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題名:一位服藥不遵從之截肢糖尿病病人的護理經驗
書刊名:榮總護理
作者:賴怡儒黃雅儀
作者(外文):Lai, Yi-luHuang, Ya-yi
出版日期:2008
卷期:25:2
頁次:頁200-205
主題關鍵詞:服藥不遵從行為糖尿病截肢Non-adherenceDiabetesAmputation
原始連結:連回原系統網址new window
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  • 點閱點閱:5
本報告運用健康信念模式探討一位中斷服用降血糖藥物、選擇草藥療法之糖尿病截肢患者的服藥不遵從行為,結果發現個案之服藥不遵從導因於自覺罹患糖尿病嚴重程度之認知不足、感覺藥物的療效無法符合個人對治療的期待、感受到長期服用藥物可能損害腎臟功能。於照護期間利用溝通技巧及不批判的態度與個案會談,了解個案不遵從行為背後的故事,並藉由促使個案知覺到疾病合併症的威脅,來引發個案學習的動機,並提昇個案堅信能夠做到醫護囑咐行為的信心程度。臨床上在照顧此類個案時,應完整的評估個案的健康信念,才能有效的改變其行為,減少個案因糖尿病不良控制而反覆入院,本報告可作為臨床上照護此一案例之參考。
This article discusses a diabetes patient who stopped medication to take herbal medicine and was hospitalized due to poor healing of a wound. The patient's non-adherence behaviors resulted fro lower severity perception, lower benefit perception of taking action, and higher barrier perception in taking action. We gathered information by using communication skills and never criticizing the patient's beliefs. We induced motivation of learning by promoting the patient's perception of possible complications. We also improved the patient's confidence in accomplishing the healthy behaviors. Physicians should assess a patient's health beliefs to change his non-adherence. This will prevent furture hospitalization due to poor control of diabetes. We are glad to share this successful experience with others.
期刊論文
1.Vermeire, E.、Hearnshaw, H.、van Royen, P.、Denekens, J.(2001)。Patient adherence to treatment: Three decades of research. A comprehensive review。Journal of Clinical Pharmacy and Therapeutics,26(5),331-342。  new window
2.蘇雅惠、梁毓敏、涂豔華(20020100)。提升精神分裂症患者服藥之遵從。長期照護雜誌,5(2),47-54。  延伸查詢new window
3.蔡世澤(2004)。糖尿病照護趨勢。糖尿病衛教學會會訊,6,3-10。  延伸查詢new window
4.Carpenter, R.(2005)。Perceived threat in compliance and adherence research。Nursing Inquiry,12(3),192-199。  new window
5.Donovan, J.(1995)。Patient decision making。International Journal of Technology Assessment in Health Care,11,443-55。  new window
6.Hamlitom, G. A.(2003)。Measure adherence in a hypertension clinical trial。European Journal of Cardiovascular Nursing,2,219-228。  new window
7.Jones, G.(2003)。Prescribing and taking medications: Concordance is a fine theory but is mostly not being practiced。British Medical Journal,327(7419),819。  new window
8.Mulik, P. K.、Mtonga, R.、Gill, G. V.(2003)。Amputation and mortality in new-onset diabetec foot ulcers stratified by etiology。Diabetes Care,26(2),491-494。  new window
9.Rosenstock, I. M.(1988)。Enhancing compliance with health recommendation。Journal of Pediatric Health Care,2(2),67-72。  new window
10.Singh, N.、Armstrong, D. G.、Lipsky, B. A.(2005)。Preventing foot ulcers in patients with diabetes。Journal of American Medical Association,293(2),217-228。  new window
11.Ulfvarson, J.、Bardage, C.、Wredling, R. A. M.、Bahr, C.、Adami, J.(2007)。Adherence to drug treatment in association with how the patient perceives cares and information on drugs。Journal of Clinical Nursing,16,141-148。  new window
12.Becker, Marshall H.、Maiman, Lois A.(1975)。Sociobehavioral Determinants of Compliance with Health and Medical Care Recommendations。Medical Care,13(1),10-24。  new window
 
 
 
 
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