團體多媒體護理指導光碟對心導管檢查病人認知及焦慮成效之探討

目的：本文旨在比較團體多媒體護理指導光碟模式與傳統衛教模式於心導管檢查病人，其檢查前後自我照護認知程度與自覺焦慮分數之差異。方法：本研究採類實驗研究設計，以方便取樣方式選取某醫學中心心臟內科病房預接受心導管檢查之病人為研究對象，依時間劃分為控制組及實驗組，2015年1月至6月入院病人者為控制組，2015年7月至12月入院病人者為實驗組。實驗組在檢查前一天主責護理師提供四份常規紙本護理指導單張後，於19:00以團體衛教方式給予觀看多媒體心導管護理指導光碟，之後病友間提問及分享討論，再由主持護理師進行問題解答，控制組由主責護理師給予四份常規紙本護理指導單張進行衛教指導，並再由病人提問由主責護理師進行問題解答。結果：在接受護理指導後，「心導管檢查前後自我照護認知」與「護理指導滿意度」方面，實驗組（M = 7.11±1.53, 4.43±0.58）的得分皆高於控制組（M = 4.83±1.53, 3.40±0.77），顯示實驗組個案的術後照護認知程度及滿意度都較控制組好（p ＜ .05）；而在「提供護理指導後自覺焦慮分數」方面，實驗組（M =2.93±1.31）的得分低於控制組（M = 3.37±1.30），顯示實驗組有較低程度的焦慮情形。經過共變數分析（ANCOVA），在「心導管檢查前後自我照護認知」之介入成效，實驗組的分數（M= 6.82）顯著高於控制組（M = 5.29）（F = 21.75, p ＜ .001），顯示實驗組的心導管檢查術後照護認知高於控制組，亦表示個案接受多媒體衛教會較紙本或口頭衛教有更佳的認知成效。結論：團體多媒體衛教除可提供臨床護理人員完整與一致性之衛教內容外，亦可提供行政管理者作為提升心導管檢查病人的衛教滿意度，以及改善持續性照護品質之策略措施。

關鍵字

心導管檢查；多媒體護理指導光碟；冠狀動脈疾病

並列摘要

Objectives: This study investigated the effects of group nursing instruction using multimedia to improve patient self-care knowledge, anxiety, and satisfaction in patients prior to cardiac catheterization procedure. Methods: This was a quasi-experimental research design using a convenient sampling to recruit patients that were scheduled to receive cardiac catheterization at the cardiology ward of a medical center. The participants were divided into the control and experimental groups based on the time they were admitted. Patients admitted to the center between January 2015 and May 2015 were assigned to the control group and patients admitted between June 2015 and October 2015 were assigned to the experimental group. Results: The participants in the experimental group had significantly higher scores of self-care knowledge (7.11 ± 1.53 vs 4.83 ± 1.53, p ＜ .001) and patient satisfaction (4.43 ± 0.58 vs 3.40 ± 0.77, p ＜ .001) than those of control group. The level of anxiety of the experimental group (2.93 ± 1.31) was lower than the control group (3.37 ± 1.30)(p = 0.047), indicating that participants in the experimental group were less anxious compared with participants in the control group. ANCOVA was conducted to explore the intervention effectiveness of post cardiac catheterization care knowledge in this study. The experimental group scored (M = 6.82) which was significantly higher than the control group (M = 5.29; F = 21.75, p ＜ .001), indicating that participants in the experimental group had more knowledge of self-care than participants in the control group. Conclusion: The results indicated that compared to paper-based and orally delivered health education, multimedia group nursing instruction was more effective in improving participants' knowledge of relevant care, increasing patient satisfaction, and decreasing the anxiety level in patients receiving cardiac catheterization. Clinical nurses may use multimedia group nursing instruction to provide more comprehensive and consistent health education.

並列關鍵字

cardiac catheterization ； multimedia vidoes ； coronary artery disease

參考文獻

Cant, R. P., & Cooper, S. J. (2010). Simulation-based learning in nurse education: Systematic review. Journal of Advanced Nursing, 66(1), 3−15. doi:10.1111/j.1365-2648.2009.05240.x

Chair, S. Y., Chau, M. Y., Sit, J. W., Wong, E. M., & Chan, A. W. (2012). The psychological effects of a videotape educational intervention on cardiac catheterization patients. Contemporary Nurse, 40(2), 225-233. doi: 10.5172/conu.2012.40.2.225.

Munk, P. S., Isaksen, K., Bronnick, K., Kurz, M. W., Butt, N., & Larsen, A. I. (2012). Symptoms of anxiety and depression after percutaneous coronary intervention are associated with decreased heart rate variability, impaired endothelial function and increased inflammation. International Journal of Cardiology, 158(1), 173-176. doi: 10.1016/j.ijcard.2012.04.085

Ruffinengo, C., Versino, E., & Renga, G. (2009). Effectiveness of an informative video on reducing anxiety levels in patients undergoing elective coronarography: an RCT. European journal of Cardiovascular Nursing, 8 (1), 57-61. doi: 10.1016/j.ejcnurse.2008. 04.002

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團體多媒體護理指導光碟對心導管檢查病人認知及焦慮成效之探討

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