背景及重要性：慢性腎臟病為漸進性的慢性病，最終可能導致腎功能衰竭。由於慢性腎臟病一至三期病患屬於無明顯症狀期，在飲食及運動等生活型態修正上無法堅持，因此需要重要他人從旁提醒及幫忙才能意識到疾病嚴重度，進而改變生活型態。
研究目的：瞭解重要他人的幫忙關係對慢性腎臟病患罹病歷程之經驗。
研究方法：採質性訪談法，經由立意取樣自南部某醫學中心選取7位慢性腎臟病患者，經由面對面、半結構式訪談指引進行深度訪談，並以內容分析法進行文本分析，研究之嚴謹度根據Lincoln及Guba（1985）提出的確實性、可推廣性、可信賴性、可確認性作為本研究資料處理與分析之參照標準。
研究結果：研究者從受訪者的主體經驗及感受，萃取出四個主題，分別為「疾病的旅途中，家人伴行」、「家人時刻提醒，走過艱辛漫長路」、「彼此扶持，增加運動的動力」及「改變的力量，存在彼此之間」。
結論/實務應用：重要他人的幫忙關係不只能達成病患健康促進行為，更能增進彼此成長，是一助人也助己的互動過程，研究發現可以提供臨床護理人員提供衛教與介入措施之依據。

SUMMARY

The research purpose was describe how helping relationships can affect a patient’s motivation to adopt a healthy life style.
This is based qualitative research analysis uses a qualitative research method, which explores how the helping relationships between early stage CKD patients and their significant others can affect diet and exercise. It adopts semistructured, openended, indepth interviews to obtain details of the respondents’ behaviors with regard to diet and exercise.
For these CKD patients, helping relationships were defined as:(1) families keep company with patients when their ill, (2) family remind for dietary and exercise controls, (3) doing exercise together can improve regularity of exercise, (4) dietary and lifestyle changes between each other.
The findings of this work can help healthcare professionals to better understanding how to educate and encourage patients’ significant others to improve their motivation and willingness to achieve healthier behaviors.

INTRODUCTION

Patients with chronic kidney disease (CKD) who have a healthy lifestyle could delay the progression of CKD and improve their quality of life. It has been shown that patients with CKD can get more emotional support from family or friends than from healthcare professionals. Moreover, the behaviors of significant others (e.g., friends, spouses, and partners) could have positive or negative effects on the dietary and exercise habits of patients.
We found that if the patients’ significant others also adopt dietary control measures, then this makes it easier for patients to engage in healthier behaviors, with a greater motivation to exercise. In addition, significant others can also help to reminded patients that they should regularly take their medication, thus also improving their habits.
This qualitative research aimed to describe how helping relationships can affect a patient’s motivation to adopt a healthy life style, including a better diet and more exercise.

MATERIALS AND METHODS

This is qualitative research method, which explores how the helping relationship between early chronic kidney disease patients and their significant others can affect health-related behaviors. It adopts semi-structured, open-ended, in-depth interviews to obtain details of the respondents’ lives. Purposive sampling is used to recruit patients diagnosed with early-stage CKD from the nephrology education departments of medical centers.
Participants were eligible for inclusion if they had been diagnosed with early-stage CKD, speak Taiwanese or Mandarin, and their diet and exercise achieved stage 6 of the TTM (Transtheoretical Model).
This study used the content analysis method, based on the following six steps: (1) prepare the data; (2) familiar your data; (3) define the unit of analysis; (4) definition of categories and temporary coding; (5) confirming common categories and themes; (6) Establishing categories or themes. This research meets Lincoln & Guba’s four indicators of research rigor.

RESULTS AND DISCUSSION

The analysis of the interviews carried out in this work led to a better understanding of the role significant others can play in the lives of patients with early chronic kidney disease, including providing helping relationship.
For these CKD patients, helping relationships were defined as:(1) families keep company with patients when their ill, (2) family remind for dietary and exercise controls, (3) doing exercise together can improve regularity of exercise, (4) dietary and lifestyle changes between each other.
Compared with previous studies, the findings of this work reveal that the help provided by significant others can effectively change patients' behaviors, and improve how they cope with CKD.
CONCLUSION

This study finding Helping relationship is between patients and significant others(including family and friends), and this relationship can improve health-promoting behavior. Compared with previous studies, our study show families support are more than health professional providers. Furthermore, helping relationships are vital in mental health recovery process.
The helping relationship is not only improving health-promoting behavior, but also enhancing growth of each other. This finding can help nurses to provide health education.

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