「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

10.3966/102673012016092703003

王霰邡(Hsien-Fang Wang)；黃久美(Chiu-Mieh Huang)；李詩敏(Shih-Min Lee)；楊馥綺(Fu-Chi Yang)

疾病表述常識模式 ； 疾病鑑別 ； 疾病因應 ； common-sense model of illness representations ； CSM-IR ； illness identity ； illness coping

長庚護理

27卷3期（2016 / 09 / 01）

334 - 341

繁體中文

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 self-care 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.

1. 陳毓璟(2011)。退化性膝關節炎中老年病人之疾病認知與因應。健康促進與衛生教育學報，36，1-33。
   連結：
2. Chen, S. L.,Tsai, J. C.,Chou, K. R.(2011).Illness perceptions and adherence to therapeutic regimens among patients with hypertension: A structural modeling approach.International Journal of Nursing Studies,48,235-245.
3. Hagger, M. S.,Orbell, S.(2003).A meta-analytic review of the common-sense model of illness representations.Psychology and Health,18(2),141-184.
4. Hamilton-Westa, K. E.,Milne, A. J.,Chenery, A.,Tilbrook, C.(2010).Help-seeking in relation to signs of dementia: A pilot study to evaluate the utility of the common-sense model of illness representations.Psychology, Health and Medicine,15(5),540-549.
5. Huston, A. A.,Houk, C. P.(2011).Common sense model of illness in youth with type 1 diabetes or sickle cell disease.The Journal of Pediatric Pharmacology and Therapeutics,16(4),270-280.
6. Jansen, D. L.,Heijmans, M. J. W. M.,Rijken, M.,Spreeuwenberg, P.,Grootendorst, D. C.,Dekker, F. W.,Boeschoten, E. W.,Kaptein, A. A.,Groenewegen, P. P.(2013).Illness perceptions and treatment perceptions of patients with chronic kidney disease: Different phases, different perceptions?.British Journal of Health Psychology,18,244-262.
7. Maclnnes, J.(2013).An exploration of illness representations and treatment beliefs in heart failure.Journal of Clinical Nursing,23(9),1249-1256.
8. Wearden, A.,Peters, S.(2008).Therapeutic techniques for interventions based on Leventhal's common sense model.British Journal of Health Psychology,13(2),189-193.
9. Wilson, E. R. H.,Wisely, J. A.,Wearden, A. J.,Dunn, K. W.,Edwards, J.,Tarrier, N.(2011).Do illness perceptions and mood predict healing time for burn wounds? : A prospective, preliminary study.Journal of Psychosomatic Research,71,364-366.
10. 謝碧玲、郭彥廷、葉盈均、張肇松、吳英璋(2010)。情緒調節與罹病意義對急性血癌病患因應疾病的影響：兩名女性個案之初探結果。高雄行為科學學刊，2，147-162。

1. 黃雅鈴,吳孟蓉(2020).一位深頸部感染病患初次接受氣切手術之護理經驗.若瑟醫護雜誌,14(1),47-58.