慢性阻塞性肺疾病老年患者出院二星期內日常活動之經驗
The experiences of daily activities within two weeks after hospital discharge among elderly patients with chronic obstructive
pulmonary disease
中文摘要 論文摘要
本研究目的，主要在探討慢性阻塞性肺疾病老年患者出院二星期內日常活動之 經驗感受，採質性研究之深入訪談，依照研究目的擬定訪談指引，以開放性的
問題分別與9 位活動受限屬 NYHA 3-4 級的慢性阻塞性肺疾病老年患者做錄音
訪談，得到受訪個案主觀的描述性資料，經內容分析法，獲得慢性阻塞性肺疾
病老年患者出院二星期內日常活動經驗的七個主題，分別為─「力不從心」、「害
怕發作」、「趨緩簡化」、「量力而為」、「自我保護」、「努力維持自我獨立生活」和
「追求生命延續」。
資料分析發現慢性阻塞性肺疾病老年患者出院二星期內會經歷「力不從心」和
「害怕發作」的過程，他們會克服出院後所面臨的種種影響因素，包括有無法掌 控的情境 ( 如天候或空氣污染等 ) 、怕增加家人麻煩、身體功能狀況、和年紀大等，
個案會察覺現況、確認差異，採取「趨緩簡化」的因應行為，凡事「量力而為」，
不勉強，並尋求「自我保護」，「努力維持自我獨立生活」維持控制感，並能從日 常活動中感受到身心獲得好處，「追求生命延續」。
此結果可增加醫護人員對慢性阻塞性老年患者出院二星期內日常活動的經驗內 涵有更清楚及深入的了解，護理人員應更精確及敏銳地了解老年患者於出日常 活動時的需求，並可將研究結果與患者共同分享，做為其因應出院環境轉換後 日常活動時的參考，避免不必要的焦慮與壓力；同時還可提供一般慢性阻塞性 肺疾病老年患者因應日常活動所採用可行的調適方法及更細緻的衛生教育內容，
來提高其體能、耐力和自信心等，不但可以減少老年患者的力不從心、且可預防 疾病的再發率、節省醫療成本，更可使老年患者在完成日常活動後感受到身心獲 得好處，有正向的意義，進而改善生活品質、生活滿意度及延長壽命。
英文摘要 Abstract
Title of thesis: The Experiences of Daily Activities Among Elderly patients With Chronic Obstructive
Pulmonary Disease-Within Two Weeks After Hospital Discharge
Author:Chiung-Hua Ho
Thesis directed by:Chii Jeng, DNS, Associate Professor, Graduate Institute of Nursing, Taipei Medical
University
The purpose of this study is to explore the experiences of daily activities among elderly patients with chronic obstructive pulmonary disease within two weeks after hospital discharge. Data were collected by using in depth interviews based on the principles of theoretical sampling, according to New York Heart Association Activity Restriction degree 3 to 4 ,7 males and 2 females aged 65-80 were interviewed from March to June 2001, and each interview lasted at least 1 hour. Interviewed were tape recorded, and then transcribed verbatim within 48 hours. The constant comparison method and content analysis were applied to data analysis and generated seven themes. They were (1) Expectation beyond strength (2) Fear of being reattacked (3) Slowing and simplifying (4) Not overestimating (5) Self protection (6) Elaborating to maintain independent living and (7) Pursuing the continuity of life.
According to the data analysis results, the elderly patients with chronic obstructive pulmonary disease within two weeks after hospital discharge will go through a process of
" Expectation beyond strength "and "Fear of being reattacked ", they must overcome all kinds of affected factors, including uncontrollable environments, fear of increasing inconvenience to their families, poor physical condition, aging,… etc.; they will be aware of their actual physical conditions, identify their physical differences, and react by underlying “slowing and simplifying”, not overestimating” their physical strength to select their daily activities from which they can gain benefits, paying more
attention to their “self protection”, “elaborating to maintain independent living” in order to keep everything under control, but also “pursuing the continuity of life” in the future.
The findings of this research can help nurses in Taiwan understand the experiences and recognize the needs of daily activities sensitively and precisely among elderly patients with chronic obstructive pulmonary disease within two weeks after hospital discharge. Nurses who take these results as reference should be able to assist other elderly patients and share the same experiences with the patients and their families to achieve mutual understanding and provide suitable nursing interventions during the discharge transition and to facilitate a higher quality life in elderly patients .
