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題名：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
書刊名：護理雜誌
作者：蔡曉婷／周汎澔 引用關係
作者(外文)：Tsai, Shian-ting／Chou, Fan-hao
出版日期：2012
卷期：59:4
頁次：頁43-53
主題關鍵詞：多媒體護理指導；焦慮；不確定感；冠狀動脈成形術；心肌梗塞；Multimedia nursing education；Anxiety；Uncertainty；Percutaneous coronary intervention；PCI；Myocardial infarction；MI
原始連結：連回原系統網址new window
相關次數：
  • 被引用次數被引用次數:期刊(11) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:11
  • 共同引用共同引用:121
  • 點閱點閱:257
背景 : 在工作繁忙的心臟加護病房（ cardiac care unit, CCU）中，如何藉由合宜的衛教方式來協助心肌梗塞患者降低其焦慮及對疾病之不確定感，可說是一大挑戰。 目的 : 探討多媒體護理指導對降低冠狀動脈血管成型術（ percutaneous coronary intervention, PCI）後心肌梗塞患者焦慮及疾病不確定感之成效。 方法 : 採類實驗研究設計，於南臺灣某醫學中心之 CCU進行收案。對照組（ n = 36）採常規護理指導（以書面護理指導手冊為指引 +口頭護理指導），實驗組（ n = 40）以多媒體護理指導為主並給予書面護理指導手冊輔助瞭解，分別探討轉入 CCU時、衛教介入後、轉出 CCU時以及出院當天等四個時期，病患的焦慮及不確定感之變化。研究工具包含疾病不確定感量表、情境特質焦慮量表及非侵入性的生理測量儀。 結果 : PCI術後心肌梗塞病患在 CCU時有中、高度的焦慮及不確定感，可藉由人力及時間花費較少的多媒體護理指導顯著改善病患焦慮（ t39 = -6.615, p < .001）與不確定感（t39 = -8.317, p < .001）；而書面護理指導亦可改善其焦慮（ t35 = -4.767, p < .001）與不確定感（ t35 = -9.739, p < .001）；實驗組於上述四個時期的改變量多數高於對照組。 應用 : 研究結果可提供CCU護理人員之實證資料，在繁忙的工作環境中，依病患情況選擇合適的衛教方式，達到個別化護理之目標；本文亦針對上述兩種不同的護理指導做較深入的論述。
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: t39 = -6.615, p < .001 and uncertainty: t39 = -8.317, p < .001; control group – anxiety: t35 = -4.767, p < .001 and uncertainty: t35 = -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.
期刊論文
1.Cant, R. P.、Cooper, S. J.(2010)。Simulation-based learning in nurse education: Systematic review。Journal of Advanced Nursing，66(1)，3-15。  new window
2.李以文、徐亞瑛、曾春典、藍忠孚(20030300)。心導管檢查之冠心病患者衛生教育的成效。臺灣醫學，7(2)，185-193。  延伸查詢new window
3.Jlala, H. A.、French, J. L.、Foxall, G. L.、Hardman, J. G.、Bedforth, N. M.(2010)。Effect of preoperative multimedia information on perioperative anxiety in patients undergoing procedures under regional anaesthesia。British Journal of Anaesthesia，104(3)，369-374。  new window
4.劉曉君、黃于芳、鍾淑媛、張月娟(20110400)。護理人員逾時下班改善專案。志為護理，10(2)，73-82。  延伸查詢new window
5.葉美玲、陳興夏、劉碧霞(20040400)。髖關節置換術護理指導：多媒體影音光碟與手冊之研發與測試。醫護科技學刊，6(2)，141-152。new window  延伸查詢new window
6.許淑蓮、黃秀梨(1996)。Mishel疾病不確定感量表之中文測試。護理研究，4(1)，59-68。new window  延伸查詢new window
7.許淑蓮(20010400)。初患心肌梗塞病人不確定感與焦慮反應--因應行為效應之探討。護理研究，9(2)，159-171。new window  延伸查詢new window
8.王曼溪(20000500)。如何製作好讀易懂的書面衛教資料。臺灣醫學，4(3)，334-337。  延伸查詢new window
9.Mishel, M. H.(1981)。The Measurement of Uncertainty in Illness。Nursing Research，30(5)，258-263。  new window
10.鍾思嘉、龍長風(19840100)。修訂情境與特質焦慮量表之研究。測驗年刊，31，27-36。new window  延伸查詢new window
圖書
1.Heinich, Robert、Molenda, Michael、Russell, James D.、張宵亭等(1995)。教學媒體與教學新科技。心理出版社有限公司。  延伸查詢new window
其他
1.丁賢偉、詹前隆Ting, H. W., & Chan, C. L.(2009)。互動式衛生教育系統對下背痛衛生教育之效果Interactive health promotion system for low back pain health education。  延伸查詢new window
2.中華民國護理師護士公會全國聯合會The National Union of Nurses’ Associations, Taiwan, ROC.(2011)。臺閩地區護理人員統計表(100年5月)Taiwan nursing manpower statistics (May, 2011)。  延伸查詢new window
3.行政院衛生署Executive Yuan, Taiwan, ROC., Department of Health(2010)。醫療統計年報Hospital and clinic statistics。  延伸查詢new window
