系統性個別護理指導方案對裝置永久性心律調節器病患自我照顧知識、態度及行為之成效

The effectiveness of a systematic patient education intervention on knowledge, attitudes and behavior about self care in patients with permanent pacemakers

目標：裝置永久性心律調節器是治療有症狀性心搏過緩病患的主要方式，至今少有針對此族群做衛教介入之成效研究。本研究目的旨在探討系統性個別護理指導方案介入對於改善裝置永久性心律調節器病患自我照顧的知識、態度與行為之成效。方法：本研究採立意取樣及前後測類實驗設計。按裝置先後順序分成對照組（n=35）與實驗組（n=37）。兩組病患均於裝置永久性心律調節器前一天收集基本資料及知識、態度與行為問卷等前測資料。植入後對照組接受常規照護，實驗組給予系統性個別護理指導方案。兩組病患於出院後首次回診時收集後測資料。介入成效則以單因子共變數分析檢驗。結果：結果顯示系統性個別護理指導方案雖無法在病患出院後一周內有效地改變病患的態度與行為，但可顯著地增加病患自我照顧的知識（F=16.99；p＜0.001）。結論：系統性個別護理指導方案可顯著地增加裝置永久性心律調節器病患自我照顧的知識。本研究設計之衛教手冊可供臨床護理人員衛教及相關研究參考使用。

Objectives: Although a permanent pacemaker (PPM) is the treatment of choice for patients with symptomatic bradycardia, little is understood about the effectiveness of a patient education intervention for this population. Methods: A quasi-experimental design was utilized to determine the effects of a systematic patient education intervention on PPM self-care knowledge, attitudes and behavior among patients with permanent pacemakers. Two groups were randomly assigned interventions: the PPM education group (n=37), received one-on-one lessons, and the control group (n=35), received usual care on the ward. Pre-test data were collected one day before implantation of the PPM, while post-test of questionnaires that includes PPM self-care knowledge, attitudes and behaviors were collected one week after discharge. The intervention effect was evaluated using one way analysis of covariance (ANCOVA). Results: A systematic patient education intervention significantly increased patients' self-care knowledge (F=16.99; p<0.001). Improvement was also observed in self-care attitudes and behavior but the differences were not statistically significant. Conclusions: Systematic patient education intervention can significantly increase patients' self-care knowledge about PPMs. Instructional materials can be provided to support patient education in clinical settings.