運用健康知能概念促進慢性腎病患者自我管理

Using the Health Literacy Concept to Promote Self-Management in a Chronic Kidney Disease Patient

腎臟病屬於慢性病的一種，病患需具備自我管理的能力以達到疾病控制和延緩併發症產生。然為達健康生活型態及行為修正的目標，病患必須能理解及運用護理指導內容，並將健康原則整合於日常生活中。文中，個案因為缺乏適當程度與可用的健康資訊，致使個案在落實執行飲食和血糖控制的行為改變過程時發生困難。因此，筆者運用健康知能（health literacy）概念，首先評估個案關於疾病控制的知識與技能程度，再提供符合其健康知能程度的教育內容，藉由個別化的照護，促使個案提升信心與動機，將自我照護活動落實於日常生活。健康照護專業人員亦應協助病患突破文字閱讀、口語表達不佳的窘境，透過建立良好的夥伴關係，讓病患學習清楚且正確地報告自身的症狀，使健康知能受限的病患達到自我管理的目標。

Patients with chronic kidney disease (CKD) must learn and use self-management skills to control their disease and delay disease progression. Comprehension of instructions is thus critical to integrating self-management principles into daily life. In this case report, the client had difficulty implementing the behavioral changes necessary to control diet and blood sugar due to the lack of proper and sufficient information. The authors applied health literacy concepts to assess the client's knowledge and skills related to disease control and then provided health teaching at a level appropriate to the client's health literacy level. This individualized care enhanced the client's confidence and motivation to implement self-care activities. Healthcare professionals should help patients overcome barriers to reading and verbal communication to help low-health-literacy patients successfully self-manage their chronic disease. Clients may thus learn to report their symptoms clearly and accurately.