4.國立成功大學附設醫院National Cheng Kung University Hospital(2010)。心導管術後之心肌梗塞病患於加護病房直接出院率Discharge rate for patients with myocardial infarctions following percutaneous coronary intervention。  延伸查詢new window
5.吳鈴珠、陳幼梅、林盈慧、潘純媚Wu, L. C., Chen, Y. M., Lin, Y. W., & Pan, C. M.(1993)。加護病房護理人力供求之探討Staffing levels and patient needs in the intensive care unit。  延伸查詢new window
6.陳小蓮、張秉宜Chen, H. L., & Chang, B. Y.(2008)。護理人員離職原因研究Nursing manpower turnover。  延伸查詢new window
7.張霄亭Chang, S. T.(1995)。視聽教育與教學媒體Audio-visual teaching and teaching media。  延伸查詢new window
8.張霄亭、朱則剛Chang, S. T., & Chu, C. T. K.(1998)。教學媒體Teaching media。  延伸查詢new window
9.蔡曉婷Tsai, S. T.(2010)。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成效The effectiveness of multimedia nursing education on anxiety and uncertainly of illness reduction for myocardial infarction patient after percutaneous coronary intervention。  延伸查詢new window
10.American Heart Association(2004)。AHA statements and guidelines/ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction-Executive summary。  new window
11.Beranova, E., & Sykes, C.(2007)。A systematic review of computer-based softwares for educating patients with coronary heart disease。  new window
12.Eastwood, J. A., Doering, L., Roper, J., & Hays, R. D.(2008)。Uncertainty and health-related quality of life 1 year after coronary angiography。  new window
13.Gallagher, R., Trotter, R., & Donoghue, J.(2010)。Preproceduarl concerns and anxiety assessment in patients undergoing coronary angiography and percutaneous coronary interventions。  new window
14.Jensen, B. O., & Petersson, K.(2003)。The illness experiences of patients after a first time myocardial infarction。  new window
15.Krishna, S., Francisco, B. D., Balas, E. A., König, P., Graff, G. R., & Madsen, R. W.(2003)。Internet-enabled interactive multimedia asthma education program: A randomized trial。  new window
16.Lai, M., D’Errico, E., Ren, W., & Zheng, F.(2009)。Uncertainty, anxiety and information need in patients treated with PCI。  new window
17.Murray, E., Davis, H., Tai, S. S., Coulter, A., Gray, A., & Haines, A.(2001)。Randomised controlled trial of an interactive multimedia decision aid on hormone replacement therapy in primary care。  new window
18.Page, M., Jackman, K., & Snowden, P.(2008)。The experiences of patients undergoing percutaneous transluminal coronary angioplasty: A qualitative exploration。  new window
19.Roest, A. M., Martens, E. J., & Johan, D.(2010)。Prognostic association of anxiety post myocardial infarction with mortality and new cardiac events: A meta-analysis。  new window
20.Tooth, L., McKenna, K., Maas, F., & McEniery, P.(1997)。The effects of pre-coronary angioplasty education and counseling on patients and their spouses: A preliminary report。  new window
21.Trotter, R., Gallagher, R., & Donoghue, J.(2010)。Anxiety in patients undergoing percutaneous coronary interventions。  new window
22.Wikström, A. C., Cederborg, A. C., & Johanson, M.(2007)。The meaning of technology in an intensive care unit-An interview study。  new window
23.World Health Organization(2008)。World Health Organization Mondiale de la Santé Department of Measurement and Health Information。  new window
 
 
 
 
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