初次罹患急性心肌梗塞病人返家後生活經驗及照護需求

本研究旨在探討初次罹患急性心肌梗塞病人返家後生活經驗及照護需求。研究採用現象學研究法，以立意取樣方式，在南部某區域教學醫院徵求九名願意分享經驗之初次罹患心肌梗塞個案，經填妥同意書後於出院返家7天至1.5個月進行一對一的深度訪談，研究者將所有訪談內容資料轉為逐字稿，再以Colaizzi的內容分析法進行資料分析及歸納。資料分析結果分為返家後生活經驗及照護需求二個部分，生活經驗歸納出二個主題九個次主題分別為：主題一『生活從「心」開始』及「罹病後的身體感受」、「與藥物共存」、「戒與不戒菸都掙扎」、「運動與勞動」、「告別油物」、「調整生活步調」六個次主題；主題二『社會角色的回歸』及「重返工作」、「失去工作」、「家庭支持」三個次主題。照護需求納出二個主題五個次主題分別為：主題一『生活起居照護需求』有「養生」、「娛樂活動」、「性知識」三個次主提題。主題二『疾病照護需求』有「疾病後續照護」、「藥物產生副作用」二個次主題。本研究結果顯示初次罹患心肌梗塞病人返家後經歷生活改變及調整包含：身體的不適症狀的適應、運動、藥物、抽菸、飲食等的調適，且在照護需求有：食療養生、日常活動、性知識及疾病後續照護、產生藥物副作用因應等需求，建議醫院可針對此類個案列為個案管理對象，協助個案出院後的居家自我照護。本研究結果有助於醫護人員更進一步了解心肌梗塞病人返家後生活狀況，以提供臨床照護此類個案之參考及實務工作時之運用。

關鍵字

初次心肌梗塞；生活經驗；照護需求

並列摘要

The purpose of qualitative research is to explore the life experiences and caring needs among newly diagnosed acute myocardial infarction patients. In-depth interviews with nine participants from a regional teaching hospital in southern Taiwan were conducted during a limited period of time (7 days to 1.5 months). Data were collected using a retrospective method based on semi-structured interview guidance, and analyzed according to Colaizzi's (1978) phenomenology approach. The result of life experience was divided into two main themes and six sub-themes: (1) life begins from "heart" and body sensations change after suffering heart disease, (2)co-exist with medication, (3)struggle between quit or not quit smoking, (4)job work and exercise, (5) say goodbye to the greasy food and (6)adjusting lifestyles. In addition, there were two main themes and five sub-themes in caring needs: (1) caring needs in daily life, including health preservation, entertainment and sexual knowledge; (2) caring needs about coping heart attack, including disease follow-up and drug side effects. The results of this study provide essential information for understanding the experience of life change process among patients with newly diagnosed myocardial infarction their adjustments to physical symptoms, exercise, medication, smoking and diet. Moreover, there were caring needs. In addition, there were caring demands about food management, daily activities, sexual knowledge, further care planing, drug side effects. To support self-management in patients after heart attack , such patients with newly diagnosed myocardial infarction were suggested to involve to case management system. This study could provide medical professionals learn more about how patients with heart attack take care of themselves while discharge from hospital to home, and apply in clinical practice.