探討應用PRECEDE-PROCEED模式對心肌梗塞病人的疾病認知及健康促進生活型態的影響

Exploring the effect of PRECEDE-PROCEED mode on disease knowledge and health promotion lifestyle of patients with myocardial infarction

李京郁(Ching-yu Li)

指導教授 ： 黃正宜

中山醫學大學/醫學院/護理系長期照護碩職專班/碩士(2022年)

https://doi.org/10.6834/csmu202200273

摘要

研究背景：心血管疾病為台灣十大死因第二位，死亡率最高的急性心肌梗塞高達30.36%。預防心肌梗塞再發作最為關鍵，病人對疾病的認知及健康生活型態至關重要。應用PRECEDE- PROCEED 照護模式提供整體評估及個別化教育介入，提升疾病認知及健康生活型態，養成良好的健康生活型態，預防心血管疾病再發生。
研究目的：探討應用 PRECEDE- PROCEED 模式對心肌梗塞病人的疾病認知及健康促進生活型態之影響。
研究方法：本研究採介入型研究設計、方便取樣方式，分為介入組及對照組。研究場所為中部某醫學中心臟內科病房，選取心肌梗塞病人為研究對象。研究工具包括 PRECEDE- PROCEED 模式介入、冠狀動脈疾病認知、健康促進生活型態量表。於應用PRECEDE- PROCEED 模式介入前、後以量表進行測量。收案期間從2020年6月至2021年4月，為期10個月，研究資料與SPSS 22.0版進行資料統計分析，以描述性統計及t檢定進行兩組間之差異比較。
研究結果：本研究共收案70位病人，研究結果發現，介入組及對照組兩組進行前、後測比較，介入組疾病認知得分由17.68 上升到25.54，達顯著差異（P <0.000），對照組疾病認知得分由對照組認知方面得分由17.71上升到17.88，差異未達顯著（P = 0.644）。介入組健康促進得分由分由99.82上升到126.71，達顯著差異（P <0.000），對照組促進總分由100.05 上升到100.60，未達顯著差異（P = 0.871）。
結論：應用 PRECEDE- PROCEED模式於臨床實務上，團隊成員可正確掌握病人資訊，個別性的衛教需求設計，再透過實際與病人討論溝通，透過持續學習反饋及個管師持續追蹤，雙向溝通回饋讓病人更有參與感，提供病人更好照護品質。

關鍵字

心肌梗塞 ； PRECEDE- PROCEED 模式 ； 疾病認知 ； 健康促進

並列摘要

Background: Cardiovascular diseases were the second in the top ten leading death in Taiwan among which Acute Myocardial Infarction (AMI) was the highest mortality rate of 30.36%. To prevent AMI recur, the awareness of the disease and healthy lifestyle are very important to the patients. In this study, we applied the PRECEDE-PROCEED Model for providing overall assessment and individual education for patients, to improve the knowledge of the disease and healthy lifestyle, and further develop a good lifestyle to prevent the recurrence of cardiovascular disease.
Objective: Investigating the effects of the PRECEDE-PROCEED model on the disease knowledge and the health-promoting lifestyle of the patients with AMI.
Research method: This study was an interventional research design and used convenience sampling, and was divided into an intervention group (experimental group) and a control group. The participants with AMI from cardiology department of a medical center in Taichung of Taiwan. We used PRECEDE-PROCEED Model, the disease knowledge of AMI and Health Promoting Lifestyle Profile-II (HPLP-II) scale as study methods to evaluate how benefits were to health before and after intervention. The trial enrollment was from June 2020 to April 2021 in 10 months. The results and the differences between two groups were statistically analyzed by descriptive statistics and t-test with SPSS 22.0 software.
Result：Seventy patients were sampled and divided into two groups, an intervention group (experimental group) and a control group with 35 samples each. The score of HPLP statistically significant increased from 17.68 to 25.54 in the experimental group after systemic intervention (disease knowledge improvement) (p < 0.000). The HPLP score of the control group without significant difference from 17.71 to 17.88 (p = 0.644).
The score of a fully implemented health promotion plan in the experimental group statistically significant elevated from 99.82 to 126.71 (p < 0.000), whereas the control group slightly increased from 100.05 to 100.60 without significant difference (p = 0.871).
Conclusion：Applying the PRECEDE-PROCEED model to clinical practice, the medial team can follow up patients’ information and design individual education for them, and then discuss with patients indeed. Through continuous health education with feedback and tracking by managers, two-way communication make patients more engaged and provides better quality of healthcare.

並列關鍵字

myocardial infarction ； PRECEDE-PROCEED model ； disease knowledge ； Health promoting behavior

參考文獻

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