慢性阻塞性肺病者之自我管理

慢性阻塞性肺病是一無法治癒且高盛行率的疾病，已是世界第五大死因， 世界衛生組織預測在2020 年，慢性阻塞性肺病將會成為世界第3 大死因。常見的症狀有呼吸困難、活動耐力下降、身體質量指數下降、憂鬱及焦慮的情緒等。其合併症也包含心血管疾病、肌肉萎縮及骨質疏鬆等情形，但這些合併症大多都未獲得適當的治療與處理。疾病的治療除了藥物之外，重要的是維持健康的生活型態，如戒菸及規律運動。但過去的衛教是由醫護人員說服患者「遵從」醫療處方的方式，並未考慮患者過去生活習慣及個人喜好，將會使患者失去控制感，無法真正做到以患者為中心的醫療照護模式。故近年來國內外許多研究著重以慢性病自我管理為照護模式，主要目的在引起患者自我照顧的動機，並促使行為的改變。

Chronic pulmonary obstructive disease (COPD) is an incurable and highly prevalent disease. It's been the fifth leading cause of deaths in the world. The World Health Organization even predicts that COPD will become the third leading cause of deaths in the world in 2020. Common symptoms include short of breathing, decreased activity tolerance, body mass index decreasing, depression and anxiety…etc. The comorbidities also include cardiovascular diseases, muscular atrophy and osteoporosis. However, most of these comorbidities don't get proper treatments and control. Other than using medications to treat diseases, maintaining a healthy life style is more important. Not only do patients learn the background knowledge of the disease and self-care skills, but they also need to learn how to monitor disease symptoms and change their life style such as smoking cessation and regular exercise. In the past, the health education is to persuade the patients to follow the medical prescriptions, but never considering patients' past life style and personal preference. It will make them feel loss of control, and won't be able to truly accomplish a patient-centered care. Therefore, in recent years, many studies at home and abroad focused on chronic disease self-management care model. The main purpose of the model is to motivate patient to self-care and give rise to behavioral change.