多媒體護理指導對降低心導管術後心肌梗塞病患焦慮及疾病不確定感的成效

The Effectiveness of Multimedia Nursing Education on Anxiety and Uncertainty of Illness Reduction for Myocardial Infarction Patient after Percutaneous Coronary Intervention

蔡曉婷(Shiau-Ting Tsai)

指導教授 ： 周汎澔

高雄醫學大學/護理學院/護理學系研究所/碩士(2010年)

摘要

根據世界衛生組織最新統計資料(2004年)顯示，冠狀動脈心臟疾病高居全球十大死因第一位(12.2%)；因此，國際間已將針對冠狀動脈心臟疾病患者，特別是心肌梗塞病患進行衛教列為近年來的工作重點。
心肌梗塞是一個突然發作，且具有致命性的疾病，在面對強大的疾病壓力源席捲而來，心肌梗塞病患往往產生強大的焦慮及不確定感。然而，回顧當前國內、外文獻所提及，多為探討非急性期心肌梗塞病患的焦慮及不確定感，卻缺乏急性期之心肌梗塞病患焦慮及不確定感的介入措施。急性期心肌梗塞患者，往往須轉入心臟加護病房接受嚴密監測及照護；因此，在加護病房繁忙的工作環境中，如何藉由合宜的衛教方式來協助患者降低焦慮及疾病不確定感，是一大挑戰。
本研究目的在於探討多媒體護理指導對降低心肌梗塞患者焦慮及疾病不確定感的成效；採類實驗研究設計，立意取樣方式，將研究對象分為實驗組和對照組，實驗組採多媒體衛教方式，對照組則採書面衛教方式，分別探討1)轉入加護病房時、2)衛教介入後、3)轉出加護病房時、4)出院當天，病患之焦慮及不確定感變化。研究結果顯示：心肌梗塞病患在加護病房時有中、高度的焦慮及不確定感，可藉由多媒體衛教或書面衛教方式達到舒緩。多媒體衛教與書面衛教之成效相當，此可提供臨床心臟加護病房護理人員在繁忙的工作環境下，依病患情況選擇合適的衛教方式，並提供臨床實證依據作為護理人員衛教病患之參考，達到人性化護理之目標。

關鍵字

多媒體護理指導 ； 焦慮 ； 不確定感 ； 心肌梗塞

並列摘要

According to the latest world health statistics published by the World Health Organization (WHO), coronary heart disease (12.2%) led the top ten global causes of death in 2004. Due to the above, international studies have been focused on health education for patients suffering from coronary heart disease, especially myocardial infarction (MI) in the recent years.
Myocardial infarction is a life-threatening disease that always being sudden onset. Patients who suffer from MI are usually attacked by severe anxiety and uncertainty of illness when they face this stressful disease. However, most of current studies about MI patients’ anxiety and uncertainty of illness focus on non-acute stage. Research and intervention for acute stage are relatively scarce. Otherwise, close monitor and care in the cardiac care unit (CCU) for MI patients are usually needed. Thus, we tried to find an adequate mode of patient education for clinical application in the CCU, an extremely busy nursing workplace.
The purpose of this study was to check the effectiveness of multimedia nursing education on anxiety and uncertainty of illness reduction for MI patients. A quasi-experimental study with judgment sampling was designed. In our study, multimedia nursing education was applied to the experimental group and written nursing education was to the control group. The reduction of MI patients’ anxiety and uncertainty of illness was discussed at four specific timing: 1) Admission to the CCU, 2) Post-intervention of nursing education, 3) Transfer to the ordinary ward, and 4) Discharge.
Based on the results of our study, we can effectively relieve MI patients’ moderate to severe anxiety and uncertainty of illness via whether multimedia or written nursing education. The effectiveness of multimedia form was equal to written form. Thus, we can just choose one of them according to the patient’s condition.

並列關鍵字

Multimedia nursing education ； anxiety ； uncertainty ； myocardial infarction (MI)

參考文獻

第七章 參考文獻

中文部分

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