背　景慢性病管理為全球重要健康議題，近年來陸續有研究運用自我管理於國內慢性病照護的成果發表，但卻缺乏系統性文獻回顧探討本土性之自我管理介入成效。目　的透過系統性文獻回顧評析自我管理方案與探討其成效。方　法搜尋台灣期刊論文索引、CEPS、CINAHL、Cochrane Library、PubMed/MEDLINE共五個中英文資料庫，2011年4月以前之文獻，鍵入「自我管理」與「Taiwan」等關鍵字，共獲得217篇相關文獻，扣除重複及略讀題目與摘要篩選文獻，最後共12篇文獻符合標準，以Modified Jadad Scale評定其研究品質得分介於2至6.5分。結　果本系統性文獻回顧結果顯示，在國內自我管理方案已應用於糖尿病、氣喘、末期腎病、心衰竭、癲
癇、自閉症等慢性病。自我管理方案有團體、個別、電訪、網路之多元介入方式，介入時間從數小時至三個月不等。自我管理可顯著提升慢性病個案的疾病認知，增進自我照顧行為，增加自我效能；生理指標之成效結果則不一。結　論／實務應用依據實證結果，建議健康照護者在運用自我管理方案於慢性病人時，介入為期時間至少四週，第一次後測時間至少大於四週，追蹤時間至少三個月，包含健康照護、日常生活、情緒壓力管理之方案內容與成效指標，設計追蹤討論與諮詢管道，以便提升自我管理的知識、行為、生理、心理之成效。

Background: Chronic illness management is an increasingly important global health issue. A growing number of studies have been conducted on chronically ill patients in Taiwan to evaluate the effects of self-management. However,systematic literature reviews are not sufficient to make positive conclusions regarding the efficacy of domestic selfmanagement interventions.Purpose: This paper used a systematic review of the literature to evaluate self-management interventions and explore
their effectiveness.Methods: Researchers searched the following five Chinese and English electronic databases for relevant literature articles:
Taiwan Journal Index, CEPS, CINAHL, Cochrane Library, and PubMed/MEDLINE. Keywords including “selfmanagement”and “Taiwan” were keyed in and the search was limited to articles published before April 2011. A total of 217 articles that matched search criteria were extracted. Article topics were screened and repeated topics removed.Twelve articles met study inclusion criteria and were selected for further analysis. The quality of the 12 studies was assessed using a Modified Jadad Scale, with scores ranging from 2 to 6.5.Results: Findings of this systematic review showed that self-management interventions have already been introduced for Taiwanese patients suffering from chronic illnesses such as diabetes, asthma, end-stage renal disease, cardiac failure, epilepsy and autism. Self-management interventions were introduced through various channels such as group therapy, one-to-one therapy, telephone interviews, and the Internet. Length of intervention ranged from as short as a few hours to as long as three months. Self-management was shown to promote significantly the disease perception of chronically ill patients. Self-care behavior and self-efficacy also both improved significantly. However, patients’ psychological indicators varied.Conclusions / Implications for practice: Empirical results demonstrated that, in order to yield the best outcome,self-management programs for chronically ill patients should be conducted for a length of at least four weeks, first
measurements should be done for at least 4 weeks, and follow-up assessments, including health care, daily life, emotional stress protocol content and management indicators, should take place for at least 3 months. Follow-up, discussions and consultations should be designed to deepen patient knowledge about self-management, shape behavior, and
prepare them physically and psychologically to handle self-management.