團體衛教對改善心肌梗塞病人認知與壓力之成效探討

Effects of Group Teaching Program on Improving Knowledge and Lessening Stress of Myocardial Infarction Patients

林明珍(M. C. Lin) ； 顧乃平(N. P. Ku)

《護理研究》 1卷4期 (1993/12) Pp. 341-350

https://doi.org/10.7081/NR.199312.0341

摘要

急性心肌梗塞的突發，造成病人生理與心理之雙重危機。從診斷、治療到預後，病人經驗一連串的不確定與壓力，作者希望建立一套團體衛教教案及衛教手冊，以教導正向認知與團體互動，來協助病人調適，並評值其成效。本研究採凖實驗設計，以某醫學中心內之急性心肌梗塞住院病人爲對象，共收實驗組16人，對照組25人；評值量表爲疾病認知、不確定、焦慮、憂鬰四項變項；兩組病人在由心臓加護中心轉至病房2天內行前測，隔1週再行後測，實驗組病人並在其間參與3個單元的團體衛教。研究結果如下：⒈除了知識與焦慮之間未達顯著相關外，四變項兩兩間呈顯著相關，即增加疾病認知可直接間接降低不確定、焦慮與憂鬰；⒉影響四變項較大的因素爲自覺疾病嚴重度與教育程度，顯示教育程度愈低、自覺疾病愈嚴重者，在認知疾病與減輕壓力上，愈需要協助。⒊實驗組病人在疾病認知、不確定、憂鬰之改善程度均顯著優於對照組，顯示團體衛教具有正向且顯著的成果。

關鍵字

心肌梗塞 ； 團體衛教 ； 認知 ； 不確定 ； 焦慮 ； 憂鬰

並列摘要

Acute heart attack is a crisis for patient both physiologically and psychologically. Patients experience periods of uncertainty and stress during the disease process. The author tried to establish a model of group teaching program for patients whenever coping with the crisis. This study was a quasi.experimental design to evaluate the effect of this group teaching program based on patient’s knowledge, uncertainty, anxiety and depression. The study consisted of 16 patients in experimental group and 25 in control’s respectively. The results of this study were as follows:
1.Each dependent variable correlated with each other significantly (p＜.0l) execpt the relation between knowledge and anxiety.
2.The most powerful predictors for 4 dependent variables were educational beckground and perc hseverity.
3.This group teaching program had a positive effect on heart attack patients not only for improving knowledge but lowering the degree of uncertainty and depression throughout the disease course.

並列關鍵字

myocardial infarction ； group teaching ； knowledge ； uncertainty ； anxiety ； depression