多媒體影音光碟介入對護理人員執行失能者功能評估知能成效之探討

The effectiveness of applying multimedia to train nurses’ competency for functional assessment of the disabled

江蕙娟(Hui-chaun Chiang)

指導教授 ： 胡月娟

中臺科技大學/護理學院/護理研究所/碩士(2010年)

摘要

失能者功能評估可做為連結各項長照服務的依據，亦可做為獲得照護成效的客觀憑據，其中日常生活功能量表(ADLs)及工具性日常生活功能量表(IADLs)是廣泛運用於長期照顧領域的評估量表。多媒體在教學的成效已獲世人肯定，本研究目的為藉由日常生活功能量表及工具性日常生活功能量表的多媒體案例教學，以探討其對護理人員執行失能者功能評估知能之成效。本研究為類實驗設計，採立意取樣法，研究對象為兩家同等級署立醫院護理之家、慢性或復健病房，同意參與研究之護理人員，共計實驗組30名及對照組32名。實驗組接受「多媒體影音光碟教學」方案，以護理人員失能者功能評估成效量表，在執行介入方案前及介入方案後第2、第4週及第8週，評值護理人員執行失能者功能評估知識與評估案例之正確性，並佐以深入訪談及錄音方式收集質化資料，以了解實驗組護理人員的對多媒體教學方案之學習感受、看法及訓練後對臨床評估之影響。對照組則以相同量表做前測，及第2、第4週共計3次評量。以卡方檢定、獨立樣本t檢定實驗組與對照組之同質性，採共變數分析探討多媒體影音光碟介入方案的效果。研究結果顯示，與對照組做比較，接受多媒體教學方案之護理人員，其失能者功能評估之知識程度有顯著提升(p ＜ .001)；日常生活功能量表(ADLs)及工具性日常生活功能量表(IADLs)案例評估準確度，實驗組高於對照組，且達統計學上的顯著差異(p＜ .01；p ＜ .05)；再者，學習成效在介入措施後8週仍維持顯著差異。訪談資料分析結果顯示，實驗組護理人員認為多媒體影音光碟可加深印象，在學習上具彈性自由度高，並能提升臨床評估的自信。建議可運用至臨床實務教學，或併入在職教育訓練方案，以增加長期照顧從業人員對失能者功能評估的能力，進而擬訂個別化照護計畫，以提升照護品質。

關鍵字

工具性日常生活功能量表 ； 日常生活功能量表 ； 多媒體

並列摘要

Functional assessment of disability would be linked to long term care service and be used to assess the effects of nursing care objectively. Activities of daily living (ADLs) and instrumental activities of daily living (IADLs) are used widely in daily living assessment of long term care. The effectiveness of multimedia teaching is confirmed. The purpose of this study was to explore the effectiveness of applying multimedia to train nurses’ competency for functional assessment of the disabled. The study was quasi-experimental design and purposive sampling in nursing home, chronic ward and rehabilitation ward of two Department of Health Executive Yuan, R.O.C. hospitals. There were thirty nurses in experimental group and thirty-two nurses in control group. The experimental group received multimedia teaching protocol. The nurse’s competency for functional assessment of disability scale was used to evaluate the knowledge of performing functional assessment of disability and the accuracy of assessment. The post-test was performed two weeks, four weeks and eight weeks after intervention approach and was used to understand the maintenance of knowledge and skill. Depth interviews and recording were used to collect qualitative data for understanding the attitude change of experimental group. The control group was assessed three times in pretest, two weeks and four weeks respectively. Chi-Square test and independent t-test were used to analyze the homogeneity of experimental group and control group. Analysis of ANCOVA was used to explore the effectiveness of multimedia intervention protocol. The result showed nurses receiving multimedia teaching protocol improved the knowledge of functional assessment of disability significantly(p ＜ .001) . The accuracy of assessment of ADLs and IADLs was higher in experimental group than control group and reached statistical significance(p＜ .01；p ＜ .05). The effectiveness of learning could be maintained significantly eight weeks later after receiving intervention protocol. The analysis of interview data for experimental group demonstrated multimedia deepened impression, was more flexible in learning, and improved self-confidence of clinical assessment. The study suggests multimedia can be used in clinical teaching and continuing education to improve the competency of functional assessment of disability for long term care personnel, and plan the individualized intervention to improve care quality.

並列關鍵字

IADLs ； multimedia ； ADLs

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