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題名：退化性膝關節炎中老年病人之疾病認知與因應
書刊名：健康促進與衛生教育學報
作者：陳毓璟 引用關係
作者(外文)：Chen, Stephanie Yu-ching
出版日期：2011
卷期：36
頁次：頁1-33
主題關鍵詞：中老年病人；因應；退化性膝關節炎；疾病認知；Coping；Elderly patients；Knee osteoarthritis；Perceptions
原始連結：連回原系統網址new window
相關次數：
  • 被引用次數被引用次數:期刊(3) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:2
  • 共同引用共同引用:6
  • 點閱點閱:176
退化性膝關節炎不僅是中老年人常見的疾病，與失智、中風和冠狀心臟病並列為造成老人失能的四大疾病。其所帶來的疼痛與腿部關節活動的限制，嚴重影響病人的生活品質。本研究以台灣南部某教學醫院 104位平均年齡約 65歲的病人為對象，參考疾病常識模式設計半結構式問卷，訪談病人對退化性膝關節炎的認知及其因應方式。 研究結果發現病人認為疼痛是主要疾病徵候，也是判斷疾病嚴重度的重要指標。多數病人認為退化性膝關節炎是長期勞動工作磨損結果或老化的自然現象，常先自行採行多種方法來減輕膝蓋疼痛所帶來的不適，無法緩解時才考慮就醫；部份老人因為缺乏陪伴就醫、經濟問題、交通不便或害怕手術的不良後果而有拖延就醫的情形；有些病人則過分樂觀手術療效而疏於自我照顧；有關退化性膝關節炎之資訊，大部分從醫生或親友得知；年齡高與低教育程度，會影響病人收集醫療資訊與理解的能力。 建議多注意病人因擔心自己失能成為子女的負擔所產生的憂鬱，以及自行用藥與接受民俗療法和延遲就醫的情形，並且發展針對疼痛緩解與預防失能之自我照顧教育方案。以及發展適合篩檢低識字老人的簡易評估問卷，來協助社區老人及早就醫與自我照顧。
Knee osteoarthritis (OA) is a common disease that affects elderly people. It is listed as one of the top four diseases, along with dementia, stroke, and coronary heart disease, leading to disabilities in elderly people. The pain and restrictions in leg joint activity caused by knee OA seriously impact quality of life. The participants of this study comprised 104 patients with an average age of 65, who were recruited from a teaching hospital in southern Taiwan. The perceptions and coping strategies of patients diagnosed with knee OA were assessed by a semistructured questionnaire, which was designed according to the common sense model. The findings revealed that the study patients considered pain to be the primary symptom of knee OA; therefore, pain is an important indicator of severity. Most patients believed that knee OA was caused by wearing out the joint from manual labor or that it was a part of the natural aging process. Medical treatment was considered only after various other measures had failed to control or relieve the pain. A number of elderly patients often delayed medical treatment because of no accompanying family, financial issue, transport inconvenience, or fear of surgery. Most of their knowledge on knee OA was based on information provided by physicians, family, or friends. Certain patients neglected self-care because of over optimism in the curative effects of surgery. Older age and lower educational background influenced the degree to which patients sought or understood medical information. We recommend that the patients suffering from OA must be monitored for their depression status and delay managing because of direct or indirect burdens and inadequate alternative treatments, respectively. We also suggest that disease surveys should be simplified for early diagnosis of knee OA, and that self-care educational programs may be developed to reduce pain and prevent knee OA among elderly people with low literacy.
