充能概念的要素與策略應用之評析－－以代謝相關慢性病為例

Appraisal of the Application of Empowerment Elements and Strategies: The Example of Chronic Metabolic Diseases

背景：充能概念常被運用於代謝相關慢性病領域，卻缺乏文獻回顧探討充能運用的要素與策略。目的 評析充能要素與策略的應用現況，提出運用建議。方法 以文獻回顧方式搜尋PubMed/MEDLINE等五個中英文資料庫，篩選出21篇運用充能方案於代謝相關慢性病之隨機臨床試驗文獻，評析充能要素與策略的應用現況。結果 充能概念之運用，於糖尿病為眾（90.48%）。六大要素的應用比率依序為行動95.24%，對話47.62%，回饋33.33%，建立夥伴關係23.81%，反思23.81%，傾聽19.05%；六大策略的應用比率依序為執行計畫與改變行為95.24%，設定目標與擬訂計畫80.95%，解決問題與克服障礙52.38%，確認關注與確定問題47.62%，激發動機與自我覺醒33.33%，回顧與持續自我管理23.81%。結論／實務應用 健康照護者在運用充能方案時，較缺乏建立夥伴關係、傾聽、反思等要素，在策略運用上則較缺乏激發動機與自我覺醒、回顧與持續自我管理之策略。建議臨床實務與研究需善用充能的六大要素與策略，以徹底發揮充能的精神，協助個案擁有掌握慢性病生活與重生的能力。

Background: The empowerment concept has been applied to chronic metabolic diseases. However, literature reviews to date are inadequate to assess their utilization status.Purpose: This study was developed to assess the application of empowerment elements and strategies to chronic metabolic diseases and then propose suggestions for improvement.Methods: A literature review was conducted using five Chinese-and English-language electronic databases, including PubMed/MEDLINE. A total of 21 articles on randomized clinical trials related to the application of empowerment intervention program to chronic metabolic diseases were appraised to examine empowerment element and strategy usage.Results: The empowerment concept was applied mostly with diabetes groups (90.48%). Application rates for the six major elements were 95.24% in action, 47.62% in dialogue, 33.33% in feedback, 23.81% in building partnership, 23.81% in reflection, and 19.05% in listening. Application rates for the six major strategies were 95.24% in action planning and behavior change, 80.95% in goal-setting and plan, 52.38% in problem solving and obstacle overcoming, 47.62% in identifying concerns and problems, 33.33% in motivation and self-awareness, and 23.81% in review and continuous self-management.Conclusion/Implications for practice: Healthcare professionals are found generally lacking in the application of elements including ”building partnership,” ”listening,” and ”reflection” and strategies including ”motivation and self-awareness” and ”review and continuous self-management” when applying empowerment programs to chronic metabolic disease patients. Therefore, the authors suggest that healthcare professionals fully apply the six major empowerment elements and strategies to clinical practice and studies to help thoroughly promote the spirit of empowerment and empower patients with chronic disease to take charge of their life and recovery.