提升心臟衰竭病人自我照護執行率之改善專案

臨床發現護理人員給予心臟衰竭疾病衛教後，病人仍無法確實執行自我照護行為，經現況調查發現：病人對於每日限水分配不清楚及無法配合、對於限鈉測量方式不清楚及無法配合、認為規律測量體重與心臟衰竭疾病控制無關，護理人員未交接評值結果、中斷衛教後未再執行，衛教工具內容文字太多且無教具及圖片輔佐，導致自我照護執行率僅有61.4%。本專案透過製作心臟衰竭衛教指導內容交接確認查檢表、心臟衰竭居家自我照護影片、舉辦心臟衰竭居家照護體驗營及設計心臟衰竭自我照護概念海報等對策實施後，心臟衰竭病人自我照護執行率提升至93.8％，達專案目標。專案推行後，心臟衰竭病人提升自我照護執行率後，進而改善生活品質，並降低再入院率。

關鍵字

心臟衰竭；自我照護；執行率；疾病認知

並列摘要

Clinical research shows that patients were still unable to actually perform self-care behaviors after nursing staff educated them about heart failure disease. Investigation and analysis of the current situation found that patients did not understand daily water restriction and could not cooperate. They were unclear about sodium restriction measurement method and could not cooperate as well. They regarded that regularly recorded body weight was not related to heart failure control. In addition, nursing staff did not hand over the evaluation result. They did not continue health education after the interruption. The health education tool was too boring. The implementation rate of self-care tools was only 61.4%. This project through the heart failure education checklist, self-care at home videos, self-care experience camps, and self-care concept posters, the implementation rate increased to 93.8%, reaching the project target. Heart failure patients improved the quality of life and reduced the chance of readmission after increasing the self-care implementation rate.

並列關鍵字

heart failure ； self-care ； implementation rates ； disease cognition

參考文獻

陳怡潓、李明珠、陳秀敏、蔡惠婷、陳萃婷（2017）護理人員交班內容一致性改善專案・健康與建築雜誌，4（1），42-50。https://doi.org/doi10.6299/JHA.2017.4.1.R5.42

陳儷月、張麗君、阮呂文貞（2020）・提升護理人員周邊置入中心靜脈導管照護正確率之專案・腫瘤護理雜誌，20（1），33-49。https://doi.org/doi10.6880/TJON.202006_20(1).03

鍾郡家、楊舜璇（2019）・運用共同決策照護一位心臟衰竭病人之護理經驗・台大護理雜誌，15（2），96-107。https://doi.org/10.6740/NTUHJN.201907_15(2).0010

藍湘湄、林靖芸、蘇芷萱、許秀紋、李成恩、許夢萍（2021）・提升主要照顧者管路照護回覆示教之完整率・護理雜誌，68（3），73-80。https://doi.org/10.6224/JN.202106_68(3).10

Alpert, C. M., Smith, M. A., Hummel, S. L., & Hummel, E. K. (2017). Symptom burden in heart failure: Assessment, impact on outcomes, and management. Heart Fail Reviews, 22(1), 25-39. https://doi.org/10.1007/s10741-016-9581-4

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