期刊論文
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2.林柳池(2006)。認識退化性關節炎。聲洋防癌之聲，115，24-27。  延伸查詢new window
3.Hochberg, M. C.、Altman, R. D.、Brandt, K. D.、Clark, B. M.、Dieppe, P. A.、Griffin, M. R.、Moskowitz, R. W.、Schnitzer, T. J.(1995)。Guidelines for the medical management of osteoarthritis。Arthritis and Rheumatism，38(11)，1541-1546。  new window
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5.Wolf, M. S.、Gazmararian, J. A.、Baker, D. W.(2005)。Health literacy and functional health status among older adults。Archives of Internal Medicine，165(17)，1946-1952。  new window
6.李孟仰(20040300)。退化性關節炎之概況與治療。藥學雜誌，20(1)=78，119-129。  延伸查詢new window
7.Tsail, Y. F.、Yeh, S. H.、Tsail, H. H.(2005)。Prevalence and risk factors for depressive symptoms among community-dwelling elders in Taiwan。International Journal of Geriatric Psychiatry，20(11)，1097-1102。  new window
8.何郁宣、洪麗珍、郭憲文(20080700)。退化性關節炎病患憂鬱程度與自我照顧能力之相關性研究。長期照護雜誌，12(2)，179-190。  延伸查詢new window
9.邱煥民(2004)。膝關節退化性關節炎。聲洋防癌之聲，冬季號，26-29。  延伸查詢new window
10.謝霖芬、陳文珊、莊志誠(2004)。關節炎之復健。輔仁醫學期刊，2(1)，17-43。  延伸查詢new window
11.侯勝茂(2009)。半膝人工關節微創手術。台灣醫學，13(2)，167-169。  延伸查詢new window
12.陳素蜜、陳俊宏、賴慧貞、林克成(2010)。獨居老人用藥安全訪視成果專案報告。中南盟臨床專刊，3(2)，133-144。  延伸查詢new window
13.湯敏生、彭偉雄、江笑娥、何劍鴻、鍾志剛、彭榮春等(2007)。老年膝骨關節炎社區保守綜合防治研究。中國社區醫學，13(3/4)，14-15。  延伸查詢new window
14.Hampson, S. E.、Glasgow, R. E.、Zeiss, A. M.(1994)。Personal models of osteoarthritis and their relation to self-management activities and quality of life。Journal of Behavior Medicine，17(2)，143-158。  new window
15.American Geriatrics Society(1998)。The management of chronic pain in older persons。Journal of the American Geriatrics Society，46，635-651。  new window
16.Baird, C. L.、Schmeiser, D.、Yehle, K. T.(2003)。Self-caring of women with osteoarthritis living at different levels of independence。Health Care for Women International，24(7)，617-634。  new window
17.Baker, D. W.、Wolf, M. S、Feinglass, J.、Thompson, J.A.(2007)。Health literacy and mortality among elderly persons。Archives of Internal Medicine，167(14)，1503。  new window
18.Barsevick, A. M.、Whitmer, K.、Walker, L.(2001)。In their own words: Using the Common Sense Model to analyze patient descriptions of cancer-related fatigue。Oncology Nursing Forum，28(9)，1363-1369。  new window
19.Cadbury, H.(1997)。Self-care in osteoarthritis。Community Nurse，3(10)，28-31。  new window
20.Creamer, P.、Hochberg, M. C.(1997)。Epidemiology of osteoarthritis。The Journal of American Medical Association，280，1569-1575。  new window
21.Felson, D. T.、Zhang, Y.、Hannan, M. T.、Naimark, A.、Weissman, B.、Aliabadi, P.(1997)。Risk factors for incident radiographic knee osteoarthritis in the elderly. The Framingham study。The Journal of Arthritis Rheumatic，40(4)，728-733。  new window
22.Felson, D.T.、Zhang, Y.(1998)。An update on the Epidemiology of Knee and Hip osteoarthritis With a View to Prevention。Arthritis & Rheumatism，41(8)，1343-1355。  new window
23.Hampson, S. E.(1997)。Personal models and the management of chronic illness: a comparison of diabetes and osteoarthritis。European Journal of Personality，11(5)，401-414。  new window
24.Luger, T.、Cotter, K. A.、Sherman, A. M.(2009)。It’s all in how you view it: pessimism, social relations, and life satisfaction in older adults with osteoarthritis。Aging & Mental Health，13(5)，635-647。  new window
25.Rejeski, W. J.、Shumaker, S.(1994)。Knee osteoarthritis and health related quality of life。Medicine and Science in Sports and Exercise，26(12)，1441-1445。  new window
26.Ryan, S.(2001)。Osteoarthritis: Symptoms and nursing management。Nursing Times，97(32)，34-35。  new window
27.Shifren, K.(2003)。Women with heart disease: can the common-sense model of illness help?。Health Care for Women International，24(4)，355-368。  new window
28.Sudore, R. L.、Yaffe, K.、Satterfield, S.、Harris, T. B.、Mehta, K. M.、Simonsick, E. M. et al.(2006)。Limited literacy and mortality in the elderly: The health, aging, and body composition study。Journal of General Internal Medicine，21(8)，806-812。  new window
29.Hopman-Rock, M.、Odding, E.、Hofman, A.、Kraaimatt, F. W.、Bijlsma, J. W.(1996)。Physical and psychosocial disability in elderly subjects in relation to pain in the hip and/or knee。The Journal of Rheumatology，23(4)，1037-1044。  new window
