運用音樂協助呼吸器依賴病人胸腔復健運動

Applying Music Program to Assist the Pulmonary Rehabilitation Exercise on Ventilator- Dependent Patients

黃琪津(Chi-Chin Huang) ； 許雅婷(Ya-Ting Hsu) ； 劉曉芸(Hsiao-Yun Liu) ； 劉冠瑩(Kuan-Ying Liu) ； 林月娥(Yueh-E Lin)

《台灣醫學》 21卷6期 (2017/11) Pp. 568-579

https://doi.org/10.6320/FJM.201711_21(6).0003

摘要

胸腔復健運動能減少長期臥床病人肌肉萎縮、增加肌耐力，而有助呼吸器脫離及縮短住院天數。因臨床發現病人執行胸腔復健運動與指導不完整，故引發改善動機。現況分析發現呼吸器依賴病人執行胸腔復健運動完整性72.2％及護理師對胸腔復健運動認知正確率76.7％。分析原因以胸腔復健運動認知不足、缺乏胸腔復健照護標準及運動輔助工具不足問題，透過運用音樂輔助策略，擬定胸腔復健運動、舉辦在職教育訓練與運用多元教材以結合音樂輔助胸腔復健運動等活動實施，呼吸器依賴病人執行胸腔復健運動完整性提升達96.4％（↑24.2％），也有效提升主要照顧者對胸腔復健指導滿意度由65.7％提升至88.2％（↑22.5％），達專案目標且提升呼吸器依賴病人照護品質。

關鍵字

呼吸器依賴病人 ； 胸腔復健運動 ； 多元衛教指導

並列摘要

Pulmonary rehabilitation exercise can reduce muscle atrophy, increase muscle endurance, help ventilator detachment, and shorten the number of hospital days for those long-term bedridden patients. Rehabilitation exercise was not completely given to some of the patients. We were motivated to improve this situation. We found that the completion rate of the rehabilitation exercise among ventilator- dependent patients was only 72.2%, and the accuracy rate of nurses' knowledge was 76.7%. We found the insufficiency knowledge about chest rehabilitation exercise, lack of guidelines and aids for the rehabilitation exercise. After rehabilitation exercise along with rhythm and in-service education programs with multiple teaching were implemented. The completion rate of the rehabilitation exercise has increased up to 96.4% (↑24.2%), and the satisfactory rate of giving rehabilitation guidance to caregivers by nurses has improved from 65.7% to 88.2 (↑27.2%). The aim of this project is reached and the quality of care for ventilator depend patients is improved.

並列關鍵字

ventilation-dependent patients ； pulmonary rehabilitation exercise ； diversified teaching strategies

參考文獻

陳姿廷、丁玉佩、郭秋雅等：以影音多媒體護理指導提升門診癌症病人化學治療認知的正確率。腫瘤護理雜誌 2010;10:39-52。[Chen TT, Ting YP, Kuo CY, et al: Multimedia nursing guide to improve the recognition accuracy rate of cancer outpatient's chemotherapy. The Journal of Oncology Nursing 2010;10: 39-52.]"

莊寒玉、馬瑞菊、林宜青：運用肺部復健於脫離呼吸器病人之護理經驗。領導護理2011;12:61-71。[Chuang HY, Ma JC, Lin YC: A nursing experience of caring for a ventilator-dependent patient receiving pulmonary rehabilitation. Leadership Nursing 2011;12: 61-71.]"

陳譽齡：音樂增進物理治療對嚴重慢性阻塞性肺疾病患的復健成效。元培學報 2006；13：35-58。[Chen YL: Effects of music enhanced physical therapy on treatment outcomes of persons with severe COPD. Journal of Yuanpei University of Science and Technology 2006;13: 35-58.]"

高秀娥、 陳玉萍、鄭之勛等：提升呼吸器依賴病人肺部復健執行率之專案與初步成效。台灣醫學 2017;21:19-28。[ Kao HO, Chen YP, Jerng JS, et al: Preliminary Results of a Pulmonary Rehabilitation Exercise Program for Ventilator Dependent Patients. Formosan J Med 2017;21: 19-28.]"

戴秀好、江亦薇、楊翠芬：互動式音樂治療於中風復健病人之臨床運用。榮總護理 2010;27:367-72。[Tai SH, Jiang YW, Yang TF: Application of interactive music therapy for patients with stroke during rehabilitation. VGH Nursing 2010;27:367-72.]"