護理指導對外科傷口照護之成效探討

Nursing Instruction on the effectiveness of the care of surgical wounds

凃淑玲(Shu-Ling Tu)

指導教授 ： 林耀仁

中臺科技大學/管理學院/健康產業管理研究所/碩士(2011年)

摘要

外科手術病患病情穩定後即返家自我照護，其中傷口照護的技能是必備的能力。因此醫護人員必須於病患出院前，提供病患或家屬傷口照護的技術與知識促進傷口癒合。本研究目的探討團體護理指導對外科手術病患傷口照護知識、技能之影響，病患對於護理指導之滿意度情形，及是否能減少衛教護理時數。方法：採所羅門四組設計 ( Solomon four-group design )，在某醫學中心教學醫院外科四個病房進行研究。兩單位採新的方案，兩個採用原本的教學方案，立意取樣的方式選取外科手術患者為研究對象，共收得實驗組及控制組共121人。實驗組患者接受研究者自編之「傷口照護護理指導單張及多媒體影帶教學」，由專人進行團體護理指導，控制組則接受傳統性護理指導。以結構式問卷進行前後測資料收集，所得資料以SPSS/PC套裝軟體進行統計分析。結果實驗組與對照組四組間傷口照護知識無顯著差異；技能進步達顯著差異（p＜0.05）；滿意度提昇有顯著差異(p＜0.05)及減少衛教護理時數。希望此實驗結果能作為未來相關衛教計劃擬定之參考 。

關鍵字

外科傷口照護 ； 護理指導

並列摘要

Wound care skills are essential abilities when a patient is in stable condition after surgery to return home and self-care. Health care workers must provide wound care skills and knowledge to patients or their families before discharge to help wound healing, and explain infection symptoms and signs. The purpose of this is to investigate the influence of group teaching on wound care knowledge and skills of surgical patients, patient satisfaction and the possibility to reduce teaching hours. The research is based on Solomon four-group design to study four surgical wards in a medical teaching hospital. Two of them use the new program, and others use the original teaching program. There were 300 surgical patients selected according to purposive sampling, and divided into experimental group and control group. Experimental group patients received "wound care nursing guidelines and multimedia video teaching" compiled by the researcher, and the control group received tradition care and guidance. Patient,s performance were measured with a structured questionnaire before and after education, and data were collected and analyzed by SPSS / PC software package. Experimental group and control group wound care knowledge among the four groups were not significantly different; skills progress are significant differences (p <0.05); satisfaction improve significantly different (p <0.05) and reduce the number of hours care and health education. It is hoped that this study will be a reference for other health education programs.

並列關鍵字

nursing instruction ； surgical wound care

參考文獻

王靜慧、林碧珠、廖孟雪、余先敏、陳琼香、曾薇、林梅絹（2007）‧骨科病房團體護理指導改善方案‧榮總護理，24（3），219-227。

王溪曼（2000）‧如何做好讀易懂的書面衛教資料‧台灣醫學，4（3），334-337。

李瑜弘、王瑞霞（2001）‧長期血液透析病患之無助感、社會之無助感與自我照顧行為之相關探討‧護理研究，9（2），147-157。

李雅玲、林安麗、林宜蓉（2000）‧系統性護理指導對腸造口病童照顧的影響‧慈濟醫學，12（3），131-139。

杜莉娟、李美玉、張德馨（2007）‧運用多媒體於產後團體護理指導之改善專案‧新台北護理期刊，9（1），81-91。