以賦權式術前衛教提昇膝關節置換術病人之自我照顧效能

Enhancing the Self-Care Efficacy of Patients Undergoing Knee Replacement Through Empowerment Preoperative Education

蔡玉梅(Yu-Mei Tsai) ； 莊峰玲(Feng-Ling Chuang) ； 陳冠蓁(Guan-Jhen Chen) ； 陳寶珍(Bao-Chen Chen)

《榮總護理》 37卷1期 (2020/03) Pp. 14-24

https://doi.org/10.6142/VGHN.202003_37(1).0002

摘要

本研究目的為探討介入賦權式術前衛教於膝關節置換術病人是否能提升其自我照顧效能。本研究為類實驗性研究，對象來源為南部某區域教學醫院準備接受人工膝關節置換術之手術前病人共收案41位（控制組21位，實驗組20位），為避免控制組與實驗組互相干擾，因此先收集控制組，再收集實驗組。實驗組衛教時機為入院後至手術前，研究工具為state-STAI問卷共20題，及手術自我照顧效能量表共21題，各在手術前、出院前及出院一週後進行問卷填寫。將控制組與實驗組進行重複測量變異數比較及獨立t檢定，結果顯示自我照顧效能的自信程度在出院前及出院一週二組間呈現顯著差異；另發現賦權式衛教較傳統式衛教能改善手術前的焦慮平均分數，雖焦慮嚴重程度無法明顯減輕，最終仍能提昇自我照顧效能。建議在住院中有計畫性的安排衛教及學習自我照顧技巧，並能推廣使用賦權式衛教進而促進術後自我照顧能力。

關鍵字

膝關節置換術 ； 焦慮 ； 自我照顧效能

並列摘要

The purpose of this study was to investigate whether interventional empowerment in the field of knee replacement surgery can improve the self-care efficacy of patients. This is a quasi-experimental study. A total of 41 patients who were prepared to undergo artificial knee replacement in a teaching hospital in a southern region were evaluated in the study (21 in the control group and 20 in the experimental group). To avoid the groups from interfering with each other, the control group was collected first and then the experimental group was collected. For the experimental group, the time for teaching was from the time of admission to the preoperative period. State-STAI 20 questionnaire and the surgical self-care efficacy table totaling 21 questions were used in the study. Patients were provided the questionnaire before surgery, before discharge, and 1 week after discharge. Results of the control group and the experimental group were compared using repeated measurement variation and an independent t test. Significant differences in self-care efficacy were observed between pre-discharge and discharge. The results of this study proved that the empowerment preoperative education reduced the average anxiety before surgery compared with the traditional preoperative education. Although the severity of anxiety cannot be significantly reduced, self-care efficacy can be improved. A systematic program is recommended for teaching self-care skills during hospitalization and promoting the use of empowered education to improve postoperative self-care.

並列關鍵字

knee replacement ； anxiety ； self-care efficacy

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