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| 題 名 | 賦權策略介入改善一位思覺失調症病患之服藥依從性=Evidence-Based Nursing: Using Empowerment Strategies to Improve Medication Nonadherence in Patients with Schizophrenia |
|---|---|
| 作 者 | 賴美靜; | 書刊名 | 彰化護理 |
| 卷 期 | 33:1 2026.03[民115.03] |
| 頁 次 | 頁12-23 |
| 分類號 | 415.983 |
| 關鍵詞 | 賦權; 思覺失調症; 服藥不遵從; 實證護理; Empowerment; Schizophrenia; Non-adherence; Evidence-based nursing; |
| 語 文 | 中文(Chinese) |
| DOI | 10.6647/CN.202603_33(1).0004 |
| 中文摘要 | 本文描述一位思覺失調症個案,因缺乏 病識感,持續受到聽幻覺干擾,導致服藥不 規則,造成反覆住院。筆者透過五大層面評 估其護理問題,針對知識缺失/對疾病、藥 物相關認知不足有關之健康問題,做實證護 理之進一步探討。運用實證護理5A步驟, 針對「賦權式疾病管理是否可改善本院住 院思覺失調症患者的藥物依從性?」提出 臨床問題;於Cochrane Library、PubMed、 CINAHL及華藝線上圖書館,等資料庫進行 搜尋,使用PICO關鍵字以Mesh及相似同義 字進行檢索,並限制十年內文獻;經篩選 後,最終選取一篇系統性文獻回顧進入評 讀,並設計個別化之認識我的疾病與藥物計 畫,透過動機式晤談與認知行為技巧進行介 入。結果顯示,賦權式疾病管理介入課程具 改善個案服藥依從性之潛力;介入前用藥配 合度量表填答不完整,僅能作描述性分析, 介入後分數為2分,較介入前實得分數 3 分 呈下降趨勢。然而,照護過程中仍面臨若干 限制與困難,個案曾出現藏匿藥物之行為, 需透過藥物磨粉與督導服藥等方式,以確保 治療順利執行,致護病關係建立過程一度趨 於緊張,此外,家屬未共同參與賦權式疾病 管理介入課程,亦構成本次介入之限制。於 個案出院後追蹤期間,已能主動表達規則服 藥之意願,進一步支持賦權策略有助於提升 疾病管理能力與治療依從性。 |
| 英文摘要 | This article reports a case of schizophrenia characterized by poor insight and persistent auditory hallucinations, leading to irregular medication use and recurrent hospitalizations. Nursing problems were assessed across five domains, with this paper focusing on health issues related to knowledge deficits regarding the illness and medications using an evidence- based nursing approach. Following the 5A steps of evidence-based nursing, the clinical question “Does empowerment-based disease management improve medication adherence in hospitalized patients with schizophrenia?" was developed. A literature search was conducted in the Cochrane Library, PubMed, CINAHL, and Airiti Library using PICO-based keywords, limited to studies published within the past ten years. One systematic review was selected for appraisal. An individualized disease and medication education program was then implemented using motivational interviewing and cognitive-behavioral techniques.The results suggest that the empowerment-based disease management intervention has the potential to improve medication adherence. The medication adherence scale was incompletely completed at baseline; therefore, the analysis was limited to descriptive findings. The post- intervention score decreased to 2 from a pre- intervention observed score of 3, indicating an improving trend. Despite challenges during the care process, including medication hoarding and limited family participation, the patient expressed willingness to take medication regularly during post-discharge follow-up, supporting the potential value of empowerment strategies in enhancing disease management and treatment adherence. |
本系統中英文摘要資訊取自各篇刊載內容。