跨理論模式於慢性病管理的應用與挑戰

非傳染性疾病（noncommunicable diseases）是全球人口的主要死亡原因。許多研究指出導致慢性病增加的主因是身體缺乏活動、抽菸、酗酒和不健康的飲食，因此慢性病病人若能調整生活型態，促進健康的生活行為，將可延緩疾病的進展，提高生活品質。跨理論模式（transtheoretical model, TTM）是行為改變中最常用的理論之一，針對不同動機分期規劃合適的介入措施，協助病人改善生活型態，已被證實對慢性病的管理具有成效，進而達到良好的慢性病管理。此文介紹跨理論模式行為改變階段，以及影響其階段之改變過程、決策權衡和自我效能等因素，並且舉慢性腎臟疾病的管理為範例，說明實際應用跨理論模式之方法，以及使用該理論時將會遇到的挑戰，提供給未來醫護團隊運用該理論於慢性病病人的疾病管理之參考。

關鍵字

跨理論模式；慢性病；疾病管理

並列摘要

This article introduces the behavioral change stages of Transtheoretical Model (TTM) and related factors in each stage, process of change, decisional balance and self-efficacy. Noncommunicable diseases are the leading causes of death worldwide. Studies indicated that physical inactivity, cigarette smoking, excessive alcohol consumption and unhealthy diets contribute to the increased number of chronic diseases. Promotion of healthy lifestyle in patients with chronic disease may delay disease deterioation and improve quality of life. TTM commonly used in behavioral change, has been recognized as an effective theory in the management of chronic diseases. It provides appropriate interventions for patients in various behavioral change stages to improve lifestyle and better manage of chronic diseases. The author uses chronic kidney disease as an example to discuss the the interventions and challenges in the process. This article may be used for future reference for chronic disease management team.

並列關鍵字

transtheoretical model ； chronic disease ； disease management

參考文獻

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