30.Diefenbach, M.、Leventhal, H.(1996)。The common-sense model of illness representation: Theoretical and practical considerations。Journal of Social Distress and the Homeless，5(1)，11-38。  new window
31.Ibrahim, S. A.、Siminoff, L. A.、Burant, C. J.、Kwoh, C. K.(2001)。Variation on perceptions of treatment and self-care practices in elderly with osteoarthritis: A comparison between African American and white patients。Arthritis Care & Research，45(3)，340-345。  new window
32.Kee, C. C.(1998)。Living with osteoarthritis: Insiders, view。Applied Nursing Research，11(1)，19-26。  new window
33.McAndrew, L. M.、Musumeci-Szabó, T. J.、Mora, P. A.、Vileikyte, L.、Burns, E.、Halm, E. A.、Leventhal, H.(2008)。Using the common sense model to design interventions for the prevention and management of chronic illness threats: From description to process。British Journal of Health Psychology，13(2)，195-204。  new window
34.Oliveria, S. A.、Felson, D. T.、Reed, J. I.、Cirillo, P. A.、Walker, A. M.(1995)。Incidence of symptomatic hand, hip, and knee osteoarthritis among patients in a health maintenance organization。Arthritis& Rheum，38(8)，1134-1141。  new window
35.Osborne, R. H.、Buchbinder, R.、Ackerman, I. N.(2006)。Can a disease-specific education program augment self-management skills and improve health-related quality of life in people with hip or knee osteoarthritis。Musculoskeletal Disorders，7(90)，1471-1487。  new window
36.Kim, I.、Kim, H. A.、Seo, Y.I.、Song, Y. W.、Hunter, D. J.、Jeong, J. Y.、Kim, D. H.(2010)。Tibiofemoral osteoarthritis affects quality of life a nd function in elderly Koreans, with women more adversely affected than men。BMC Musculoskeletal Disorders，11，129-129。  new window
37.Laborde J.M.、Powers M.J.(1985)。Life satisfaction, health control orientation and illness-related factors in persons with osteoarthritis。Research in Nursing and Health，8(2)，183-190。  new window
38.Wearden, A.、Peters, S.(2008)。Therapeutic techniques for interventions based on Leventhal's common sense model。British Journal of Health Psychology，13(2)，189-193。  new window
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研究報告
1.韓幸紋、鄭清霞(2011)。退化性膝關節炎病患特性與相關健保費用變化趨勢。  延伸查詢new window
學位論文
1.林尹霈(2005)。應用常識模式探討罹患退化性關節炎老人的疾病認知及其因應策略(碩士論文)。中國醫藥大學。  延伸查詢new window
2.田維哲(2006)。初次全人工髖與膝關節置換術的盛行率與病人的醫療費用分析－1996年－2004年。高雄醫學大學，高雄市。  延伸查詢new window
3.林芷伊(2007)。機構關節炎老人之慢性疼痛及其相關因素探討。輔英科技大學，高雄市。  延伸查詢new window
4.陳郁馨(2009)。退化性膝關節炎老人生活品質及其相關因素探討－以台北市萬華區某醫院為例。國立台北護理學院，台北市。  延伸查詢new window
5.蔡蕙馨(2009)。健康素養對退化性關節炎的知識與自我照護行為之影響-以花蓮市某社區居民為例。慈濟大學，花蓮市。  延伸查詢new window
圖書
1.Leventhal, E. A.、Leventhal, H.、Robitaille, C.、Brownlee, S.(1999)。Psychosocial factors in medication adherence: A model of the modeler。Processing of medical information in aging patients: Cognitive and human factors perspectives。Mahwah, NJ。  new window
2.Leventhal, H.、Idler, E.、Leventhal, E. A.(1999)。The impact of chronic illness on the self system。Self, social identity, and physical health: Interdisciplinary explorations. Second Rutgers symposium on self and social identity。New York。  new window
3.Leventhal, H.、Leventhal, E. A.、Cameron, L.(1999)。Representation, procedures and affect in illness self-regulation: A perceptional-cognitive model。Handbook of health psychology。London。  new window
4.Wanless, D.(2006)。Securing good care for older people: Taking a long-term view。London。  new window
5.Yelin, E.(1998)。The economics of osteoarthritis。Osteoarthritis。New York。  new window
其他
1.行政院內政部(2008)。人口政策白皮書，台北市。  延伸查詢new window
2.呂紹睿(2009)。膝關節健康促進方案-源起及架構，台北市。  延伸查詢new window
3.李丞華(2009)。退化性膝關節炎健康照護之現況-健保局觀點，台北市。  延伸查詢new window
4.行政院衛生署(2008)。全民健康保險醫療統計年報，台北市。  延伸查詢new window
5.Centre for Disease Control and Prevention & Arthritis Foundation(2011)。A National Public Health Agenda for osteoarthritis，http://www.cdc.gov/arthritis/docs/OAagenda.pdf， 20110712。  new window
6.Department of Veterans Affairs(2011)。Patient and Provider Interventions for Managing Osteoarthritis in Primary Care，http://clinicaltrials.gov/ct2/show/NCT01130740， 20110712。  new window
 
 
 
 
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