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Title: 退化性膝關節炎中老年病人之疾病認知與因應
Other Titles: Perceptions and Coping Strategies of Elderly Patients with Knee Osteoarthritis
Authors: 陳毓璟
Stephanie Yu-Ching Chen
Issue Date: Dec-2011
Publisher: 國立台灣師範大學健康促進與衛生教育學系
Department of Health Promotion and Health Education National Taiwan Normal University
Abstract: 退化性膝關節炎不僅是中老年人常見的疾病,與失智、中風和冠狀心臟病並列為造成老人失能的四大疾病。其所帶來的疼痛與腿部關節活動的限制,嚴重影響病人的生活品質。本研究以台灣南部某教學醫院104位平均年齡約65歲的病人為對象,參考疾病常識模式設計半結構式問卷,訪談病人對退化性膝關節炎的認知及其因應方式。研究結果發現病人認為疼痛是主要疾病徵候,也是判斷疾病嚴重度的重要指標。多數病人認為退化性膝關節炎是長期勞動工作磨損結果或老化的自然現象,常先自行採行多種方法來減輕膝蓋疼痛所帶來的不適,無法緩解時才考慮就醫;部份老人因為缺乏陪伴就醫、經濟問題、交通不便或害怕手術的不良後果而有拖延就醫的情形;有些病人則過分樂觀手術療效而疏於自我照顧;有關退化性膝關節炎之資訊,大部分從醫生或親友得知;年齡高與低教育程度,會影響病人收集醫療資訊與理解的能力。建議多注意病人因擔心自己失能成為子女的負擔所產生的憂鬱,以及自行用藥與接受民俗療法和延遲就醫的情形,並且發展針對疼痛緩解與預防失能之自我照顧教育方案。以及發展適合篩檢低識字老人的簡易評估問卷,來協助社區老人及早就醫與自我照顧。
Knee osteoarthritis (OA) is a common disease that affects elderly people. It is listed as one of the top four diseases, along with dementia, stroke, and coronary heart disease, leading to disabilities in elderly people. The pain and restrictions in leg joint activity caused by knee OA seriously impact quality of life. The participants of this study comprised 104 patients with an average age of 65, who were recruited from a teaching hospital in southern Taiwan. The perceptions and coping strategies of patients diagnosed with knee OA were assessed by a semistructured questionnaire, which was designed according to the common sense model.The findings revealed that the study patients considered pain to be the primary symptom of knee OA; therefore, pain is an important indicator of severity. Most patients believed that knee OA was caused by wearing out the joint from manual labor or that it was a part of the natural aging process. Medical treatment was considered only after various other measures had failed to control or relieve the pain. A number of elderly patients often delayed medical treatment because of no accompanying family, financial issue, transport inconvenience, or fear of surgery. Most of their knowledge on knee OA was based on information provided by physicians, family, or friends. Certain patients neglected self-care because of over optimism in the curative effects of surgery. Older age and lower educational background influenced the degree to which patients sought or understood medical information.We recommend that the patients suffering from OA must be monitored for their depression status and delay managing because of direct or indirect burdens and inadequate alternative treatments, respectively. We also suggest that disease surveys should be simplified for early diagnosis of knee OA, and that self-care educational programs may be developed to reduce pain and prevent knee OA among elderly people with low literacy.
Other Identifiers: FB32C05C-BC0C-C7A8-3232-41C99776C00C
Appears in Collections:健康促進與衛生教育學報

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