比較不同鼻胃管灌食衛教方式對病患家屬於知識及焦慮之成效

A Comparison of Different NG Feeding Education Strategies on Knowledge and Anxiety for the Family

林紋麗(Wen-Li Lin) ； 吳佩樺(Pei-Hua Wu) ； 孫嘉玲(Jia-Ling Sun) ； 張雅萍(Ya-Ping Chang) ； 陳淑銘(Shu-Ming Chen)

《高雄護理雜誌》 28卷2期 (2011/08) Pp. 7-21

https://doi.org/10.6692/KJN-2011-28-2-2

摘要

背景：家屬首次為病患進行鼻胃管灌食前，會因管灌知識不足而感到焦慮，不同衛教方式對其管灌知識與焦慮的效果不得而知。目的：本研究目的在比較不同的衛教策略，對初次執行鼻胃管灌食的家屬，於管灌知識與焦慮之差異。方法：研究採類實驗研究設計，針對南區某醫學中心一般外科病房42位需要鼻胃管灌食病患之家屬為對象，分為實驗組Ⅰ給予常規指導方法，實驗組Ⅱ再輔以光碟片教學(VCD)，在衛教前後以鼻胃管灌食知識量表及醫院焦慮與憂鬱量表測量管灌知識與焦慮程度。結果：病患家屬之焦慮程度在常規指導加上VCD教學組，在衛教前後於焦慮程度有統計上顯著的降低(p=0.001)。管灌知識方面：兩組在接受不同方式之衛教後，知識程度均有顯著的增加，常規指導加上VCD教學組之知識平均值(12.32±1.61)明顯高於常規指導組(11.17±1.96)。在廣義估計方程式(Generalized estimating equation, GEE)模式下，兩組組間知識與焦慮差異皆未達統計意義。結論：以組內效果而言，常規指導加上VCD教學組同時具有知識提升與焦慮下降之效果，故輔以光碟片衛教教學可增強其知識程度進而降低焦慮。雖然在GEE模式下，統計控制組別與測驗變項後，兩種衛教模式並無顯著之改變量，但本研究結果仍然可供臨床醫護人員在執行家屬衛教方法選擇上之參考。

關鍵字

衛教 ； 鼻胃管灌食 ； 家屬 ； 焦慮 ； 知識

並列摘要

Background: When family members are first confronted with applying the nasogastric (NG) tube feeding, they will suffer anxiety due to deficit NG tube feeding knowledge. However, the effects of the different strategies on knowledge and anxiety are still unknown.Purpose: The purpose of this study was to compare different educational strategies on the family's knowledge and anxiety as first applying the NG tube feeding.Methods: A quasi-experimental design was used for this study. The participants were divided into two groups, experimental groups Ⅰ and Ⅱ. Experimental group Ⅰ was applied with routine care, whereas experimental group Ⅱ received extra VCD teaching program. The pre-and post-tests used the NG Feeding Knowledge Scale and the Hospital Anxiety and Depression Scale to evaluate the effects of educational strategies on the knowledge and anxiety.Results: The results showed that there were concurrent effects of the levels of anxiety decreasing in experimental group Ⅱ (p=0.001). Statistical analysis showed that both groups had an increase in their knowledge of NG tube feeding after the education, while experimental group Ⅱ had significantly higher knowledge than group Ⅰ by means of analysis. Between groups however, there was no significant difference in the knowledge and anxiety by Generalized estimating equation models.Conclusion: As within-group effects were concerned, there were concurrent effects of the levels of knowledge increasing and anxiety decreasing in experimental group Ⅱ. Nurses could apply the VCD program to the relatives for learning about NG feeding at the first time to strengthen realization and reduce anxiety. In the GEE models, there was no significant difference among knowledge and anxiety by controlling for group and test. It is hoped that findings will provide nurses with timely information to select an optimal approach for different educational strategies on families.

並列關鍵字

educational strategy ； nasogastric tube feeding ； family ； anxiety ； knowledge