臺灣博碩士論文加值系統

本研究目的在了解心臟衰竭病人採用個案管理意願及其相關因素，以南部某醫學中心之心臟衰竭病人為研究對象，採橫斷式調查法。研究
工具為「心臟衰竭疾病知識量表」、「多層面健康控制信念量表」、「採用個案管理方式意願」結構性問卷，共發放 99 份問卷，有效回收 99 份，
有效回收率為 100%。資料以 SPSS 22.0 版進行獨立樣本 t 檢定(independent t test)及單因子變異數分析(One-way ANOVA) 之統計分析。
研究結果顯示: (1)心臟衰竭病人整體疾病知識得分方面之認知程度不高，在三部分疾病知識中，以心臟衰竭疾病治療知識最好; 尤其是規
則藥物服用的重要性部分較好，在心臟衰竭疾病一般知識得分最低，尤其是對會引發心臟衰竭症狀迅速惡化的原因方面。(2)研究對象較趨向內
控，且大多有意願採用個案管理。(3)性別、年齡、婚姻、教育程度、工作狀況、經濟狀況、支持系統與採用個案管理意願無顯著差異。(4)年齡
及教育程度在心臟衰竭疾病知識方面具顯著差異。(5)心臟衰竭整體及症狀知識得分高的心衰竭病人傾向採用個案管理；心臟衰竭疾病一般知識
及疾病治療知識在採用個案管理意願上均無顯著差異。(6)內外控傾向人格與採用個案管理意願無顯著差異。 本研究結果可運用在護理實務和護理研究及做為心臟衰竭個案管理政策推行之參考。

The purpose of this study was to understand the willingness of patients with heart failure to adopt case management and its related factors. A crosssectional survey design was adopted to collect relevant data of patients with heart failure from a medical center in southern Taiwan. Structured
questionnaires combining " Dutch Heart Failure Knowledge Scale", " multidimentional health locus of control scale ", and "Willingness to Use Case
Management" were used as research tools. A total of 99 questionnaires were distributed and 99 valid samples were obtained with an effective 100%
response rate. SPSS 22.0 version was applied to analyze collected data for independent t test and one-way ANOVA. The research results show: (1) The total score of heart failure knowledge among patients with heart failure is not high. Among the three parts of disease related knowledge, the knowledge on the treatment of heart failure disease has the highest score, especially on the important part of regular medication. The general knowledge of failure diseases scored the lowest, especially on the cause of the rapid deterioration of the symptoms of heart failure. (2) The research objects of this study tend to be internally controlled, and most of them are willing to adopt case management. (3) Different demographic variables, including gender, age, marital status, education level, work status, economic status, support system, are not related to the willingness to adopt case management. (4) Age and education level have significant correlation with knowledge of heart failure diseases in different demographic characteristics. (5) Patients with high scores of overall heart failure and symptom knowledge tend to adopt case management. However, there is no significant difference between the willingness to adopt case management and general knowledge of heart failure disease and disease treatment knowledge. (6) There is no significant correlation between the personality of internal and external control tendency and the willingness to adopt case management. The results of this study could serve as a helpful reference in nursing practice and nursing research for the implementation of heart failure case management related policies and measures.

目錄
摘要........................................................................................................................................i
Abstract..................................................................................................................................ii
目錄....................................................................................................................................... v
表目錄.................................................................................................................................vii
圖目錄................................................................................................................................viii
第一章 緒論....................................................................................................................... 1
第一節 研究背景......................................................................................................... 1
第二節 研究目的......................................................................................................... 2
第三節 研究問題......................................................................................................... 2
第二章 文獻探討............................................................................................................... 4
第一節 心臟衰竭......................................................................................................... 4
第二節 個案管理......................................................................................................... 7
第三節 內外控人格特質........................................................................................... 11
第四節 心臟衰竭病人採用個案管理意願............................................................... 19
第三章 研究方法............................................................................................................... 22
第一節 研究架構....................................................................................................... 22
第二節 研究設計....................................................................................................... 23
第三節 研究工具....................................................................................................... 24
第四節 研究工具之信度檢定................................................................................... 26
第五節 研究流程....................................................................................................... 27
第六節 研究倫理....................................................................................................... 28
第七節 資料收集與分析........................................................................................... 29
第四章 研究結果............................................................................................................... 31
vi
第一節 心臟衰竭病人基本特性............................................................................... 32
第二節 心臟衰竭病人的疾病知識........................................................................... 34
第三節 心臟衰竭病人內外控傾向表現................................................................... 38
第四節 心臟衰竭病人採用個案管理意願情形....................................................... 40
第五節 心臟衰竭病人人口學特性在在心臟衰竭知識上之差異性分析............... 40
第六節 不同人口學特性在心臟衰竭病人採用個案管理意願的差異情形........... 44
第七節心臟衰竭病人其心臟衰竭疾病知識與採用個案管理意願之差異性......... 46
第八節 心臟衰竭病人內外控傾向與採用個案管理意願之相關性....................... 47
第五章 討論....................................................................................................................... 48
第一節 心臟衰竭病人之心臟衰竭疾病知識........................................................... 48
第二節 不同人口學特性心臟衰竭病人心臟衰竭知識之間的差異性................... 49
第三節 不同人口學特性在心臟衰竭病人選擇個案管理意願之差異性............... 50
第四節 心臟衰竭病人其心臟衰竭疾病知識與選擇個案管理意願之關聯........... 50
第五節 心臟衰竭病人內外控傾向與採個案管理意願之關係............................. 51
第六章 結論與建議........................................................................................................... 52
第一節 結論............................................................................................................... 52
第二節 建議............................................................................................................... 53
第三節 研究限制與展望........................................................................................... 53
參考文獻............................................................................................................................. 55
中文............................................................................................................................. 55
英文............................................................................................................................. 61
附錄..................................................................................................................................... 68
附錄一、研究問卷同意書 ......................................................................................... 68
附錄二、研究問卷表 ................................................................................................. 71
附錄三、量表引用同意書之一................................................................................. 74
vii
附錄四、量表引用同意書之二................................................................................. 75
附錄五、專家效度信函............................................................................................. 76
附錄六、奇美醫院人體試驗委員會核准函............................................................. 80
表目錄
表 2-1 台灣個案管理照護模式應用領域及執行者角色彙整表 ................... 9
表 2-2 內外控傾向量表彙整表 ............................................ 16
表 3-1 研究變項、變項屬性及統計分析表 .................................. 30
表 4-1 心臟衰竭病人之人口學特性 ........................................ 32
表 4-2 心臟衰竭病患之心臟衰竭疾病知識答對情形 .......................... 37
表 4-3 健康內外控的三項次量表得分情形 .................................. 39
表 4-4 採用個案管理意願情形 ............................................ 40
表 4-5 不同人口學特性於心臟衰竭疾病知識之差異 .......................... 43
表 4-6 心臟衰竭病人基本屬性人口學與是否採用個案管理意願之差異 .......... 45
表 4-7 心臟衰竭疾病知識與採用個案管理意願之差異性 ...................... 46
表 4-8 心臟衰竭病人內外控傾向與採用個案管理意願之相關 .................. 47


viii
圖目錄
圖 3-1 研究架構 ........................................................ 22
圖 3-2 研究流程圖 ...................................................... 27

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