研究目的：探討心臟衰竭病人的患病表徵與自我照顧行為之相關性。
研究設計：採橫斷性、相關性研究設計，以便利取樣法於南部某醫學中心臟內科門診收案，納入條件為年滿20歲經醫師診斷為心臟衰竭之病人，共120位。
研究方法：以自擬心臟衰竭症狀量表、心臟衰竭患病信念量表、飲食遵從信念量表、第六版心臟衰竭自我照顧指標等結構式問卷收集資料，統計分析法包括二變項分析法與階層複迴歸分析。
研究結果：個案平均年齡為65歲，多數個案對心臟衰竭的患病表徵普遍不正確、自我照顧維持與管理行為不佳、自我照顧信心低落。階層複回歸分析結果顯示，當控制人口學與疾病變項，患病表徵和限鹽飲食遵從信念可以解釋自我照顧維持行為10.7%以及11.2%的變異量，患病表徵之「疾病控制」以及飲食遵從信念之「限鹽飲食所感受到的好處」是其顯著預測因子；患病表徵和限鹽飲食遵從信念可以解釋自我照顧管理行為13.4%以及10.6%的變異量，左心室射出率、患病表徵之「疾病控制」以及飲食遵從信念之「限鹽飲食所感受到的好處」是其顯著預測因子；患病表徵和限鹽飲食遵從信念可以解釋自我照顧信心19.3%以及2.6%的變異量，患病表徵之「疾病辨認」、「疾病時間軸」、「疾病後果」是其顯著預測因子。
研究結論：心臟衰竭病人的患病表徵與飲食遵從信念會影響其因應疾病的自我照顧行為，醫護團隊在提供衛生教育之時，若能了解病人自我詮釋心臟衰竭的信念，將有助於協助病人修正錯誤的患病表徵，進而改變健康行為模式，以增強其自我照顧。
關鍵字： 心臟衰竭、患病表徵、自我照顧行為

Aim:To investigate the relationship between illness representation and self-care behaviors among patients with heart failure.
Design:A cross-sectional correlational research design with a convenience sampling was used. Participants were recruited from the outpatient cardiology unit of a medical center located in southern Taiwan. Inclusion criteria were at least 20 years old and having a diagnosis of heart failure by physician (N=120).
Methods:Data were collected using the structured questionaire. Bivariate correlation analysis and hierarchical multiple regression analysis were used in data analysis.
Results:The results showed that the mean age was 65 years old. Participants generally had an inaccurate illness representation, poor self-care maintenance, management and confidence. Hierarchical multiple regression analysis revealed that 10.7% and 11.2% of the variance in self-care maintenance could be explained by illness representation and beliefs about dietary compliance, the significant predictors are "illness control" and " perceived benefit"; 13.4% and 10.6% of the variance in self-care management could be explained by illness representation and beliefs about dietary compliance, the significant predictors are left ventricular ejection fraction (LVEF), " illness control" and " perceived benefit"; 19.3% and 2.6% of the variance in self-care confidence could be explained by illness representation and beliefs about dietary compliance, the significant predictors are "illness identify , " illness timeline " and " illness consequences ".
Conclusions: Illness representation and beliefs about dietary compliance can influence self-care behaviors among patients with heart failure, health care team should understand heart failure patients’ beliefs before providing health education to help them by correcting the inaccurate illness representation in order to enhance their self-care behaviors.
Keywords:heart failure; illness representation; self-care behaviors

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