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研究生: 鍾宜庭
Chung, Yi-Ting
論文名稱: 愛滋感染者達到病毒量抑制的服藥動機
The motivation of HIV patients keep taking HAART to viral load undetectable
指導教授: 柯乃熒
Ko, Nai-Ying
學位類別: 碩士
Master
系所名稱: 醫學院 - 護理學系
Department of Nursing
論文出版年: 2019
畢業學年度: 107
語文別: 中文
論文頁數: 66
中文關鍵詞: 愛滋病抑制病毒量動機現象學
外文關鍵詞: HIV, undetectable viral load, motivation, phenomenology
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  • 研究背景:成功抑制病毒量至無法測得為治療愛滋疾病的首要目標,不僅可以降低死亡率、提升免疫力、促進健康的身體、提升生活品質,更可以減少疾病的傳播。動機為促進從事某項行為的原因、理由或念頭,是影響服藥遵從性的重要因素之一,對於是否能成功抑制病毒量則扮演著重要角色。

    研究目的: 了解愛滋感染者服用抗病毒藥物至病毒量無法測得的動機。

    研究方法: 本研究採質性研究現象學方法,在南部某醫學中心感染科門診,以立意取樣選取成功抑制病毒量的愛滋感染者個案,使用半結構式訪談大綱進行深度訪談,了解個案的自身想法經驗。

    結果:本研究訪談10位愛滋感染者其在三階段服藥歷程:從開始服藥、開始服藥至病毒量無法測得、持續服藥之服藥動機,其中包含9位男性及1位女性。控制好疾病、他人的影響、個人的想法是感染者開始服藥的動機,前兩個主題同時為開始服藥至病毒量無法測得的動機,而除了上述提到的三個主題,再加上個人的想法及生命的實現為持續服藥的動機。

    結論:控制疾病好好的活著為愛滋感染者服藥很重要的動機,而身旁有重要他人的幫忙協助及支持對於服藥這件事有著重要的正向影響。期望臨床醫療人員可以更加瞭解感染者的動機想法並協助找尋人生目標,提高生活品質、降低發病率及死亡人數,努力達成愛滋病零傳染的目標。

    This study aimed to understand the motivation of taking Highly Active Anti-Retroviral Therapy (HAART) till viral load undetectable among people living with HIV. Phenomenology with semi-structured interview was applied in this study, and Colaizzi’s distinctive seven step process was used to analyze the transcripts. A total of ten participants included nine male and one female. The duration between first HAART initiation to viral load undetectable (<20 copies/mL) was between 1.5-15months. The process of taking HAART can be divided into three stages: (1) start to take HAART, (2) taking HAART until viral load undetectable, and (3) sustained medication. Five themes were emerged in three stages, including “controlling for HIV”, “the influences of significant others” , “personal thought” , “survival will” and “realization of live”. “Controlling for HIV” and “the influences of significant others” were the two most affective motivations that affect the experience of taking HAART among people living with HIV.

    摘要 I Abstract II 誌謝 IV 目錄 VI 表目錄 VIII 第一章 序論 1 第一節 背景 1 第二節 重要性 3 第三節 研究目的 5 第二章 文獻查證 6 第一節 影響抑制病毒量的重要性 6 第二節 動機 8 一、動機的定義 8 二、動機對於服藥遵從性的重要性 9 第三章 研究方法 12 第一節 研究設計 12 第二節 研究對象 12 第三節 研究工具 13 一、研究者本身 13 二、主觀性檢核 15 三、訪談大綱及問題 17 四、訪談設備 17 第四節 資料收集過程及策略 18 一、收案流程 18 二、訪談事前準備 18 三、訪談過程 19 第五節 資料整理與分析 20 一、資料整理 20 二、資料分析 20 第六節 研究嚴謹度考量 24 第七節 研究倫理 26 第四章 研究結果 28 第一節 受訪者基本資料描述 28 第二節 訪談反思紀錄 30 第三節 愛滋感染者開始服藥的動機 35 第四節 愛滋感染者服藥至病毒量無法測得的動機 39 第五節 愛滋感染者持續服藥的動機 41 第五章 討論 49 第一節 控制愛滋疾病好好活著 49 第二節 重要他人的影響 50 第三節 人生目標,實現夢想 52 第四節 研究限制 52 第六章 結論與建議 54 第一節 結論 54 第二節 應用與建議 54 第七章 參考文獻 57 附錄一 訪談大綱及問題 60 附錄二 同意人體研究證明書 61 附錄三 現象主題及意義 62

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