研究背景：冠狀動脈性心臟病為心血管疾病中最為普遍的種類之一，發生率更是隨著年齡增加，其危險因子包括高血脂、抽菸、高血壓、缺乏身體活動、肥胖、糖尿病、冠心病家族史，年齡（男性大於45歲或女性大於55歲）等，除了先天性因子外，其餘皆可經由自我健康管理行為，加以預防或改善病況，國際上已有許多研究指出社會支持有助於個人的自我健康管理行為，但是，鮮少研究將病患日常生活中的社會互動情境納入考量。

研究目的：探討身處與個人、非個人關係網絡成員的社會互動情境中的冠心病患者，接受到的社會支持如何影響其自我健康管理行為，進而幫助冠心病患者的社會支持提供者，包含家人、朋友、健康專業人員等等，瞭解個案可能面臨的問題情境以及自我健康管理障礙，並可協助健康專業人員因應各情境的特異性，更能掌握各困難情境，給予患者適切的支持。

研究方法：由於社會互動表現為各種社會情境，因此採取情境分析取向，以立意取樣選取21名來自台南市相關醫院或診所之老年冠心病患者，透過深度訪談法，從個案的角度出發，經由對個案的訪談，獲得與健康行為相關的情境訊息，並輔以診間及院內附設之社區健康中心的參與觀察，觀察期間為96年7月至11月間，經由觀察個案與健康專業人員之互動，以對應個案所描述之現象與感受。
研究結果：社會支持對健康的意義需視互動場合而定。由家庭成員組成的社會網絡傾向使個人從事較有益健康的行為，例如較清淡的飲食、規律的用藥、運動、減少或不吸菸等等；家庭成員以外的個人社會關係網絡則偏向為個人的自我健康管理行為帶來較為負面的影響。
單一提供訊息性的社會支持可能不足以促使個人維持自我健康管理行為。雖然醫師、護理人員與衛教師皆屬健康專業人員，但是，其所提供的社會支持類別，以及扮演的角色在患者眼中並不相同。醫師與患者的聯繫較偏向單向傳播，導致患者放棄或隱瞞自我健康管理現況；護理人員及衛教師則扮演醫師與患者的中介角色，透過象徵性的社會支持增強其自我健康管理動機與意願。

Background: Coronary heart disease (CHD) is one of the most common one of cardiovascular disease. Its incidence rate is increasing with adult age, risk factors including lipid disorders, smoking, hypertension, lack of physical activities, obesity, diabetes, family history of CHD age etc. Except congenital factors, the others can be adjusted via one's own self-management behaviors. There are many studies in the world have pointed out social support could facilitate self-management behaviors but few studies integrate patients’ social interaction situations in their daily life into the consideration.

Objectives: By taking the interactive situations, elders with CHD, who interact with personal and impersonal relationship networks members, into account, this study aims to explore how social support patients accepted affect their self-management behaviors. Then, help their social support providers, including family members, friends and health professionals and so on, to understand the impedimental situations and barriers patients faced and offer them appropriate support.

Materials and Methods: Because social interaction performance as various social situations, therefore this study adopts the situational analysis. Through purposive sampling, 21 elderly CHD patients from hospitals or clinics in Tinan City were selected to perform in-depth interview. Simultaneously, the author observed how cases interact with health professionals in consulting room and community health center to examine the cases’ description and perception.

Results: Social support is benefit or detrimental to health depends on interactive situations. The social network composed of kinsfolk who lived with patients inclines to make individuals engaged in healthy behaviors, for example, lighter diet, regular medicine use, exercise, smoking cessation etc. Comparatively, the social network comprised friends leant to bring negative influence to patients’ self-management.
Information support along may not be enough to impel individuals to implement or maintain the self-management behaviors. Though doctors, nurses and health educators are all health professionals, however, social supports offered by them and the role they acted are different in patients’ point of view. Doctor's connection with patients is relatively leant to one-way dissemination, it may cause patients to drop or conceal the conditions of self-management. Nurses and health educators act the mediators between doctors and patients, and they strengthen patients’ motive and will to carry on self-management via providing emotional support.

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