類風濕性關節炎患者疾病知識、社會支持及自我效能與自我照顧行為之相關探討

The Relationship among Disease Knowledge, Social Support, Self-Efficacy and Self-Care Behavior of the Patients with Rheumatoid Arthritis

陳素燕(Su-Yen Chen)

指導教授 ： 王秀紅

高雄醫學大學/護理學院/護理學系研究所/碩士(2003年)

摘要

本研究目的在探討類風濕性關節炎患者的疾病知識、社會支持、自我效能與自我照顧行為之相關性，並找出其自我效能與自我照顧行為之重要預測因子，採橫斷式之研究設計。研究者在南部一所區域醫院及一所醫學中心的免疫風濕科門診取樣，選取類風濕性關節炎患者為研究對象，有效樣本為129位。研究工具採結構式問卷，包括基本資料表、身體功能評估量表、疾病知識量表、社會支持量表、自我效能量表及自我照顧行為量表；本研究所得資料以JMP5.0套裝軟體進行統計分析。
研究結果發現：研究對象之自我效能之標準化得分為62.6，以功能性的自我效能得分最高，疼痛性的自我效能得分最低；自我照顧行為之標準化得分為83.6，以服藥遵從性得分最高，日常活動方式得分最低。年齡、教育程度、職業、社經狀況與自我效能有顯著差異，身體功能缺損狀況與自我效能呈顯著負相關；疾病知識與自我效能呈現顯著正相關。就醫醫院層級與自我照顧行為有顯著差異，疾病知識與自我照顧行為呈現顯著正相關；社會支持與自我照顧行為呈現顯著正相關。自我效能之預測因子為身體功能缺損程度及教育程度，可解釋總變異數為52.8%；自我照顧行為之預測因子為就醫醫院層級與社會支持，可解釋之總變異數為13.8%，疾病知識較佳及身體功能較差者其有較高的比率會有較高的自我照顧行為。
本研究結果可幫助護理人員了解類風濕性關節炎患者自我照顧
行為之現況及相關性。依研究結果建議，臨床護理人員應多提供此類患者及其家屬疾病相關治療訊息包括疼痛冷、熱敷的使用及日常活動關節保護及省力原則，並可藉由病友會的成立，進而提昇患者的自我照顧行為。

關鍵字

類風濕性關節炎 ； 疾病知識 ； 社會支持 ； 自我效能 ； 自我照顧行為

並列摘要

The purpose of this study was to explore the relationship among knowledge of disease, social support, self-efficacy, and self-care behavior of the patients with rheumatoid arthritis in order to predict the variable significant factors associated with self-efficacy and self-care behavior. A total of 129 rheumatoid arthritis patients who recruited from a local and a medical center as outpatients in South of Taiwan were interviewed by a questionnaire. A questionnaire was constructed for this study including personal demography, health assessment, disease knowledge, social support, self-efficacy and self-care behavior. The data was analyzed by using the JMP packaged statistical software.
Major findings were as follows：Subjects of the study showed that the standardized score of self-efficacy was 62.6. Subjects had the highest scores in self-efficacy function subscale, and also had the lowest scores in the self-efficacy pain subscale. Subjects of the study showed that the standardized score of self-care behavior was 83.6. Subjects had the highest scores in the compliance of taking medicine, and also had the lowest scores in the daily existence. Self-efficacy were related to age, education, vocation, social economic level. Health disability level was significantly negative correlated with self-efficacy. Self-efficacy was also significantly correlated with disease knowledge. Self-care behavior was related to Hospital level. Self-care behavior was also significantly correlated with disease knowledge, social support. Health disability level and education explained 52.8% of the total amount of variance in self-efficacy. Hospital level and social support explained 13.8% of the total amount of variance in self-care behavior. The higher scores of disease knowledge and health disability were higher ratio to practice the higher self-care behavior.
The findings of this study can give guidance to nurses in developing stage-specific interventions and providing individual therapeutic information such as how to apply a local cold compress or a hot packing in pain to patients and their families. It is hope to enhance the self-care behavior of the patients with rheumatoid arthritis.

並列關鍵字

Rheumatoid arthritis ； disease knowledge ； social support ； self-efficacy ； self-care behavior

參考文獻

一、中文部分

王瑜欣（2000）．類風濕性關節炎患者生活品質及其相關因素之探討．

長庚護專學報，3，71-95。

王璟璇、王瑞霞、林秋菊（1998）．門診診斷初期非胰島素非依賴型糖尿

病患者的自我照顧行為及其相關因素之探討．護理研究，4（2）,60-