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血液透析病患在罹病過程中之訊息需求探討

An Exploration of Education for Patients with Hemodialysis

摘要


在血液透析治療過程,護理人員所提供的衛生教育,即是讓個案能具備照護知識、自我照顧能力而能因應生活改變,但在進行衛生教育時,若未先瞭解病患的知識背景及訊息需求,難免會因衛教內容不符合病患所需而降低學習動機或誤解其需求。本研究之目的在了解血液透析病患在罹病過程中之訊息需求,並探討不同屬性病患其訊息需求之差異性。本研究爲描述相關性研究,以立意取樣、結構性問卷訪查南部某區域醫院洗腎室之血液透析病患,共收案120位。研究工具包括基本屬性問卷及尿毒症病患訊息需求量表,其量表內在一致性Cronbach's α係數爲.96,內容包含認識尿毒症、認識透析治療、了解腎臟移植可行性、了解透析治療對個人、家庭及社會的影響及了解飲食及水分控制五大層面,共的題,採四分法,每題由(1)不想知道至(4)非常想知道,整體量表分數越高代表個案訊息需求程度越高。所收集資料以spssl2.0版進行描述性統計、Mann-Whitney U跑到、Kruskal-Wallis Test及Spearman correlation分析。研究結果爲血液透析病愚整體訊息需求平均分數爲174.57分,而「了解飲食及水分控制」層面得分最高,平均得分2.94分,其次是「了解腎鵬移植可行性」層面,平均得分2.79分。最高訊息需求題項爲「如何申請政府對洗腎病人的補助或福利措施」及「中央健保局對洗腎愚者醫療給付的範圍」;腹膜透析如何植管」與「腹膜透析植管手術後的照顧」則爲需求性最低題項。年齡、教育程度、平常有無休閒活動及接受洗腎時間長短爲影響訊息需求之相關因素。此結果反應出血液透析病息對社會福利、醫療補助及腎移植等訊息有高度需求,故臨床實務建議發理人員將腎友可申請的社會補助、福利措施或腎臟移植資訊列入新病患護理常規衛教項目。機構亦需將此些議題列入在職教育宣導,如此,才能滿足病患在此層面的需求。

並列摘要


During hemodialysis, the nurse provides the patient with knowledge and information focusing on self care; therefore, the patient can adapt to the life change due to long-term treatment. However, without consideration of the patient’s educational background and learning needs, the provision of impractical educational information could lower patients' motivation to learn or misestimate their needs. The purpose of this study was to explore the learning needs of patients with hemodialysis , the difference between patients’ wanted educational information, and the selected demographic variables. This was a descriptive correlation-based research that used purposeful sampling and strnctural questionnaires. The data were collected from 120 subjects receiving hemodialysis at a dialysis center of a regional hospital in Southern Taiwan. Instrnments for the study included the basic demographic sheet, the informational needs scale in uremic patients, the Mann-Whitney U test, the Kruskal-Wallis test, and the Spearman correlation analysis by using the SPSS 12.0 software. The study findings reported that the overall mean score of the educational information needs was 174.57 .Among all informational subjects, the highest score of known information was on ”understanding dietary and fluid control,” and second highest was on ”understanding the feasibility of kidney transplantation.” The highest wanted information was on ”how to apply for social support or welfare from the government” and ”medical cost coverage for dialysis by the National Health Insurance.” The least wanted information was on ”rocedures of the catheter insertion for peritoneal dialysis ”and” self care after peritoneal catheter insertion.” The relative factors such as age, educational background, leisure activities, and length of hemodialysis had statistically significant correlation to informational needs. The study's findings revealed that the information on social welfare, medical aid, and kidney transplantation was insufficiently provided to dialysis patients during patient education. Therefore, it can be added to the routine patient education to new patients in the future. The dialysis centers and the government also need to promote this information to the health care professionals during in- services in order to satisfy the patients’ educational needs.

並列關鍵字

hemodialysis informational needs

被引用紀錄


林庭如(2015)。糖尿病腎病變中年洗腎病患之生活經驗〔碩士論文,長榮大學〕。華藝線上圖書館。https://doi.org/10.6833%2fCJCU.2015.00116
劉晏妃(2016)。一位敗血症併發急性腎損傷個案成功脫離呼吸器之護理經驗彰化護理23(2),37-49。https://doi.org/10.6647%2fCN.23.02.11
蘇煒婷、連麗芬(2022)。照護一位初次接受血液透析患者之護理經驗領導護理23(4),53-67。https://doi.org/10.29494%2fLN.202212_23(4).0004

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