運用現象學探索心臟衰竭病人的疾病經驗

Phenomenology for Investigating Illness in Patients with Heart Failure

心衰竭影響個案生理、心理、社會與靈性各層面，兼具慢性病程與急性代償失調，充滿嚴重度與不穩定性。本研究旨在探索心衰竭病人疾病經驗及因應策略，採現象學研究法，以低結構性問卷訪談個案，了解其在疾病急性期與相對穩定階段的疾病感受及因應策略。10 名心衰竭病人（7 名男性，平均年齡60±12歲，平均罹病時間42±20 個月）參與本研究，發現個案在病程穩定期的因應策略包括活動管理、飲食管理、心靈管理與自我測試；急性期則有減少體力透支、促進體能恢復與尋求醫療協助。研究結果有助於瞭解心衰竭病人疾病經驗，可供護理照護參考。

Heart failure (HF), a common disease worldwide, affects patients physically, psychologically, socially, and spiritually. The illness trajectory of HF is long and with acute exacerbation situation. This study explored the illness perception of and coping strategies for HF. Narrative data from patients with HF were collected using a descriptive qualitative method. Ten patients with HF (7 males; aged 60 ± 12 years; 42 ± 20 months since diagnosis) were recruited for this study. They experienced two phases of illness: stable and unstable. HF experience has four dimensions: physical, psychological, social, and spiritual. Coping strategies adopted by these patients in the unstable phase were preventing exhaustion, promoting physical recovery, and seeking medical assistance, whereas those in the stable phase adopted activity, diet, and spiritual management and self-testing. We comprehensively explain the illness perception of and coping strategies for patients with HF, which are expected to be useful for providing effi cient care for patients with HF.