全人工關節置換術患者的治療決策之初探

Decision-Making Regarding Total Joint Replacement Surgery: An Exploratory Study

鍾鳳玲(Feng-Ling Chung) ； 郭耿南(Ken-Nan Kuo) ； 蔡憶文(Yi-Wen Tsai) ； 蔡慈儀(Tzu-I Tsai)

《護理暨健康照護研究》 6卷3期 (2010/09) Pp. 191-199

https://doi.org/10.6225/JNHR.6.3.191

摘要

背景　關節疾病是一種影響身體功能及生活品質的慢性疾病，全關節置換術是目前最有效改善疼痛及生活品質的方法，其決定接受手術治療是一個錯綜複雜的過程。
目的　探討全人工關節置換術患者經歷治療決策之經驗。
方法　採質性研究設計，自97年11月至98年2月，於北區某醫學中心門診，訪談11位接受全人工關節置換術患者，利用半結構式訪談指引，進行一對一的深度訪談，所有訪談內容均予以錄音並轉為逐字稿，以主題分析法進行分析。
結果　本研究發現關節置換術患者經歷治療決策的生命經驗，歸納出五個主要概念，包括：⑴身體經驗；⑵認命並重獲對生命意義；⑶權衡所關心的事件；⑷家庭功能的展現；⑸解謎。
結論　決定是否接受手術是攸關生命的重大決策，治療決策是一種複雜和不斷思考的過程，亦因不同文化背景其影響因素也不盡相同。研究結果提供臨床護理人員在協助此類病患進行治療決策時之參考依據，進而減少病患在進行治療決策時出現之困擾。

關鍵字

治療決策 ； 全人工關節置換術 ； 決策

並列摘要

Background: Joint disease is a common chronic disease that causes disability and reduces quality of life. The decision-making process regarding total joint replacement (TJR) surgery is a complex process.
Purpose: This study was designed to better understand the decision-making process of total joint replacement (TJR) patients.
Methods: We used a qualitative research study design to explore the decision-making experience. Eleven patients were interviewed using semi-structured interview guidelines. Interview contents were audio taped and transcribed. Qualitative research was analyzed using content analysis.
Results: Results were organized into the following five categories: (1) self-experience (2) accepting fate and restoring meaning to life (3) weighing concerns (4) displaying family functions (5) inexorable riddle.
Conclusion: For bone joint replacement patients, surgical treatment decision-making is an important and life-anddeath decision. Treatment decision making is a complex process fraught with many issues that must be carefully weighed and considered. Study results provide a reference for caring for patients with total joint replacement needs, and emphasize the need to decrease patient decision-related distress prior to undergoing treatment.

並列關鍵字

treatment decision making ； total joint replacement ； decision-making