自我調節方案對慢性病患之生理、心理社會功能成效－系統性文獻回顧

Effectiveness of the Self-Regulation Protocol on Physical and Psychosocial Functions in Patients with Chronic Illness: A Systematic Review

吳雅歌(Ya-Ke Wu) ； 蔡富棉(Fu-Mian Tsai) ； 林秋菊(Chiu-Chu Lin)

《護理暨健康照護研究》 7卷1期 (2011/03) Pp. 26-34

https://doi.org/10.6225/JNHR.7.1.26

摘要

背景　近年來慢性病盛行率高，生活型態及個人行為與慢性病發展有關，而個人生活行為也影響慢性病嚴重度。自我調節理論為一行為改變理論，陸續有研究者嘗試將此理論用於慢性病患，有鑑於慢性病之普及，實需針對慢性病領域探討此理論之系統性文獻回顧。
目的　本文透過系統性文獻回顧，整合自我調節方案運用於慢性病患生理、心理社會功能之成效。
方法　搜尋Medline(Ovid)等七個中英文資料庫。年份自1986年至2010年5月，依納入及排除條件篩選後由三位作者以Modified Jadad Scale評定文獻品質。
結果　共五篇文獻符合篩選標準，研究對象為成年慢性病患。在生理功能上，四篇研究呈現實驗組受試者身體功能計分較高、體重控制較好、步行距離較遠、症狀困擾較少且有顯著差異，餘一篇研究之生理功能測量無統計上差異；在心理社會功能上，一篇研究顯示實驗組受試者自我控制氣喘信心顯著增加且生活品質提昇，兩篇研究無統計上顯著差異，餘兩篇研究未探討。
結論／實務應用　本文結果顯示慢性病患可透過學習自我調節技巧改善生理功能，尤其適合已回歸社區，需要自主管理健康的慢性病患，但心理社會功能仍須進一步探討。然受試對象多為有動機且學習能力足夠的慢性病患，未來實務上可針對動機及學習能力不足對象發展措施，建構更完整的慢性病照護模式。

關鍵字

系統性文獻回顧 ； 自我調節方案 ； 慢性病患 ； 生理及心理社會功能

並列摘要

Background: The prevalence of various chronic illnesses has risen in recent years. Previous research has associated both lifestyle and personal behavior with the development of chronic illness, and personal behavior has been shown to affect chronic illness symptom severity. Self-regulation is one theory of behavior change. Recently, researchers have worked to apply this theory to the field of chronic illness. A systematic review of the self-regulation theory as applied to chronic illness is necessary due to the prevalence of chronic illness.
Purpose: This study tried to correlate the application of the self-regulation protocol with improvements in physical and psychosocial functions in patients with chronic illness.
Methods: Researchers searched seven Chinese and English electronic databases for relevant articles published between January 1986 and May 2010. Data were collected using inclusion and exclusion criteria. A modified Jadad Scale was used by three authors to evaluate the quality of articles published.
Results: Five studies met inclusion criteria. Subjects were all adult patients with chronic disease. In terms of physical functions, four studies indicated that subjects in the intervention group who scored higher on physical function, had better weight control and did longer distance ambulation experienced less symptoms and distress. These three found statistically significant differences, while the remaining one reported no statistically significant differences in terms of patient physical functions. With regard to psychosocial functions, one study found significant improvements in the intervention group in terms of confidence to self-control asthma and enhanced life quality. The other four studies either found no statistically significant difference or did not mention such.
Conclusion/Implications for practice: Study results indicate patients with chronic illness may improve physical functions by learning and using self-regulation techniques. This protocol is particularly suited for patients who have already returned to the community from the hospital and need to self-mange their health. However, the efficacy of self-regulation techniques on psychosocial functions remains unclear and requires further exploration. Most subjects addressed by this study were patients who were already motivated to improve their condition and who had sufficient learning ability. In order to develop a more comprehensive chronic disease care program, the authors recommend that, in addition to assisting patients to improve physical functions, related tools should be developed to further assist those who lack adequate motivation and learning ability.

並列關鍵字

systematic review ； self-regulation protocol ； patients with chronic illness ； physical and psychosocial functions