| Summary: | 碩士 === 高雄醫學院 === 護理學研究所 === 85 === The purpose of this study was to explore the experiences of
uncertainty and caring needs among patients with myocardial
infarction during the time from be-ing attacked by the illness
to being discharged from the hospitals. As both anurse and a
researcher, the author collected the data by observation and
ind- epth interviews based on a semi-structured interview guide
with 25 qualified patients. Interview was made in the intensive
care unit, before patients had operation and before patients
were dischargged from the hospital. The data was analyzed and
categoried by means of content analysis. The
findings of the study showed that the essence of uncertainty
coming from patients with myocardial infarction were
unpredictable, incomprehensible, unj-udgable, uncontrollable,
indecisive. Their experiences concerning uncertainty varied in
three aspects which were physical, psychological, and social.
The physical aspect consisted of the illness related,
examination and treatment reelated. Among those, the illness
was the most concern of patients. Faced with harassment of
the illness, most of the patients felt uncertain of (1)be-ing
able to judge the seriousness of the illness (2)being able to
comprehend the symtoms, the cause of the illness and self-care
methods (3)being able to predict the prognosis and the effect
of treatment. As to the examination and treatment, patients
felt uncertain of (1)being able to comprehend the necessi-ty and
the process of the examination and treatment (2)being able to
predict the effectiveness, the safety and results of the
examination and treatment (3) being able to judge the
appropriateness of the examination (4)being able to predict
the recovering situation after the treatment and its side-effect
(5) being able to decide the method of treatment. In the
psychological and social aspects, most of the patients felt
uncertain of (1)being able to predict the influence of the
illness on their families, friends, work, the quality of care,
others''attitude as well as safety of travelling (2)being able to
controll the self-care behavior (3)being able to comprehend
the medical culture and theresponsibility of the medical staff.
The study also found that the caring needs coming from patients
with myocar-dial infarction can be classified into 5 different
types:(1)information needs (2)psychological needs
(3)instrumental needs (4)physiological needs (5)social needs.
The information needs were to possess the knowledge of
myocardial infa-rction, the risk factor, the examination, the
recurrence and its handling, as well as self-care methods. The
psychological needs included friendly and enth-usiastic attitude
of medical staff, others'' consideration and encouragement,
others'' understanding and respect, faith and security in
examination and trea-tment, the acquaintance with the medical
staff. Instrumental needs included immediate care on the
attack of the illness, careful treatment by experienced doctors
in a well-equiped hospital, shortening the length of the
hospitalizat-ion and the time for waiting for examination, the
interaction with other pati-ents, doctors''explanations related
to the process of the illness, good care before and after the
examination and treatment, financial suppport, medical in-
formation concerning the illness, accessible medical care when
needed as wellas continuous and safe care when receiving an
invasive examination and treat-ment. Physiological needs
included the release of the symptom coming from theattack of the
illness and the suffering of the examination and treatment as
well as a quiet, clean, and comfortable environment. Social
needs included sh-aring experiences with people recovering from
the illness and being able to work and funtion as a normal
person.
The study involved an in-depth exploration on the essence and
the content related to patients'' experiences of uncertainty
and caring needs. The essay can not only make people
understand the concept of uncertainty, but also be a good
reference of enhancing the quality of a caring, humanized, and
complete nursing care system, it helps to formulate the
uncertainty scale and can be asteaching material of nursing
education as well.
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