重要關鍵人幫忙關係於慢性腎臟病患照護——策略及應用

Applying the Strategies of Helping Relationship From Significant Others in Patients With Chronic Kidney Disease

慢性腎臟病因初期症狀不明顯，使得國人警覺性偏低，對於可以延緩疾病惡化的預防措施，像是生活型態的改變、定時返診追蹤、按時服藥…等等，往往遵從性低。若能藉由重要關鍵人所提供的幫忙關係，透過互相信任、瞭解體會、關心分享、陪伴指導，時時協助甚至陪伴病人共同執行健康行為，將有助於促進健康生活型態並延緩疾病的惡化。重要關鍵人需具備可靠性、可信性、正向性，並透過體會瞭解、關懷、信任、接受、坦誠來協助病人面對困境、解決危機及提升自我成長。本文將以慢性腎臟病重要關鍵人的角度，提供四個幫忙策略：提醒機制、協助設立目標、鼓勵支持、及回饋，期望重要關鍵人得以發揮監督、陪伴、支持等功能，在日常生活中幫助病人從事健康生活型態、加強醫療遵從性，進而達到延緩疾病惡化、健康促進之目的。

The absence of easily perceived symptoms in the early stages of chronic kidney disease (CKD) causes low levels of awareness and treatment of this disease. Therefore, adherence to measures that may prevent disease progression, i.e., lifestyle changes, regular clinic visits, and timely medication administration, is often low among early-stage CKD patients. However, continuous assistance from significant others through trusting, understanding, sharing, and coaching assistance may promote a healthy lifestyle and prevent progression of the disease. The necessary characteristics of significant others include dependability, credibility, and positivity. Significant others may use their understanding, caring, faith, and honesty to help patients face CKD and improve self-care efficacy. This article discusses the assistance that significant others may provide to CKD patients, including warning mechanisms, target setting, encouragement, and feedback. By developing the functions of supervision, companionship, and support, significant others may help patients live a healthier life and improve their medical compliance and thus postpone disease progression.