衛生教育指導對未通過首次聽力篩檢之新生兒產婦

閩嘉娜

指導教授 ： 姜逸群

國立臺灣師範大學/教育學院/衛生教育學系在職進修碩士班/碩士(2002年)

摘要

探討衛生教育指導課程對未通過首次聽力篩檢之新生兒產婦的焦慮程度、知識、信念之影響。本研究以台大醫院婦產科參加新生兒聽力篩檢首度未通過新生兒母親為樣本共113名，以隨機方式將其分成實驗組與對照組。重要結果如下：
一、 社會人口學特徵：年齡、生產胎次、分娩方式、流產次數、家庭社經等級，與知識無顯著相關。
二、 研究對象介入前之信念中，新生兒聽障出院後聽力追蹤檢查利益信念分別與「流產次數」呈現負相關，「分娩方式剖腹產較自然產的利益信念較強」，並呈現顯著差異。其他「自覺新生兒聽障罹患性、嚴重性信念與新生兒聽障出院後聽力追蹤檢查障礙性信念」與社會人口學特徵中年齡、生產胎次、家庭社經等級無顯著差異。
三、 研究對象介入前，研究對象知識答對率只有58%；焦慮程度方面普遍得分增高；健康信念方面，「自覺新生兒聽障罹患性和嚴重性」得分偏低，「自覺新生兒聽障出院後聽力追蹤檢查障礙信念」及「自覺新生兒聽障出院後聽力追蹤檢查利益性信念」則較為正向。

四、 實驗組在衛生教育介入後，其後測時之「新生兒聽力篩檢追蹤檢查知識」、「健康信念」、「焦慮程度」得分顯著優於前測；但對照組在相較下，其後測時「新生兒聽力篩檢追蹤檢查知識」、「焦慮程度」與前測相較無顯著差異。健康信念中只有「新生兒聽障出院後聽力追蹤檢查利益和障礙性」項目與前測相較有顯著差異，其他信念項目「自覺新生兒聽障罹患性和嚴重性」與前測相較無顯著差異。
五、 衛生教育介入後，實驗組與對照組在「新生兒聽力篩檢追蹤檢查知識、健康信念、焦慮程度」相較下有顯著差異。
整體來說，「衛生教育」能有效提昇研究對象之「新生兒聽力篩檢出院後聽力追蹤檢查知識」及減緩研究對象焦慮程度；並且降低研究對象自覺新生兒聽障「罹患性、嚴重性信念」與、產婦「自覺新生兒聽力追蹤檢查的障礙性信念」 認知，至於產婦帶寶寶參加新生兒聽力追蹤檢查的利益性部分，有提昇加強研究對象帶寶寶參加追蹤檢查確認聽障的認知。

並列摘要

This study is to explore the effects of intervention of the health education on the anxiety, knowledge, and health beliefs of the mothers whose newborn baby fails in hearing screening. One hundred and thirteen subjects from Obstetric Ward of National Taiwan University Hospital were included. Their newborn babies have participated but failed to pass the first hearing screeing test. The 113 mothers are random-sampled into the experiemental group and the controlled group. The exclusive results are listed as the following:
1. Knowledge is not significantly related to the demographic characteristics, such as age, numbers of delivery, the type of delivery, numbers of abortion, and family’s socioeconomic status.
2. Before the intervention of health education, the subjects’ perceived benefit of action of the follow up hearing test after discharge from the hospital was negatively related to abortion numbers. the perceived benefit of action of subjects after cesarean section is significantly stronger than that of those after natural spontaneous delivery. Other perceived beliefs are not significantly different from the three factors of demographic characteristics.

3. Before the intervention the correct rate for answering questionnaires of follow-up hearing test was 58%. The score in anxiety degree is high in average. Pertaining to the health beliefs, the scores were low for the perceived susceptibility and severidy of hearing loss. The perceived barrier of the follow-up hearing test after discharge from the hospital was negative where as the perceived benefit was more positive.
4. After the educational intervention, the experimental group showed significant improvement in items of health beliefs as well as the concept of follow-up hearing test and the anxiety in post-test.
In the control group, significant improvement in the perceived benefit and barrier of follow-up hearing test was showed in post-test where as no significant difference in concept, anxiety, perceived susceptibility and severity of hearing loss was showed in post-test.
5. After the educational intervention, the post-test showed significant differences in the concept of follow-up hearing test, anxiety state and all items of health belief between the experimental group and controal group.

In conclusion, the intervention of “health education” can efficiently improve the “concept of the follow-up hearing test after the hospital discharge,” and the study subjects’ anxiety. Meanwhile, the intervention of health education decreases the study subjects’ perceived susceptibility and severity of hearing loss, and barrier acknowledge as well as the perceived barrier of the follow-up hearing test after discharge from the hospital. The perceived benefit of the follow-up hearing test will encourage the study subjects to have their babies participate in the follow-up hearing test in order to confirm the hearing loss.