以實驗設計分析多媒體麻醉衛教光碟 對病人術前焦慮與認知之影響

An experimental study of the effect of a video-assisted preanesthetic patient education on patient’s preoperative anxiety and cognition

林虹妙(Hung-Miao Lin)

指導教授 ： 盧 燕 嬌

中山醫學大學/護理學院/護理研究所/碩士(2010年)

https://doi.org/10.6834/CSMU.2010.00140

摘要

許多研究顯示多媒體的視覺效果有助於學習，至於系統性的護理指導則能顯著地降低病人的焦慮程度。有鑑於此本研究係參考國內外文獻並與多位麻醉專科醫師共同參與設計一套多媒體麻醉術前衛教光碟，目的讓病人了解即將接受全身麻醉的過程。
研究採立意取樣，隨機分組方式收案，採兩組前後測之實驗設計(Two-group pre-post test experimental design)。目的在分析多媒體麻醉衛教光碟對病人術前焦慮與認知之影響，並同時監測客觀性之生理指標。實驗組及控制組各30位進行全身麻醉的個案。實驗組個案接受6分鐘多媒體麻醉衛教光碟與麻醉術前訪視，控制組個案則採常規傳統麻醉術前訪視。研究工具為情境與特質焦慮量表、認知調查表及生理測量儀器。資料利用SPSS for window 16.0 套裝軟體進行描述性及推論性統計分析。
研究結果顯示，在情境焦慮量表分數，實驗組由11.50分明顯下降至8.90分(p=.033)。病患認知調查表方面，發現病人對麻醉方式的了解程度、應配合事項、麻醉步驟、術後注意事項及麻醉流程有顯著差異。生理指標方面，實驗組在心跳次數 (次/分鐘)，由前測77.73降至後測的72.63(p=.000)，呼吸次數 (次/分鐘)，由前測19.43 降至後測17.40 (p=.000)，血壓(mmHg)，由前測117.4/71.3 mmHg降至後測的114.9/76.6 mmHg (p=.008)。顯示實驗組在焦慮程度顯著降低，包括生理性與主觀感受性，代表個案在接受多媒體麻醉衛教光碟與麻醉術前訪視的確能使個案達到減緩焦慮的功效。臨床麻醉護理師在照護過程中，可以適時提供衛教光碟與麻醉術前訪視，減低個案焦慮感受。

關鍵字

多媒體衛教光碟 ； 麻醉術前訪視 ； 焦慮 ； 認知

並列摘要

Many studies have shown that the video-based instruction can facilitate patients’ cognitive learning, and that systematic nursing instruction was able to significantly lower the patient's anxiety. After reviewing relevant literature and with assistance of an anesthesiologist, the researcher designed a multimedia nursing instruction video to teach patients the process of general anesthesia.
The purpose of this experimental research study was to evaluate the effect of a preanesthesia teaching video on patients’ anxiety level and patients’ cognition learning . Subjects were randomized to either the control or the experimental group. The experimental group (n=30) received a 6-minute multi-media preanesthesia video instruction and a preanesthesia visit from a clinical nurse anesthetist, while the control group (n=30) received only a preanesthesia visit from the same nurse anesthetist.
Survey instruments included the Trait Anxiety Scale, a cognitive learning questionnaire and vital sign monitors to measure heart rate, blood pressure and respiratory rate. Data was then analyzed using the SPSS for window 16.0 software package. The results showed that state anxiety scores in the experimental group significantly decreased from the 11.50 to 8.90(p=.033). Patients’ cognitive learning showed better understanding of the general anesthesia process, preanesthesia instructions, postanesthesia instructions . Patients in the experimental group had significantly lower heart rate (pretest: 77.73; posttest: 72.63, p=.000), blood pressure (pretest: 117.4/71.3 mmHg; posttest: 114.9/71.3 mmHg, p=.008), and respiratory rate (pretest: 19.43; posttest: 17.40, p=.000). The results suggested the multimedia-based preanesthesia nursing instruction video was effective in the reduction of patients’ anxiety level. Thus, it was recommended that all patients undergoing general anesthesia receive a preanesthetic visit as well as a multimedia-based preanesthesua nursing instruction video to reduce their anxiety.

並列關鍵字

preanesthesia education ； multimedia-based nursing instruction video ； preanesthesia visit ； preanesthesia anxiety

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