病人參與之概念分析

A Concept Analysis of Patient Engagement

隨著醫療保健系統生態從以疾病為中心的模式演變為現今以病人為中心的模式，提高了讓病人積極地參與自身疾病管理的重要性，且世界衛生組織呼籲病人必須為自身的健康負起責任。許多研究調查發現，病人積極地參與其自身醫療保健會有較好的預後，並會減少不必要的醫療費用，病人參與也是提高病人安全的關鍵因素。本文將依Walker和Avant（2019）之概念分析方法，統整相關文獻對「病人參與」概念進行深入的探討與剖析，以闡述其定義性特徵，並通過列舉典型案例、邊緣案例、相關案例和相反案例以釐清概念，且搜尋具信效度之相關評估工具，並檢視相關實證資料，確認病人參與發生之前因與後果。期望藉由此文提供護理人員對於此概念的認知，且運用於臨床病人自我照護的引導。

With the shift in healthcare from a disease-centered model to a patient-centered approach, the importance of actively involving patients in managing their own health has become increasingly evident. The World Health Organization has emphasized patients’responsibility for their personal health. Numerous studies have demonstrated that patients who actively engage in their healthcare experience better outcomes, incur fewer unnecessary healthcare costs, and contribute to improved patient safety. Accordingly, this article employs Walker and Avant’s (2019) concept analysis method to conduct an indepth exploration of the concept of patient engagement. By integrating relevant literature, this analysis clarifies the defining attributes of patient engagement through the development of model, borderline, related, and contrary cases; identifies reliable and valid assessment tools; and examines empirical evidence to determine the antecedents and consequences of patient engagement. The findings of this analysis are intended to enhance nurses’understanding of the concept and support its application in guiding clinical practice, particularly in promoting patient self-care.