strengthen families and social supporting system to promote doctor-patient communication. Moreover, providing sufficient illness information is needed to maintain positive relations between professionals and patients. (3) Educational aspects: medical schools or hospitals could plan training courses about culture of Anthropology, culture of caring, caring skills to deep understand patients’ voices, explore their care needs and provide what they really want. (4) Research aspects: the results include four themes and thirteen clusters obtained from the open pulmonary tuberculosis patients’ experience and illness-related behaviors. Thus, the findings could provide as a reference for future nursing research.

並列關鍵字

Open pulmonary tuberculosis ； Illness experience ； Qualitative research

參考文獻

黃伊文（2010）．多重抗藥性結核病於台灣之變遷與治療現況．中南盟臨床專刊，3(2)，61-67。

鍾鳳嬌、周鳳珍（2007）．新進護理人員照護肺結核病患之壓力與調適．美和技術學院學報，26（1），55-72。

陳新綠譯(1997) •現代生死學—談病說痛：人類的受苦經驗與痊癒之道•台北：桂冠。

龔卓軍（2003）．生病詮釋現象學-從生病經驗的詮釋道醫病關係的倫理基礎．生死學研究，創刊號，57-75。

林金定、嚴嘉楓、陳美花（2005）．質性研究方法：訪談模式與實施步驟分析．身心障礙研究，l3（2），122-136。