不遵從之概念分析

Concept Analysis of Noncompliance

10.6692/KJN-2007-24-2-8

杜玉卿(Yu-Ching Tu)；葉淑惠(Shu-Hui Yeh)

概念分析 ； 遵從 ； 不遵從 ； Concept analysis ； compliance ； noncompliance

高雄護理雜誌

24卷2期（2007 / 11 / 01）

95 - 110

繁體中文

不遵從(noncompliance)不僅影響治療照護的成效，更對個案的健康帶來危害。臨床護理個案的經驗中，不乏有個案出現非醫護人員所期盼的行為，而此「非期盼之行為」常被臨床工作人員稱之謂「不遵從」，如此的判定是否合乎「不遵從」之意義？值得進行文獻探討。因此，本文以Walker及Avant (1999)所提之概念分析步驟進行說明，經由概念分析與文獻查證的結果，對「不遵從」概念做更清楚的陳述。「不遵從」概念的定義性特徵為，個案意願或非意願接受醫療專業人員所提出的健康建議，但未確實履行該健康建議。筆者提出各式案例加以說明，並與相關概念作區分，亦探討此概念發生的前提及後果，以及舉例實證性的參考題材，期望能釐清臨床醫護人員對此概念的用法與誤解。希望醫護人員瞭解，面對個案出現不遵從行為時，宜探求並澄清造成個案不遵從的真正原因，訂定合宜之護理措施，以協助個案排除造成不遵從行為的種種阻礙。

Noncompliance not only affects outcomes in nursing interventions but also causes hurt to clients. Sometimes, the behavior shown by clients is unexpected for primary care nurses. This ”unusual” behavior means usually ”noncompliance” by clinical staff. How can we define noncompliance? The aim of this manuscript is to describe noncompliance more clearly through the result of concept analysis and literature review. The process of concept analysis is quoted from Walker and Avant (1999). The defining attributes of noncompliance are willingness or unwillingness to receive health advice from health professors. We bring up a variety of cases to describe this concept and separate it from some others (interrelated concepts). This study also examined the antecedents, consequences and empirical subjects of noncompliance. We expect to clarify the usage and misconstruction of this concept for clinical staff. Clinical nurses might attempt to understand the reasons and develop suitable nursing intervention strategies to remove any barriers for clients when they have noncompliant behavior.

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