慢性病患之疾病衝擊、健康行為與因應結果之模式檢定

An Empirical Study of Chronicity Impact, Health Behaviors, and Coping Outcomes in People with Chronic Illness

胡月娟(Yueh-Juen Hwu) ； 林豐裕(Feng-Yu Lin)

《實證護理》 1卷2期 (2005/06) Pp. 140-148

https://doi.org/10.6225/JEBN.1.2.140

摘要

裁至目前為止，少有研究探討健康行為對慢性病患者因應結果方面所扮演的角色，本研究目的即在檢視當健康行為變成一個中介變項時，其在降低慢性病對患者所引發的衝擊程度，與促進病人因應慢性病（對健康狀態與生活品質的感知）二層面的結果。本研究以中部地區某區域教學醫院的內科門診為研究情境，採立意取樣法，以結構式問卷（含慢性病衝擊量表、健康行為量表與因應慢性病結果量表）訪談慢性病患者500人，由500位慢性病患者的實證資料，以驗證健康行為在降低慢性病衝擊與促進病人因應結果的因果模式。研究結果顯示，最起始的模式不是很適配，經過修正後，則顯示此模式與實證資料呈現絕佳的適配性：χ^2(23, N=500)=53.32, P=.00, RMSEA＝.051, GFI=.98, AGFI=.96，與CFI=.98。就慢性病患者的因應結果而言，此模式可解釋27.8%的變異量。研究結果可提供護理人員參考，透過促進慢性病患者的健康行為，可以減輕病人所承受的衝擊程度，以及促進病人的因應其疾病。

關鍵字

慢性病衝擊 ； 健康行為 ； 因應結果

並列摘要

Few studies have investigated the role that health behaviors play in the coping outcomes (the perception of health status and quality of life) of people with chronic illness. The purpose of this study was to examine the role of health behaviors as a mediator that may reduce the impact of chronic illness on patients and improve coping outcomes in people with chronic illness. The sample was comprised of 500 people with a diagnosed chronic illness, recruited in the outpatient department of a teaching hospital in central Taiwan. Face-to-face structured interviews were conducted. A hypothesized causal model was tested to examine the role of health behaviors as a mediator of the impact of chronic illness on coping outcomes. The initial model was not a good fit and was modified to obtain the appropriate fit, χ^2(23, N=500)=53.32, p=.00, RMSEA=.051, GFI=.98, AGFI=.96 and CFI=.98. The antecedent variables accounted for 27.8% of the variance in the coping outcomes. The impact of chronic illness on coping outcomes was mediated by health behaviors. The results of this study will help nurses to provide more practical interventions to reduce the impact of chronic illness and promote adaptation among the chronically ill population.

並列關鍵字

chronicity impact ； health behaviors ； coping outcomes