提升造血幹細胞移植病人接受護理指導完整率

Project to Promote the Complete Rate of Nursing Education for Patients undergoing Hematopoietic Stem Cell Transplantation

曾珮菱(Pei-Ling Tseng) ； 曾鈺雯(Yu-Wen Tseng) ； 韓晴軒(Ching-Hsuan Han) ； 陳佳佳(Chia-Chia Chen) ； 李淑慧(Shu-Hui Lee)

《腫瘤護理雜誌》 16卷2期 (2016/12) Pp. 45-58

https://doi.org/10.3966/168395442016121602005

摘要

本專案目的在提升造血幹細胞移植病人接受護理指導之完整率。造血幹細胞移植是治癒許多重大血液疾病（如：白血病、淋巴瘤、再生不良性貧血等）的重要治療措施，而造血幹細胞移植的風險及複雜度高，病人及家屬須投入更多心力配合治療，並學習自我照顧。若於治療實施前有完整的護理指導，將有助於增進病人及家屬對造血幹細胞移植的認知，降低焦慮並提升自我照顧能力。臨床照護中發現，此類病人未能得到整體護理指導之原因包括：造血幹細胞移植病人，對自我照護內容缺乏充分瞭解、護理人員對造血幹細胞移植認知不足、護理指導手冊內容不符合臨床需求等，因此引發改善之動機。改善方案有：一、建立造血幹細胞移植護理指導標準作業程序；二、製作造血幹細胞移植病人護理指導隨身護照；三、舉辦造血幹細胞移植照護在職教育訓練。結果顯示造血幹細胞移植病人接受護理指導完整率由50.8%提升至97.1%。透過建立護理指導標準作業程序，運用護理指導隨身護照及舉辦在職教育，可有效提升造血幹細胞移植病人接受護理指導之完整率。

關鍵字

造血幹細胞移植 ； 護理指導 ； 完整率

並列摘要

Hematopoietic stem cell transplantation (HSCT) is a major treatment for hematologic diseases such as leukemia, lymphoma and aplastic anemia. HSCT comes with high risks and complexity, which require intense cooperation and self-care skills from patient and family. Pretreatment nursing education can improve cognition, anxiety, and promote self-care ability. The purpose of the project was to improve the completion rate of nursing education in patients undergoing hematopoietic stem cell transplantation. Before this project, there was insufficient understanding of self-care in patients and insufficient knowledge of hematopoietic stem cell transplantation in nursing staffs; the education manual was inappropriate and nursing continuing education was incomplete. With analysis data of the current procedures, the proposed improvement project included: (1) building a standard operating procedure of nursing care for hematopoietic stem cell transplantation; (2) creating a self-care pamphlet of hematopoietic stem cell transplantation; and (3) arranging nursing continuing education for hematopoietic stem cell transplantation. At the end of the improvement project, the completion rate of nursing education increased from 50.8% to 97.1%. The project entailed constructing standard operating procedure of nursing care, utilizing a self-care pamphlet, and arranging nursing continuing education, all of which contributed to the improvement of completion rate of nursing education for hematopoietic stem cell transplantation.

並列關鍵字

Hematopoietic stem cell transplantation ； nursing education ； completion rate

參考文獻

莊紫雲、劉淑珍、李宜恬、謝麗鳳（2015）．造血幹細胞移植後病人之生活品質及症狀探討．榮總護理，32（2），208-218。[Chuang, T. Y., Liou, S. C., Lee, I. T., & Hsieh, L. F. (2015). Quality of life and symptoms after hematopoietic stem cell transplantation. VGH Nursing, 32(2), 208-218.] doi:10.6142/VGHN.32.2.208

李雅萍、蔡青娥、黃淑貞、梁靜娟（2010）．提升護理人員對膀胱訓練護理指導完整率．榮總 護理，27（4），345-352。[Lee, Y. P., Tsai, C. E., Huang, S. C., & Lian, C. C. (2010). Project for promoting completeness of nurses’ instruction of bladder training. VGH Nursing, 27(4), 345-352.]

高麗雀（2005）．團體護理指導之實務技巧．台灣腎臟護理學會雜誌，4（1），1-8。[Kao, L. C. (2005). The practical technique of group nursing instruction. Journal of Taiwan Nephrology Nurses Association, 4(1), 1-8.]

陳瑞儀、胡文郁（2013）．造血幹細胞移植及護理．陳敏鋑、黃采薇、趙子傑、簡淑慧、陳秋慧、陳瑞儀⋯顧乃平，癌症護理學（187-212）．台北市：華杏。[Chen, R. Y., & Hu, W. Y. (2008). Hematopoietic stem cell transplantation and nursing. In Chen, M. C., Huang, T. W., Chao, T. Z., Chien, S. H., Chen, C. H., Chen, R. Y., ... Ku, N. P. Oncology Nursing (187-212). Taipei City, Taiwan, ROC: Farseeing.]

劉淑倩、黃芷誼、李秋琴、胡雅娟（2010）．肝臟移植手術後護理指導之改善專案．長庚護理，21（3），323-334。[Liu, S. C., Huang, C. Y., Lee, C. C., & Hu, Y. C. (2010). A project to improve post liver transplantation nursing instruction. Chang Gung Nursing, 21(3), 323-334.]