提升癲癇病童家屬執行生酮飲食作業正確性

Improving the Accuracy for Caregivers to Implement Ketogenic Diet Administration

李珮珊(Pei-Shan Li) ； 林育竹(Yu-Chu Lin) ； 楊惠婷(Hui-Ting Yang) ； 黃婉苓(Wan-Ling Huang) ； 李銘櫻(Ming-Ying Lee) ； 林素雯(Su-Wen Lin)

《志為護理-慈濟護理雜誌》 22卷1期 (2023/02) Pp. 108-119

摘要

本專案旨提升癲癇病童家屬執行生酮飲食作業之正確，對頑固性癲癇病童而言，藥物控制有限，生酮飲食成為另一項選擇，經現況發現教材不足以提供家屬參考，護師對生酮飲食認知有限，家屬返家後對照護有疑問來電諮詢，故引發動機。對策制定生酮飲食教材、增加圖示操作步驟、拍攝教學影片、製作每日衛教暨評值表，出院前測試家屬認知、技能，舉行跨領域會議，並納入專科在職教育；結果顯示家屬執行生酮飲食作業正確性從60.0%提升97.7%，護理師對生酮飲食認知正確率84.2%提升92.5%，專案目的達成，提升病童家屬對生酮飲食認知與技能，增加執行生酮飲食正確性，期盼生酮飲食對病童治療之有效，改善症狀頻率，增進家庭生活品質。

關鍵字

兒童 ； 生酮飲食 ； 頑固性癲癇

並列摘要

The aim of this study is trying to improve the accuracy of family members in implementing ketogenic diet administration for those children with epilepsy. Refractory epilepsy had been diagnosed in pediatric patients and ketogenic diet seems to be an alternative option. Currently there is insufficient teaching material on ketogenic diet for children available in Taiwan which causes family dependents to sometimes contact nursing staff for information after they are back home. Motivation for this study had been triggered due to nurses having limited knowledge about ketogenic diet. In addressing this issue, our strategies included: teaching materials making of ketogenic diet; increasing pictures and video instructing; daily evaluation tables for health education; cognition rechecking and proper skill confirmation; and inter-professional education and practice would be arranged for family members or caregivers before patients discharge. Our intervention was effective according to the result which showed the accuracy rate of ketogenic diet performance had elevated from 60% to 97.7%, while the rate of comprehension of ketogenic diet among nursing staff increased from 84.2% to 92.5%. It is expected that as a result of enhancing the understanding, skillfulness and correctness of ketogenic diet implementation, better therapeutic outcomes will be promoted with decreasing frequency of symptoms and ameliorating quality of life.

並列關鍵字

children ； ketogenic diet ； refractory epilepsy

參考文獻

李姵萱、洪燕萍(2019)．運用跨領域合作模式提升血液腫瘤病人對營養認知之正確率．台大護理，15(1)，146-159。https://doi.org/10.6740/NTUHJN.201901_15(1).0014。

周建成(2018)．癲癇手術的術前評估．臨床醫學，81(2)，77-80。https://doi.org/10.6666/ClinMed.201802_81(2).0015。

陳燕慈、李旺祚(2016)．頑固型癲癇病童生酮飲食治療對主要照顧者生活品質的影響．台灣醫學，20(4)，335-343。https://doi.org/10.6320/FJM.2016.20(4).1。

陳美慧、許瀞云、陳寶純、洪碧蓮、侯玫玲、邱燕甘(2020)．提升頑固性癲癇病童對生酮飲食之醫療遵從率．長庚護理，31 (2)，189-201。https://doi.org/10.6386/CGN.202006_31(2).0005。

連心瑜、張自強、陳麗如(2011)．癲癇兒童的疾病適應．台灣職能治療研究與實務，7 (1)，64-73。https://doi.org/10.6320/FJM.2016.20(4).1。