透過社會網路強化病患的服藥遵從性

Abstract

遵從服藥的目的是實現預期的治療效果，改善病患的生活品質，同時將病患 用藥的風險降至到最小。然而，現行不遵從服藥的行為普遍存在，不但造成每年 約 1000 多萬美金的藥物成本浪費，同時也使病患的身體產生抗藥性，導致病情 因後續的併發症而日漸惡化、甚至帶來死亡的風險。而回顧現行服藥遵從性改善 作為，醫療機構雖針對病患的認知面與行為面，加強病患藥物知識、並降低服藥 行為困難，然而，卻未進一步考量病患長期服藥過程中，所遭遇到的情感層面議 題與需求；過去研究發現，若病患缺少以自身為中心所形成的社會網路成員，提 供病患所需的情感性支持，將會導致病患缺乏自我動機，來維持長期的遵從服藥 行為。因此為提供病患適切的情感面支持，本研究透過快速人種誌、深入訪談等 需求分析手法，洞察病患外在服藥情境、並擷取內在的服藥認知與過去經驗，深 入探索病患不遵從服藥的背後因素；再藉由紮根理論方法，以既有理論為基礎， 從收集到的資料中，抽取病患遵從服藥的議題與需求，確保資料產出結果符合使 用者中心需求；最後依據分析結果，透過參與式工作坊，集體建構出提供情感支 持的來源與具體支持的形式，並發展為行動裝置上的功能設計，期望藉由適切的 社會網路成員，提供的不同層面情感支持，來強化病患服藥的自我動機，進而達 到維持病患長期遵從服藥行為的目的。

The act of non-adherence is widespread. It not only causes about ten million medicine costs waste but also leads to the drug resistance, and the subsequent complications would make illness worse and even cause a risk of death. Recalling the improvement of nowadays, although the medical institutes have considered the cognition and behavior of patients to improve their medicinal knowledge, and to reduce the difficulty of dosing, they haven’t further considered the emotional demands which would be faced in the long-term medication. In order to provide the appropriate emotional support, this research is based on the user-centered design method. Through Ethnography, In-depth interview and Ground theory methology. Observing the external dosing condition of patients, and understand their medication knowledge and the experience to discover the reason why patients don’t comply with medication. Then, through a workshop gather the ideas of where to get emotional supports and what is the specific form, and develop them into the functions on the mobile device. Hope we could reach the purpose of keeping patients to comply with the long-term medication through different levels of emotional supports which is from social network members and would reinforce the medication spontaneity.