以衛教APP提升中風病人之中風知識和生活品質─隨機對照試驗研究

背景：為使中風病人了解中風和其危險因子的產生，以預防再中風，實是當今長照領域的重要臨床議題，但是現今國人對腦中風的知識仍然缺乏正確的觀念，不僅會影響本身的健康與生活品質，甚至造成整體醫療資源的浪費。目的：本研究發展一套以預防中風病人再次中風的衛教內容，並且以行動醫療的衛教方式進行衛教APP的介入，以有效提升中風病人的中風知識與生活品質。方法：本研究以單盲隨機對照試驗，將篩選76位中風病人至介入組（n=38）與對照組（n=38）且簡易智能測驗（MMSE）大於24分，為期10天到30天的APP衛教介入後以「中風知識問卷」與「歐洲五維健康量表（EQ-5D indexs和EQ-5D VAS）」測量中風知識和生活品質，統計結果在介入前以卡方檢定、獨立樣本t檢定進行兩組的人口學屬性、中風程度、生活品質與知識分析；在介入後以獨立樣本t檢定進行兩組的中風知識與生活品質的比較分析。結果：本研究總共納入63位中風病人，介入組（n=30）、對照組（n=33），介入後在中風知識部分，介入組與對照組在介入後的分數皆顯著提升（P<0.05），然而介入後兩組間的分數比較未呈現顯著差異（P=0.434）；在生活品質的部分，EQ-5D indexs 與EQ-5D VAS介入組與對照組在介入後的分數未呈現顯著差異（P>0.05），以及EQ-5D indexs 與EQ-5D VAS在介入後兩組間的分數也未呈現顯著差異（P=0.073）討論：本研究結果發現中風病人可經由中風衛教APP與手冊衛教方式提升中風知識；而在生活品質部分，中風衛教APP與手冊衛教方式皆無法有效提升中風病人的生活品質。未來貢獻：本研究結果在以APP提供中風病人衛教知識有顯著且正向的影響，但對於生活品質無顯著的差異，本研究為台灣首款以行動醫療整合中風危險因子的中風衛教APP，並期許能提供未來照護服務之行動醫療系統介入之參考。

關鍵字

中風；中風知識；生活品質；衛生教育；行動醫療

並列摘要

Background：Up to date, the stroke knowledge of Taiwanese people is insufficient leading to lots of cost wasted. Furthermore, there are more and more stroke patients with poor health and quality of life. Therefore in order to prevent stroke patient from stroke again, allowing stroke patients understand the risk factors of stroke is an important issue in the practical field of long-term care purpose：This study had developed an APP that provides health education about preventing stroke patients from stroke again. That can improve stroke knowledge and quality of life in stroke patients. Method：This study employed a single-blind, Randomized controlled trial design. Seventy-six stroke patients were randomly assigned to the health education APP intervention experimental group (n=38) and traditional paper control group (n=38). Subjects of this study had all been diagnosed a stroke and been tested with Mini-Mental Status Examination scoring more than 24. After 10-30 days of the health education APP intervention, the Stroke Knowledge Questionnaire and EuroQOL Instrument will be filled. Participation：76 individuals （30 in experimental group；33 in control group） diagnosed stroke and MMSE scores >24 .Intervention：10-30 days of the health education APP were intervened to improve the stroke knowledge and quality of life. Measurements：The primary outcome was the stroke knowledge, assessing by the Stroke Knowledge Questionnaire. The secondary outcomes were quality of life, assessing by the EuroQOL five dimensions questionnaire （EQ-5D）. Results：Our results supported that the health education APP produced significant improvement in stroke knowledge between groups but the EQ-5D has no significant improvement. Conclusions：The findings supported the clinical efficacy of the health education APP in stroke patients to improve knowledge and quality of life