運用情境模擬影片教學提升護理人員之譫妄知識與評估能力

本研究旨在探討介入情境模擬影片教學，能否提升護理人員譫妄知識及評估的正確性。採類實驗研究設計，方便取樣自某醫學中心六個內科病房之護理人員，使用結構式問卷，內容包括：基本資料、譫妄知識與混亂評估法（confusion assessment method, CAM），共收案130位護理人員，實驗組65位、對照組65位，實驗組採情境模擬影片搭配簡報教學、對照組只採簡報教學。教學後實驗組譫妄知識平均分數93.1分，顯著高於對照組76.6分（p=.034）。使用CAM評估譫妄影片的正確率為：第一段影片病人有譫妄，兩組在正確率及答題正確之進步率皆無顯著差異。第二、三段影片病人無譫妄，教學後實驗組正確率高於對照組，故進一步比較兩組答題正確之進步率，實驗組於第二段影片（p<.001）及第三段影片（p<.019）的答題正確之進步率顯著優於對照組。結果顯示情境模擬教學後，護理人員的譫妄知識、CAM評估譫妄影片正確率及進步率皆有顯著提升。經本研究結果獲知，採用情境模擬影片教學，使學習者可連貫譫妄特徵，提升譫妄知識及評估正確性，增加譫妄課程的教學效益，具參考價值，建議未來使用影片或建立情境模擬等方法加入譫妄課程教學。

關鍵字

情境模擬；譫妄；混亂評估法

並列摘要

This study investigated whether the use of scenario simulation videos enhanced nurses' knowledge of delirium and the accuracy of delirium assessment. A quasiexperimental design was used to recruit 130 nurses from six internal medicine wards at a medical center. A self-developed structured questionnaire was used, which included a basic information section, a delirium knowledge questionnaire, and an evaluation of the consistency of application of the confusion assessment method (CAM). The participants were allocated to an experimental group (n=65) or control group (n=65). The experimental group received scenario-based simulation video instruction accompanied by PowerPoint-based instruction, and the control group received only the traditional PowerPoint-based instruction. After instruction, the experimental group achieved a significantly higher average score of 93.1 for delirium knowledge than did the control group (76.6; p= .034). Delirium assessment using the CAM for the first video segment, in which a patient exhibited delirium, did not differ significantly between the two groups in terms of accuracy or improvement rate. However, for the second and third video segments, in which patients did not exhibit delirium, the experimental group demonstrated higher accuracy in their assessments than did the control group. The improvement rates of the experimental group were significantly higher for the second (p< .001) and third segment (p< .019) of the video. These findings indicate that the scenario simulation-based teaching significantly improved the nurses' knowledge of delirium and accuracy in assessing delirium in videos using the CAM. The use of scenario simulation videos helped the learners to comprehend delirium characteristics coherently, enhancing their knowledge of delirium and accuracy of delirium assessment. Therefore, incorporating scenario simulation methods or videos into delirium education is recommended to enhance its effectiveness. The findings of this study are a valuable reference for nursing education.

並列關鍵字

scenario simulation ； delirium ； confusion assessment method

參考文獻

林麗華、黃秀英、詹雅惠、鄭慧娟（2021）．某醫學中心骨科老人術後多面向照護預防譫妄之成效．榮總護理，38（2），112-119。

陳杰（2022）．老年病患發生譫妄症的診斷與處置．秀傳醫學雜誌，21（1），97-102。

楊星瑜（2020）．加護單位重症患者譫妄的生理病理機轉與評估．護理雜誌，67（3），14-22。

羅心怡、陳雅芳、陳怡君、鄭青青（2022）．運用多元化策略降低外科高齡病人譫妄發生率．護理雜誌，69（6），65-74。

Cacchione, P. Z. (2020). Innovative care models across settings: Providing nursing care to older adults. Geriatric Nursing, 41(1), 16-20.

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