探討自體高濃度血小板血漿注射退化性膝關節炎病人之焦慮、不確定感及其相關因素

An investigation on degenerative knee arthritis patient's anxiety, feelings of uncertainty and other associated factors before the procedure of autologous PRP injection

張瑟紋(Se-Wen Chang) ； 石惠美(Whei-Mei Shih) ； 吳素蘭(Su-Lan Wu) ； 王琦(Chi-Wang) ； 賀倫惠(Lun-Hei He) ； 詹益聖(Yi-Sheng Chan)

《健康科技期刊》 5卷1期 (2018/10) Pp. 48-67

https://doi.org/10.6979/TJHS.201810_5(1).0004

摘要

目的：自體高濃度血小板血漿（PRP）關節注射，是目前治療退化性膝關節炎方法之一。本研究以結構式問卷調查法，探討病人接受PRP治療之不確定感及焦慮程度。方法：以北部某醫學中心，罹患退化性膝關節炎，首次接受「自體高濃度血小板血漿關節注射」的骨科病人為研究對象。利用病人關節注射治療前之等候時間，填寫「基本屬性登錄表」，「疾病不確定感量表」及「貝克焦慮量表」，並採用SPSS 20.0版統計套裝軟體，進行相關統計分析。結果：共收錄90位符合條件的個案。疾病不確定感得分平均為61.61±14.94。焦慮得分平均為23.23±8.62，其中15人（16.7%）有輕度焦慮，47人（52.2%）有中度焦慮，28人（31.1%）有嚴重焦慮。病人焦慮程度與不確定感有顯著的正相關（p=0.029）。女性比男性焦慮程度高（p=0.024）。低經濟收入者比高經濟收入者焦慮程度高（p=0.007）。教育程度愈低者，焦慮程度愈高（p=0.014）。注射前等候時間較長者，焦慮程度較高（p=0.036）。結論：接受關節PRP注射之病人，疾病的不確定感與焦慮有相關。護理之重點為：病人接受關節注射治療前，應提供更充分的醫病溝通，手術室與門診護理師做跨部門合作，提供護理衛教資訊。尤其針對女性、低經濟收入及教育程度較低者，是特別需要加強的對象。

關鍵字

自體高濃度血小板血漿 ； 焦慮 ； 不確定感

並列摘要

Objective: Intraarticular injection of autologous platelet-rich plasma is a new treatment for degenerative knee osteoarthritis. This study adopts a structured questionnaire to investigate uncertainty and anxiety levels of patients before receiving intraarticular injections. Methods: Orthopedic patients suffering from degenerative knee arthritis in a medical center in northern Taiwan, and who were undergoing intraarticular injection of autologous platelet rich plasma for the first time, were included as the research objects. During the waiting time for the intraarticular injection therapy, patients were asked to fill in the ＂basic attribute registration form＂, ＂disease uncertainty scale＂ and ＂Baker anxiety scale＂. Using SPSS 20.0 statistical package software, a relevant statistical analysis was conducted. Results: A total of 90 eligible cases were included. The average score for disease uncertainty was 61.61±14.94. The average score for anxiety was 23.23±8.62. Among these scores, 15 patients (16.7%) had mild anxiety, 47 (52.2%) had moderate anxiety and 28 (31.1%) had severe anxiety. There was a significant positive correlation between patient anxiety and uncertainty before intraarticular injection (p=0.029). Women had higher anxiety levels than men (p=0.024). Patients with low incomes had higher anxiety level than patients with high incomes (p=0.007). Lower education levels were correlated with higher anxiety levels (p=0.014). Longer waiting times before the intraarticular injections were correlated with higher anxiety levels (p=0.036). Conclusions: The uncertainty of the disease is related to anxiety in patients receiving PRP intraarticular injections. Key points for care provided before patients receive intraarticular injection treatment include more comprehensive communication among doctors, nurses and patients, and cross-sector cooperation between operating room nurses and out-patient department nurses in providing relevant health care education. Patients who are women or who have low economic incomes or low education levels should be given more attention during nursing care.

並列關鍵字

Platelet- Rich Plasma ； Anxiety ； Uncertainty

參考文獻

內政部統計處（2017 年，3 月11 日）。106 年第10 週內政統計通報(105年底人口結構分析)。取自http://www.moi.gov.tw/stat/news_content.aspx?sn=11735

朱正一、曾稼志(2011)。骨科手術病人之健康知能、知覺同理心、術前資訊理解程度與術前焦慮之探討。醫務管理期刊。12(3)，177-190。

江正陽、徐振祥、黃良吉、林喬棣、林淑君、傳鍔(2005)。血小板豐厚血漿在牙周骨缺損之應用。中華牙周醫誌。10(4)，261-270。

江鴻生(2015)。膝關節骨科醫學與微創手術。台灣醫學。19(1)，30-35。

車先蕙、盧孟良、陳錫中、張尚文、李宇宙(2006)。中文版貝克焦慮量表之信效度。台灣醫學。10(4)，447-454。