從慢性腎臟病患者觀點，探討應用智慧健康對於疾病自我管理之感受

Exploring the experience of applying eHealth to self-management of diseases from the perspective of patients with chronic kidney disease

"背景:慢性腎臟病(Chronic Kidney Disease, CKD)是全球性臨床與公共衛生嚴重問題。臺灣佔世界第一盛行率，如何提昇CKD患者的疾病自我管理能力是為重要議題。在傳統衛教上，已很難符合快速、及時的需求。網路資訊系統其便利及功能性提升，影響醫療照護提供與獲得健康科技服務。目的:以CKD患者觀點，探討智慧健康(eHealth)在不同階段疾病歷程照護經驗，疾病自我管理之感受，對未來eHealth功能之期望。方法:質性研究設計深入訪談法，以CKD1-5期及血液透析(Hemodialysis, HD)俗稱「洗腎」患者為訪談對象。結果:訪談6位CKD及4位HD之患者，年齡介於48~77歲，研究歸納出三大主題:一、疾病自我管理的責任(CKD)﹔二、飲食原則(CKD/HD)﹔三、疾病的小管家(HD)。疾病自我管理的責任:掌握生理資訊監測，建立在家測量血壓、血糖，同時可記錄測量數值的生理資訊APP，可供回門診時給專業人員參考；發展督促患者服藥的溝通安全機器人；建構隨時問問題的健康諮詢指導聊天機器人。飲食原則:開發飲食警示訊號及監測APP。疾病的小管家:研發洗腎日誌記錄APP模組，開發能夠協助患者上、下床，上廁所的照護支援機器人；讓身體有轉動能力的復健輔具型機器人；陪患者到醫院洗腎；甚至機器人是一台可攜帶式的洗腎機自立支援的照護機器人之願景，提升CKD患者對於疾病自我管理能力。結論/實務應用:本研究可做為智慧健康管理可近、可回應性、立即獲得相關健康資訊服務需求，增進CKD患者疾病管理的能力。可推廣醫院管理者採用智慧健康照護管理，亦期望引發對於智慧健康照護採用行為之相關研究。"

"BACKGROUND：Taiwan is fronting the world's highest prevalence rate of Chronic Kidney Disease (CKD), which has become a rigorous clinical, global, and public health problem. Thus, improving the self-management ability of patients with chronic kidney disease is a requisite. In traditional health education, it is necessary to meet the rapid and timely demand. Consequently, the convenience and functionality of network information systems have improved, ensuring the delivery of medical care and access to health technology services.PURPOSE：From the perspective of CKD patients, this study aims to explore the care experience of electronic Health (eHealth) in different stages of the disease process, the feelings of disease self-management, and the expectations for future eHealth functions.METHOD：Interviews with 6 CKD and 4 HD patients, aged between 48-77 years old, summarized three themes: 1. The responsibility of disease self-management (CKD); 2. Dietary principles (CKD/HD); 3. Disease the Little Butler (HD). Responsibility for disease self-management includes: mastering physiological information monitoring, establishing physiological information apps that can measure blood pressure and blood sugar at home, simultaneously recording the measured values, which can be used for professional reference when returning to the clinic; developing a communication safety robot that urges patients to take medication; building health that asks questions at any time via consultations and guided chatbots. Dietary principles include: developing dietary warning signals and monitoring apps. Disease the Little Butler include: developing a dialysis log apps module, developing a care support robot (also a portable kidney dialysis machine) that can help patients get in and out of bed and go to the toilet; a rehabilitation robot that allows the body to rotate; and accompanying the patient to the hospital for dialysis. Therefore, the vision of a self-supporting care robot could help improve the self-management ability of CKD patients.CONCULSIONS/IMPLICSTIONS for PRACTICE：The results of this study can be used as an approachable, responsive and immediate access to relevant health information service needs for eHealth management to enhance the ability of disease management in CKD patients. It can promote to use of eHealth care management by hospital managers, also expected to lead to related research on eHealth care adoption behavior."