護理師正教導一位剛確診的病人進行自我管理。根據健康信念模式 (Health Belief Model)，哪項因素最能驅使病人遵從治療計畫？
A nurse is teaching a client about self-management of a newly diagnosed condition. According to the Health Belief Model, which factor is most likely to motivate the client to adhere to the treatment plan?
- AThe client's previous experience with other healthcare providers.病人與其他醫療提供者過去的經驗。
- BThe complexity of the prescribed medication regimen.處方藥物治療方案的複雜度。
- CThe availability of a support group in the local community.當地社區是否有支持團體可用。
- DThe client's belief that the disease will have a significant impact on their life.✓ 正解病人相信此疾病將對其生活產生重大影響。
核心概念：健康信念模式 (HBM) 的應用。HBM 認為行為改變取決於個人對疾病的認知。為何正確答案 D 對：在 HBM 中，「自覺嚴重性」(Perceived Severity) 和「自覺易感性」共同構成對疾病的威脅感。如果病人相信這個病會嚴重影響工作、生活或生命，他們採取行動的動機最強。為何其他選項錯：選項 C 雖然有幫助，但屬於行動線索或支持系統，並非 HBM 的核心動力；選項 B 藥物複雜度是「自覺障礙」，反而會降低遵從性；選項 A 與模式的直接激勵因素相關性較低。臨床思路：護理師在衛教時，應著重於強化病人對疾病風險的正確認知（威脅感）以及治療帶來的效益（自覺利益）。
Core concept: application of the Health Belief Model (HBM). The HBM holds that behavior change depends on personal perceptions of disease. Why correct answer D is right: in the HBM, 'perceived severity' and 'perceived susceptibility' together form the sense of threat from disease. If the client believes the illness will significantly affect their work, life, or survival, motivation to act will be greatest. Why other options are wrong: Option C is helpful but represents a cue to action or support system, not a core driver of HBM; Option B, medication complexity, is a 'perceived barrier' that decreases adherence; Option A has less direct relevance to the model's motivational factors. Clinical approach: in patient education, the nurse should strengthen the client's accurate perception of disease risk (perceived threat) and the benefits of treatment (perceived benefit).
美國護理教育非常看重行為科學理論（如 HBM）的實戰應用，考題常將理論與臨床行為結合。台灣臨床則較多強調「病從口入」或「遵從醫囑」的權威式教育，較少有系統地應用心理模型。