「看」病：病人如何表述自己的疾病－疾病表述常識模式(CSM-IR)的應用

Enabling Patients to Describe Their Own Illness by Applying the Common-Sense Model of Illness Representations

護理病人的過程中，民眾對於疾病與其治療的認知表述很重要，會影響其對疾病的感受，情緒反應，進而影響行為。對於疾病與治療的誤解，將限制或降低病人的遵從性或自我照護的執行。疾病表述常識模式(CSM-IR) 乃為臨床護理照護評估模式之一，醫護人員以此評估模式可以了解個案與家庭對於疾病的感受，有助於護理過程中發展適切的介入措施，藉以提升個案與家庭的疾病因應。本文旨在探討疾病表述常識模式之意義、應用現況，並藉由實例說明疾病表述常識模式在臨床之應用方式。疾病表述常識模式是以家庭為中心和全人、全家的照護為原則的評估方式，故誠摯期望能藉由本文，能提供醫護人員理論架構的評估模式，以提升照護品質。

The patients’ cognitive representations of illnesses and received treatment are critical. These illness representations affect the patients’ feelings and emotional reactions to the illnesses and their subsequent health behaviors. Misunderstanding the illnesses and treatment impairs the regimen adherence and selfcare performance of the patients. By using the common-sense model of illness representations (CSM-IR), a nursing assessment model, healthcare personnel can understand the feelings of patients and their family members toward the illness, thereby incorporating appropriate intervention measures into their caring process. Consequently, healthcare personnel would enhance coping strategies to the illness. This study aimed to explore the implications of the CSM-IR and the extent of its application, using examples to show its use in clinical situations. The CSM-IR is an approach to illness assessment that is family-center and based on the principle of holistic person care. The report can serve as a reference for healthcare personnel by providing a theoretically structured assessment model for improving quality of care.