老年住院病人預防跌倒衛生教育介入成效研究-以臺北縣立醫院為例

Evaluation of a Fall Prevention Education Intervention for Elderly Inpatients in Taipei County Hospital

沈希哲(Hsi-Che Shen)

指導教授 ： 陳政友

國立臺灣師範大學/教育學院/健康促進與衛生教育學系/博士(2010年)

摘要

本研究主要目的在於探討「老年住院病人預防跌倒衛生教育」之成效。本研究採「準實驗設計」，實驗組為臺北縣立醫院三重院區65歲以上內科病人50位；對照組為板橋院區65歲以上內科病人50位。
實驗組之介入教材包括：以健康信念模式為理論基礎之預防跌倒衛生教育DVD及手冊，教材內容包括1.生活起居注意（鞋具衣著注意、睡前注意、上下床注意）2.住院環境安排（日常物品擺設、地面、燈光）3.行動注意（行走及使用輔具注意，如輪椅、手杖、助行器等）等三大部分，進行衛教之人員則為受過訓練之研究員及醫院護理人員；對照組則採取原來衛教方式。實驗組與對照組皆接受前測、後測的「老年住院病人預防跌倒衛生教育介入成效問卷」調查。
本研究之重要結果如下：
一、老年住院病人預防跌倒衛生教育介入後，經共變數分析發現實驗組在「預
防跌倒知識」、「預防跌倒健康信念」、「預防跌倒行動線索」、「預防跌倒自我效能」與「預防跌倒行為」的分數皆顯著優於對照組，顯示老年住院病人預防跌倒衛生教育介入在「預防跌倒知識」、「預防跌倒健康信念」、「預防跌倒行動線索」、「預防跌倒自我效能」與「預防跌倒行為」等效標變項上皆產生效果。
二、老年住院病人預防跌倒衛生教育介入後，經共變數分析發現實驗組與對照組在「跌倒次數」上尚未顯著差異。
本研究中「跌倒次數」雖未產生效果，但依據次數調整後平均數發現實驗組之後測跌倒次數低於對照組，可能由於觀察時間較短尚未產生效果，其效果有待較長時間之觀察。建議未來研究可延長觀察時間以及增加肌力訓練等衛生教育內容以增加其效果。

關鍵字

老人 ； 住院病人 ； 預防跌倒

並列摘要

The purpose of this study is to explore the effect of “health education of falling prevention for aged hospitalized patients”. In this study, we adopted “quasi-experiment design”--- the experimental group is the 50 patients of internal medicine who are over 65 in Sanchung Branch of Taipei County, while the control group is the 50 patients of internal medicine who are over 65 in Banqiao Branch of Taipei County.
The involving teaching materials for the experimental group include health education of falling prevention DVD and manual based theoretically on the model of health belief with the contents of 3 parts such as1.attentions for living（attention for footwear, attention before sleeping, attention for getting on and off bed）2.arrangement for hospitalizing environment（settings of daily utensils, ground, lights）3. attentions for actions（attentions for walking and using assistives like wheelchairs, canes and walking-assisting device）, and the health educational personnel are the trained researchers and nurses in hospital; as for the control group, it adopted the previous health education. Both experimental group and control group accepted pre-test and post-test of the survey of “questionnaires for the involving effect of health education of falling prevention for aged hospitalized patients”.
The important results of this study are as follows:
I. After the involvement of health education of falling prevention for aged hospitalized patients, through the analysis of covariance, we find experimental group’ scores in “knowledge of falling prevention”, “health belief of falling prevention”, “action clue of falling prevention”, “self-efficacy of falling prevention” and “behavior of falling prevention” are all better than those of control group showing that the involvement of health education of falling prevention for aged hospitalized patients created effects the validity variables of “knowledge of falling prevention”, “health belief of falling prevention”, “action clue of falling prevention”, “self-efficacy of falling prevention” and “behavior of falling prevention”.
II. After the involvement of health education of falling prevention for aged hospitalized patients, through the analysis of covariance, we find there is no salient deviation in “frequency of falling” between experimental group and control group.
In this study, though “frequency of falling” doesn’t have effect, but according to the average after frequency adjustment, we find the post-test frequency of falling is fewer than that of control group; this is possibly because the short time of observation didn’t create effect, so its effect needs longer time of observation. We suggest, in the future researches, they can prolong time of observation and increase such health education content as muscle force training to enhance its effect.

並列關鍵字

aged persons ； hospitalized patients ； fall prevention

參考文獻

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