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多媒體護理指導緩解冠狀動脈成形術後心肌梗塞病患焦慮及疾病不確定感之成效

The Effectiveness of Multimedia Nursing Education on Reducing Illness-Related Anxiety and Uncertainty in Myocardial Infarction Patients after Percutaneous Coronary Intervention

摘要


Background: Properly educating myocardial infarction (MI) patients in the extremely busy cardiac care unit (CCU) work environment is difficult for CCU nurses.Purpose: This study examined the effectiveness of multimedia nursing education in reducing illness-related anxiety and uncertainty in MI patients following percutaneous coronary intervention (PCI).Methods: A quasi-experimental study with judgment sampling was designed and performed at a medical center in South Taiwan. The control group (n = 36) received written nursing education material and the experimental group (n = 40) received multimedia nursing education. Participant illness-related anxiety and uncertainty was measured at four specific periods, namely (1) at admission to the CCU, (2) immediately after completing the nursing education interventions, (3) upon transfer to the general ward, and 4) at discharge. Measurement tools included Mishel's uncertainty in illness scale (MUIS), the state-trait anxiety inventory (STAI), and noninvasive physiological monitoring instruments.Results: Results showed that both interventions lowered anxiety / uncertainty in participants with moderate to severe levels (experimental group - anxiety: t(subscript 39) = -6.615, p < .001 and uncertainty: t(subscript 39) = -8.317, p < .001; control group – anxiety: t(subscript 35) = -4.767, p < .001 and uncertainty: t(subscript 35) = -9.739, p < .001). The experimental group achieved significantly greater reductions than the control group in terms of anxiety and uncertainty in each of the four measurement periods.Conclusions / Implications for Practice: Based on the evidence, both nursing education formats are valid for patient education and may be chosen based on CCU clinical conditions.

並列摘要


Background: Properly educating myocardial infarction (MI) patients in the extremely busy cardiac care unit (CCU) work environment is difficult for CCU nurses.Purpose: This study examined the effectiveness of multimedia nursing education in reducing illness-related anxiety and uncertainty in MI patients following percutaneous coronary intervention (PCI).Methods: A quasi-experimental study with judgment sampling was designed and performed at a medical center in South Taiwan. The control group (n = 36) received written nursing education material and the experimental group (n = 40) received multimedia nursing education. Participant illness-related anxiety and uncertainty was measured at four specific periods, namely (1) at admission to the CCU, (2) immediately after completing the nursing education interventions, (3) upon transfer to the general ward, and 4) at discharge. Measurement tools included Mishel's uncertainty in illness scale (MUIS), the state-trait anxiety inventory (STAI), and noninvasive physiological monitoring instruments.Results: Results showed that both interventions lowered anxiety / uncertainty in participants with moderate to severe levels (experimental group - anxiety: t(subscript 39) = -6.615, p < .001 and uncertainty: t(subscript 39) = -8.317, p < .001; control group – anxiety: t(subscript 35) = -4.767, p < .001 and uncertainty: t(subscript 35) = -9.739, p < .001). The experimental group achieved significantly greater reductions than the control group in terms of anxiety and uncertainty in each of the four measurement periods.Conclusions / Implications for Practice: Based on the evidence, both nursing education formats are valid for patient education and may be chosen based on CCU clinical conditions.

參考文獻


丁賢偉、詹前隆(2009).互動式衛生教育系統對下背痛衛生教育之效果.醫護科技期刊,11(4),235-247。
李以文、徐亞瑛、曾春典、藍忠孚(2003).心導管檢查之冠心病患者衛生教育的成效.台灣醫學,7(2),185-193。
王曼溪(2000).如何製作好讀易懂的書面衛教資料.台灣醫學,4(3),334-337。
許淑蓮(2000).初患心肌梗塞病人不確定感與焦慮反應─因應行為之探討.護理研究,9(2),159-171。
許淑蓮、黃秀梨(1996).Mishel疾病不確定感量表之中文版測試.護理研究,4(1),59-68。

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