忒休斯的迷宮: 僵直性脊椎炎患者的病患旅程與治療決策分析

Abstract

本研究旨在探討僵直性脊椎炎（Ankylosing Spondylitis, AS）患者在治療旅程中的決策過程及其影響因素。研究主要集中在四個核心構面：健康素養、治療決策積極度、遵醫囑性和治療滿意度。透過調查台灣地區AS患者的問卷數據，研究採用結構方程模型（SEM）來驗證這些構面之間的關係。 研究結果顯示，健康素養對治療決策積極度和遵醫囑性有顯著正向影響，進而提高患者的治療滿意度。具體而言，健康素養較高的患者更能理解醫療資訊，並積極參與治療決策。此外，健康素養較高的患者也顯著影響其遵醫囑行為，最終影響治療整體滿意度。 本研究強調了在AS患者治療過程中提升健康素養的重要性，建議應加強患者教育和支持，促進患者積極參與治療決策。這不僅有助於改善治療滿意度，進而提高患者的生活品質。研究發現也為未來臨床實踐和健康政策制定提供了實證支持。 本研究在理論上填補了健康素養、治療決策、遵醫囑性與治療滿意度之間關係的研究空白，並在實務上建議通過提高患者的健康素養和遵醫囑性來改善治療結果和患者滿意度。 論文標題中的「忒休斯的迷宮」象徵僵直性脊椎炎患者在治療過程中面臨的複雜且困難的決策旅程。本篇論文旨在幫助患者走出這個迷宮。

This study aims to explore the decision-making process and influencing factors in the treatment journey of patients with Ankylosing Spondylitis (AS). The research focuses on four core dimensions: health literacy, treatment decision-making engagement, medication adherence, and treatment satisfaction. By surveying AS patients in Taiwan, the study employs Structural Equation Modeling (SEM) to validate the relationships among these dimensions. The results show that health literacy has a significant positive impact on treatment decision-making engagement and medication adherence, which in turn enhances treatment satisfaction. Specifically, patients with higher health literacy can better understand medical information and actively participate in treatment decisions. Additionally, higher health literacy significantly influences patients' adherence behaviors, ultimately affecting overall treatment satisfaction. This study highlights the importance of improving health literacy in the treatment process of AS patients, recommending that patient education and support be strengthened to promote active participation in treatment decisions. This not only helps improve treatment satisfaction but also enhances the quality of life for patients. The findings provide empirical support for future clinical practice and health policy development. The study theoretically fills the research gap regarding the relationships among health literacy, treatment decision-making, medication adherence, and treatment satisfaction. Practically, it suggests that improving patients' health literacy and adherence can enhance treatment outcomes and patient satisfaction. The title of the thesis, "Theseus' Labyrinth," symbolizes the complex and challenging decision-making journey faced by AS patients during their treatment process. This thesis aims to help patients navigate and find effective treatment options, improving their health literacy and treatment satisfaction.