足部照護教育課程對血液透析合併糖尿病病患之成效

Effects of the Foot Care Course for the Hemodialysis Patients with Diabetics Mellitus

謝湘俐(Hsiang-Li Hsieh) ； 孫嘉玲(Jia-Ling Sun) ； 張春鳳(Chun-Feng Chang) ； 楊惠娟(Hui-Chuan Yang) ； 薛雅菁(Ya-Ching Hsueh) ； 黃小玲(Hsiao-Ling Huang) ； 彭鈺貞(Yuh-Chen Peng) ； 許珮芸(Pei-Yun Hsu) ； 謝琬琦(Wan-Chi Shie)

《臺灣腎臟護理學會雜誌》 5卷2期 (2006/12) Pp. 31-43

摘要

糖尿病為國人十大死因的第四位，罹患糖尿病後，不良的照顧會使病患罹息合併症的機會增加，如腎臟疾病或足部病變。因此，衛生指導便成為相當重要的課題，故本研究的目的即在比較二種足部照護課程對血液透析合併糖尿病病患的效果。本研究為類實驗設計，對象取自於台北縣某區域醫院的血液透析室，接受血液透析且診斷第2類型糖尿病者，共計56名，採隨機分派成二組，其中一組接受單張文字衛教，另一組給予錄影帶及衛教手冊之教學課程，共實施四次測驗，前測於足部照護課程前，後測則分別於課程後立即測、二天後之再測及課程後兩個月測驗，以追蹤足部照護課程之延遲效益。研究結果顯示：一、不同的教育課程方式介入，兩組對足部照護的前後測，在統計上分別有顯著差異。二、不同衛教方式在兩組之間無顯著差異。三、兩種衛教方式在施行兩個月後，兩組對足部照護衛教之瞭解仍具成效。足部照護衛教可提升血液透析合併糖尿病病患對足部照護之瞭解，建議照顧此類病患至少要使用文字型的足部衛教方式，以提升足部照顧知識。

關鍵字

糖尿病 ； 血液透析 ； 衛教方案 ； 足部照護

並列摘要

Diabetes Mellitus (DM) is the fourth leading cause of deaths in Taiwan. Without proper care, diabetic patients would get multiple complications more probably, such as kidney disease and foot pathogen. Therefore, it is most important to educate the patients with DM. Thus this study would focus on evaluating and comparing different effects of the two foot-care education courses on diabetic patients in hemodialysis. This quasi-experimental research would take 56 patients as subjects from the hemodialysis center of certain local hospital in Taipei County who accepted hemodialysis and were diagnosed with type II diabetes. Then they would be randomly divided into two groups, one instructed only with one handout of hygienic education, while the other educated with videotape and a well-designed handbook. All of them would be tested for four times, including a pretest practiced before the class and posttests immediately after the class as well as two days later so as to trace the delayed effects of the foot-care course. The results show: 1. There are significant statistic differences between the pretest and posttests of the two groups after they received different educational interventions. 2. There is no clear difference between the varied teaching-method of hygienic for the two groups. 3. Two months after the two varied hygiene education models, the evidence indicates that the effects of understanding for the class in both groups have still been remained. It is obvious that the class could help hemodialysis patients complicated with diabetes to enhance their understanding of foot-care, so it is suggested that the printed form of foot-care hygiene education should be used at least while caring for such patients so as to step up their knowledge of foot-care. The main purpose of this research is to compare the effects of those two classes of foot-care education for the hemodialysis patients complicated with diabetes.

並列關鍵字

diabetes mellitus ； hemodialysis ； education program ； foot care