運用健康信念模式及認知療法於一位認知偏差之ESRD個案臨床照護上

An Application of the Health Belief Model and the Cognitive Therapy in Clinical Care for an ESRD Case with Dysfunctional Cognitions

Ellis曾說人類天生具備了所謂＂非理性的人格傾向＂，使個人產生許多不合理、不合邏輯或和事實不符合的非理性信念。這些非理性信念具有扭曲事實的特性。因此，在面臨健康處理型態驟然改變的情形，其所採取的健康處理行為往往與現行醫療措施有所衝突，也使得臨床護理人員深感困擾。本文即在介紹利用健康信念模式（health belief model）及認知治療理論（cognitive therapy）以照顧一位認知偏差末期腎臟疾病（end stage renal disease）個案之護理經驗。其能提供臨床護理人員在面臨類似情境時，能有一個具體、實際可行的方法，促使個案採取正確的健康維護行為。

Ellis mentioned that the natural “irrational personality” can produce many irrational, illogical, and unrealistic dysfunctional beliefs. These beliefs can distort the truth. Therefore, the individual facing significant changes of personal health status might adopt unreasonable behaviors to maintain his/her health status. However, these behaviors might impede medical treatments. These conflicts also make his/her nursing care become an difficult task. The purpose of this article is to introduce the experience of application of the health belief model and cognition therapy in the care of an End Stage Renal Disease (ESRD) case with dysfunctional cognition. The results can provide other nurses with a practical guide for assistance while they face a similar situation.