多媒體教材與衛教手冊於糖尿病患藥物衛教之成效分析

( (一)背景及目的：糖尿病自1987年以來已高居台灣前5大死因，盛行率亦不斷增加，至2025年世界衛生組織預估有三億三千萬名糖尿病患。在民眾缺乏對糖尿病的認知以及缺乏適當的醫療資源時，將導致糖尿病併發症很快的發生。藥師利用多媒體教材或衛教手冊教導糖尿病患疾病、自我照護及正確用藥觀念後，比較不同教材，對糖尿病患藥物與疾病的認知及滿意度之影響。 (二)方法：於101年1月至101年7月編輯印製衛教手冊與錄製多媒體教材，擷取101年08月至101年10月住院之糖尿病患者，針對糖尿病及用藥觀念給予前測，分別提供衛教手冊或以平板電腦觀看多媒體教材讓病患自我學習後，再進行後測，最後由藥師對病患加強衛教正確用藥觀念，並給予滿意度問卷調查。 (三)結果：分析兩種教材衛教前後檢測結果，病患在疾病及自我照護認知觀念都有顯著進步(平均分數由8.33±2.97提升至16.37±2.98, p＜0.001)；其中使用多媒體教材者，認知進步程度顯著高於衛教手冊者 (9.33±2.54 vs 6.73±3.25, p=0.001)。在藥物認知問卷，兩種教材衛教前後也有顯著性的認知進步(平均分數由12.00±1.17提升至14.55±0.85, p＜0.001)，多媒體教材組認知進步分數亦顯著高於手冊組（3.03±1.81 vs 2.07±1.48, p=0.027）。對教材整體滿意度，多媒體教材滿意度高於衛教手冊（44.20±4.71 vs 39.27±5.17, p＜0.001）；對藥事服務滿意度，「藥師提供教材對您是有幫助的」，多媒體教材滿意度高於衛教手冊（4.73±0.45 vs 4.37±0.67, p＜0.05）。 (四)結論：本研究確立藥師參與糖尿病照護的正面影響，由藥師提供教材對於糖尿病病患自我學習是有幫助的；並且提供住院病患平電腦觀看多媒體教材，相較於衛教手冊組，對病患之疾病、自我照護與藥物認知觀念，可達相同或較高的認知進步。

關鍵字

糖尿病；糖尿病衛教；多媒體教材；衛教手冊；滿意度

並列摘要

Background: Diabetes is one of the top five causes of mortality in Taiwan since 1987. Low literacy on diabetes knowledge and improper treatment leads to rapid progress of complications. There is evidence that patient education provided by pharmacists improve diabetes knowledge. Aim: Assess the difference in knowledge improvement using multimedia program and printed manual and analyze patient satisfaction with pharmaceutical services in diabetes. Method: We recruit diabetic patients hospitalized between August and October 2012. A pre-and post-test on diabetes knowledge followed by self-education by watching the multimedia program or reading the printed manual. Satisfaction questionnaire was given at the completion of patient education on diabetes medication. Results: Intervention of multimedia or printed manual showed significant improvement in understanding the disease and self-care (mean score of 8.33±2.97 to 16.37±2.98, p<0.001). The multimedia group showed better improvement in knowledge than printed manual (9.33±2.54 vs. 6.73±3.25, p=0.001). There was also a significant raise in knowledge of diabetes medication (mean score of 12.00±1.17 to 14.55±0.85, p<0.001), with better improvement in the multimedia group than printed manual (3.03±1.81 vs. 2.07±1.48, p=0.027). Overall satisfaction with the multimedia program is higher than using printed manual (44.20±4.71 vs. 39.27±5.17, p<0.001). Conclusion: As compared to printed manual, the use of multimedia device to intervene in diabetes learning was as effective or demonstrated better outcomes in raising knowledge about the disease, diabetes self-care and medication.