心臟手術病人居家期間克服壓力行為追蹤比較研究

Coping Behaviors of Heart Surgery Patients after Discharge - A Follow-Up Study

廖玟君(Wen-Chun Liao) ； 鄭靜瑜(Ching-Yu Cheng) ； 黃嗣棻(Suz-Fen Hwang) ； 張瑛(Ying Chang) ； 黃秀梨(Shiow-Li Hwang)

《慈濟醫學雜誌》 10卷3期 (1998/09) Pp. 221-229

https://doi.org/10.6440/TZUCMJ.199809.0221

摘要

心臟手術病人出院回家後仍需面對長期的心臟復健及心理社會適應過程，本研究的目的在追蹤比較心臟手術病人出院後一個月及六個月的克服壓力行為探討其影響因素。研究採敘述性、重屣測量法，以心臟手術病人克服壓力行為量表進行資料收集。研究對象為北部某醫學中心50位心臟手術病人。研究結果發現，心臟手術病人出院後一個月及六個月平均使用28及27項克服壓力行為，病人經常使用這些行為而且相當有效。病人出院後一個月以面對現實; 與醫護人員合作; 信任醫院及醫師的處理等方法來因應壓力；出院後六個月則以信任醫院及醫師的處理、與醫護人員合作、對自己有信心等為使用頻率高、效果好的克服壓力行為。已婚、教育程度低、社會階層低者，傾向於使用較多的情緒導個性行為，而年齡較、教育程度高者會使用較多項目的問題導向性行為。本研究結果可協助醫護人員了解手術病人居家復健期所使用的克壓力行為，並進一步有效地協助病人減少壓力，促進病人的恢復。

關鍵字

心臟手術 ； 居家期間 ； 克服壓力行為 ； 護理

並列摘要

Heart surgery patients are not only under a great deal of stress, they also have to make many adjustments in their lives after hospital discharge.The purpose of this study was to investigate the coping behaviors of heart surgery patients at 1 and 6 months after discharge. A descriptive repeated measure was used in this study. Fifty patients recovering from coronary artery bypass graft surgery or valve replacement surgery were interviewed using a coping scale. The results showed that heart surgery patients used 28 coping behaviors at 1 month and 27 coping behaviors at 6 months after discharge. There were 10 emotion-focused and 7 problem-focused coping behaviors used by the pa-tients which differed significantly between 1 and 6 months after discharge. The frequency and effectiveness of total coping behaviors, emotion-focused coping behaviors, and problem-focused coping behaviors showed statistically sig-nificant decreases from the first month to the six month after discharge. “Face reality”, “compliance with medical regime”, and “trust physician and hospital” were used most frequently and effectively by the patients 1 month after discharge, while “trust physician and hospital”,”compliance with medical regime”, and “confidence in myself” were the most important coping behaviors 6 months after discharge. Patients who were married, had low educational levels, and had low social status used more emotion-focused coping behaviors, while younger patients with high educational levels used more problem-focuwed behaviors. This study is helpful for the planning of nursing care for heart surgery patients during the first 6 months after hospital discharge.

並列關鍵字

heart surgery ； post-discharge ； coping ； nursing