心肌梗塞病患住院期間發生不確定感內容及其相關因素之探討

An Exploratory Study on the Uncertainty Contents and Relative Factors of Patients with Myocardial Infarction during Their Hospital Stay

葉玫伶(Mei-Lin Yeh) ； 邱艷芬(Yann-Fen Chao)

《護理研究》 6卷6期 (1998/12) Pp. 501-512

https://doi.org/10.7081/NR.199812.0501

摘要

本研究在探討心肌梗塞病患住院期間（加護病房、病房、出院前）出現不確定感項目及其相關因素。以東部某區域教學醫院三名心肌梗塞病患深度訪談所得內容，經分析、歸納後得不確定感項目製成量表，並將此量表施測於北部某醫學中心30名病患，以SPSS統計軟體進行統計。發現有些不確定感項目（疾病本身、預後、檢查等）持續存在於住院期間，有些（家庭調適、治療、醫療作業、疾病復姿處理、衰弱現象）隨不同階段而改變。65歲以下、女性、獨居、在職、健保、高中以下、未曾聽過心肌梗塞、接受氣球擴張術或支架或血栓溶解劑、左心梗塞等病患分別於各階段有較高不確定感得分。本研究發現將提供心肌梗塞病患宜觀察之不確定感內容及易感族群之參考。

關鍵字

心肌梗塞 ； 住院期間 ； 不確定感

並列摘要

The purpose of this study was to investigate the contents and related factors of uncertainty of patients with acute myocardial infarction (AMI) during their hospital stay (ICU, ordinary ward, and prior to their discharge). An in-depth interview was conducted to discover the contents of uncertainty AMI victims experienced. Three subjects from a regional hospital in Hualien were interviewed in December of 1996 and yielded 26 process recordings for content analysis. The uncertainty items obtained were: 28 items during patients ICU stay, 35 items during ward stay, and 8 items prior to discharge. Three uncertainty rating scales were developed and 30 AMI patients admitted to a medical center in Taipei city in the spring of 1997 were enrolled to validate these findings. Data were obtained by interviews which were guided by the uncertainty rating scales. SPSS/PC was used to process the data. The results indicated that some uncertainty foci (uncertainty about the disease, the prognosis, and the treatment/diagnostic procedures) were persistent during the hospital stay, and some (family adjustment, treatment/diagnostic procedures, management plan, weakness of physical status, self-care at home to handle possible recurrence of the disease) were varied in different periods. The following groups had significantly higher levels of uncertainty during their hospital stay: patients with age less than 65, female, with high school education or less, living alone, currently in a job, never heard of MI, no angina experience, left heart infarction, and receiving angioplasty, stent, or thrombolytic therapy. The findings of this study provided references to identify AMI patients who tend to experience uncertainty and the contents of uncertainty a patient might experience. It was suggested to assess and recognize patients’ uncertainty to assist them in coping with AMI.

並列關鍵字

myocardial infarction ； hospital stay ； uncertainty