隨著近年來經濟之成長,國民對高熱量食物的攝取量逐年增加,迫使尿酸過高的人口急遽上升,也使得痛風人口增加亦趨向年輕化。痛風發作頻繁之病人應長期規則服用降尿酸藥物來控制尿酸濃度,這不僅可以降低痛風的復發率也減少痛風的相關合併症。然而,根據研究發現痛風病患之服藥遵從性並不高,且國內尚無針對痛風病患服藥經驗探討之相關研究。 本研究係採用描述性現象學研究法,以台中市某區域教學醫院,經免疫風濕科醫師確診為痛風,且曾服用降尿酸藥物之病患為研究個案,透過非結構式深入訪談來收集資料及分析。 本研究共收集九位研究對象的訪談資料,其研究結果歸納出五個主題及二十個次主題。主題及其次主題依序為(一)痛不欲生之回首:疼痛的煎熬、活動的受限、工作的停擺與復發的苦惱;(二)痛徹心扉之隱情:執著主觀想法、疏忽按時服藥、取捨藥物種類、擔心藥物副作用、排斥長期服藥與誤信民俗療法;(三)痛不堪言之苦衷:醫藥資訊的不足、經濟方面的負擔、醫療處置的缺失與就醫治療的羈絆;(四)痛滌前非之決心:疼痛症狀的改善、身體心像的復原與正常工作的回歸;(五)痛定思痛之改變:專業醫療的認同、醫療政策的便利與成功典範的學習。 期望藉由此研究結果,可以提供臨床醫護人員未來在改善痛風病患服藥意願的方向,教導痛風病患瞭解規則服用降尿酸藥物治療的重要性,並針對痛風病患個人因素給予個別性之相關護理指導,且在這個領域中進一步設計出提高病患服藥意願的介入措施,以提供病患完整且連續之醫護照護。
As the level of economy growing, people increase having high calorie foods. Therefore, people with high uric acid and the number of younger population with gout are increasing. In order to control the level of uric acid, patients with frequent gout attack should take regularly medications in a long-term. Taking medication regularly can not only prevent gout attacks, but also reduce related complications. However, researches showed that the compliance of medication taking was poor, and, there were no researches to explore the experience of medication taking for patients with gout. This research applied the descriptive-phenomenology method to explore issues on the experience of medication taking for patients with gout. Participants were recruited from the Rheumatology outpatient department and hospitalized patients in a regional teaching hospital of Taichung, Taiwan. Participants were diagnosed as a gout patient and had a history of long-term medication taking. Through an in-depth unstructured interview about their experiences of medication taking with gout. Data were collected via interviewing with tape-recording and notes taking. The preceding data were analyzed deliberately. In this study, nine subjects were collected interviews. The result of the research showed that there are five major themes and 20 sub-themes : (1) a unbearably melancholic memory : painful suffering、 limited activities、tasks suspension、suffering from disease recurrence ; (2) a miserable Hidden secrets : subjective insistence、ignoring of medicine taking regularly、choosing favorite medication、worrying about side effects of medication、reluctantly taking medication in long-term、believing mistakenly of traditional folk remedy ; (3) an anguished concern : lacking of related medical information、an economic burden、mistakes of medical intervention、the fetters of medical remedy;(4) an invincible determination : relieving from pain、recovery of self-image、returning to job duty;(5) a successful transformation : recognized by professional medical staffs, benefit from medical policies and learning from successful role models. The result of this research will be provided as a guild to take care of patients with gout. Nurses can teach patients to understand the importance of medication taking to decrease the level of uric acid, plan an individualized nursing care program, and design an intervention program for patients'' medication taking. These can benefit patients with gout and facilitate to have more complete and continuous nursing care.
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