燒傷病患出院後壓力感受、壓力處理自我效能及其相關因素探討

Stress, Stress Management Self-Efficacy and Related Factors of Burn Patients Following Hospitalization

李雅文(Yea-Wen Lee) ； 易麗珍(Lee-Chen Yi) ； 陳雅玲(Ya-Ling Chen) ； 黃靜宜(Chin-Yi Huang)

《實證護理》 1卷4期 (2005/12) Pp. 273-282

https://doi.org/10.6225/JEBN.1.4.273

摘要

本研究在探討出院後燒傷病患壓力感受、壓力處理自我效能及其相關因素。以中部某醫學中心1999年2月至2002年2月間完成燒傷治療出院返家三年內之燒傷病患為對象，採立意取樣，並以郵寄方式寄出349份問卷，共收回101份有效問卷(289%)。問卷內容包含三部份，第一部份是人口學資料；第二部份是疾病特性及照護；第三部份是出院後燒傷病患壓力量表，共23題，每題又分成二部分，分別是壓力感受程度（困擾的程度）及壓力處理自我效能（可以克服或解決之程度）。信度採內在一致性Cronbach's α達．92，效度則為專家內容效度，共5位專家，專家內容效度指標(Content Validity Index, CVI)達．8，以描述性統計、皮爾森相關、ANOVA、MANN-WHITNEY U test進行統計分析。結果發現：(1)壓力感受排名前三名是傷口癢、傷口痛、皮膚怕熱或對熱敏感。(2)壓力處理自我效能排名前三名分別是對接受疤痕修復而有經濟方面困擾、疤痕攣縮造成日常生活困擾、因皮膚不適如痛癢而造成睡眠受干擾。(3)是否穿彈性衣(p=.00)、是否參加支持性團體(p=.02)之壓力感受有顯著差異；此次燒傷後住院時間長短(p=.01)及燒傷面積(p=.00)和壓力感受有顯著相關。(4)是否穿彈性衣(p=.00)、是否參加支持性團體(p=.02)與壓力處理自我效能有顯著差異；此次燒傷後住院時間長短(p=.00)及燒傷面積(p=.03)和壓力處理自我效能有顯著相關。研究結果可提供燒傷醫療團隊提供更完整的出院病患照護方向之依據。

關鍵字

燒傷 ； 壓力感受 ； 自我效能 ； 出院病人

並列摘要

This study examined the stress and self-efficacy experiences of post-hospitalization burn patients. Study subjects were purposefully sampled to include patients who had been treated at a burn center in central Taiwan during the three-year period running from Feb. 1999 to Feb. 2002. A total of 349 questionnaires were mailed, with 101 questionnaires returned. Questionnaires comprised three sections covering demographic data; condition characteristics and care; and stress factors and issues. Each of the 23 questionnaire topics was divided into two sections that evaluated stress perception and the efficacy of stress self-help measures. Internal consistency reliability was checked, achieving a Cronbach°¶s £\ value of .92. Expert validity was used, which indicated a content validity index of .8. Study results included the following: (1) The three primary indices of stress perception in study subjects included itching, pain, and fear of heat (or skin heat sensitivity); (2) The three primary indices of self-efficacy included financial problems related to scar repair; disturbance caused by scar contraction; and sleep difficulties caused by skin discomfort; (3) Significant factors influencing subject stress levels included whether or not the subject wore pressure garments (p=.00), whether or not the subject participated in a support group(p=.02); length of hospitalization(p=.0l); and the total body surface area (TBSA) of subject burns(p=.00); (4) Factors found to significantly influence self-efficacy included the wearing of pressure garments(p=.00); support group participation(p=.02); length of hospitalization(p=.00); and TBSA of subject burns(p=.03). The results of this study indicate that the burn team should provide a comprehensive discharge plan and direct social resources to assist burn patients following their release from the hospital.

並列關鍵字

burn ； stress ； self-efficacy ； post-hospitalization patients