Yang Lin-Chi, Lin Chiu-Chu
Department of Nursing, Kaohsiung Armed Forces General Hospital, ROC.
Hu Li Za Zhi. 2010 Jun;57(3):105-10.
Patients interpret illness through personal knowledge and experience, while illness representation guides patient attitudes with regard to seeing a doctor, accepting treatment and adopting healthy behavior. Nurses who understand the illness representation of patients may be better able to provide intervention in order to enhance patient self-care skills and ultimately improve patient health. This article describes a nurse's experience providing care to a patient with diabetic nephropathy. He suffered from decreasing urine output, lower limb edema and shortness of breath. He also underwent a role transformation from a healthy individual to hemodialysis patient. He interpreted hemodialysis to be the end of meaning in his life and as preventing his continuing to work and earn money. He thus rejected hemodialysis treatment. The authors applied the illness presentation model to understand the patient's perception of his illness, then helped the patient to correct his misconceptions about the hemodialysis treatment in order to change his illness representation of hemodialysis and guide him to accept his new role. After one month of care, the patient accepted arterio-venous shunt surgery and accepted that hemodialysis both mitigated his illness and improved life quality. The authors would like to share their report on this case to provide nursing professionals with a reference on one approach to improving healthcare quality.
患者通过个人知识和经验来诠释疾病，而疾病认知则指导患者在就医、接受治疗和采取健康行为方面的态度。了解患者疾病认知的护士或许能够更好地提供干预措施，以增强患者的自我护理技能并最终改善患者健康状况。本文描述了一名护士为一名糖尿病肾病患者提供护理的经历。该患者出现尿量减少、下肢水肿和呼吸急促的症状。他还经历了从健康个体到血液透析患者的角色转变。他将血液透析视为自己生命意义的终结，认为这使他无法继续工作赚钱。因此，他拒绝接受血液透析治疗。作者运用疾病呈现模型来理解患者对自身疾病的认知，随后帮助患者纠正了对血液透析治疗的误解，以改变他对血液透析的疾病认知，并引导他接受自己的新角色。经过一个月的护理，患者接受了动静脉分流手术，并认识到血液透析既能缓解病情又能提高生活质量。作者希望分享此病例报告，为护理专业人员提供一种改善医疗质量方法的参考。
