背景
慢性阻塞性肺疾病患者疾病自我管理不似其他慢性疾病自我管理有清楚的定義與內容。本研究基於患者為中心的理念，期望以質性研究探討慢性阻塞性肺疾病患者自我管理過程，以期提升其生活品質。

目的
探討慢性阻塞性肺疾病患者自我管理過程與其影響因素。

方法
以質性研究進行資料收集，收案地點臺 灣某醫學中心之胸腔科病房、門診與呼吸治療 室。本研究採方便取樣訪談19 位患者，以內容分析法分析資料。

結果
結 果與慢性阻塞性肺疾病共存是一個自我調節及選擇適合的健康照顧行為過程。健康照顧行 為包括：症狀處理、運動執行、環境控制、情緒調適、維持健康生活型態和利用社區 健康照顧資源。有一些因素會影響與慢性阻塞性肺疾病共存的過程，包括：患者身體 和心理狀況、疾病相關認知以及社會支持。特別是患者不滿意健康照顧行為的結果， 他們又會重新選擇健康照顧行為，並且開始連續的自我調節過程。

結論／實務應用
經由一連串的嘗試錯誤，患者已是自己生活的專家；醫療專業人員在患者疾病自我管理過程中扮演關鍵性角色，必須幫助慢性阻塞性肺疾病患者因應生活中不同的問題。研究結果的發現可以幫助醫療專業人員發展以實證為基礎的自我管理措施以提升患者生活品質。

Background: Disease self-management for patients with chronic obstructive pulmonary disease (COPD) is less well characterized than that for patients with other chronic diseases. A patient-centered perspective calls for qualitative research to investigate the process of self-management as a means of enhancing quality of life in patients with COPD.

Purpose: This study explores the process of self-management for patients with COPD and the factors that impact the efficacy of this process.

Methods: A qualitative inquiry approach was used to collect data in the thoracic ward, outpatient department, and respiratory therapy roomof a medical center in Taiwan. A convenience sample of 19 patients was collected. Qualitative content analysis was used to analyze data.

Results: Living with COPD is a process that involves selfregulation and selecting suitable healthcare behaviors. The related healthcare behaviors identified in this study include symptom management, exercise implementation, environmental control, emotional adjustment, maintenance of a healthy life style, and utilization of community and healthcare resources. The factors that were found to influence this process include the physical and psychological conditions of the patient, his or her disease-related cognition, and the social support that he or she receives. In this study, once participants became dissatisfiedwith the consequences of their healthcare behaviors, they chose a new set of healthcare behaviors and continued to engage in the process of self-regulation.

Conclusions/Implications for Practice: Patients naturally become experts with regard to their lives through a process of trial and error. Even so, healthcare professionals play a key role in the process of self-management and help patients with COPD cope with various problems in their daily lives. The findings of this study contribute to the development of evidencebased self-management interventions that promote quality of life in patients with COPD.