提升周邊血液幹細胞移植病人之自我照護認知專案

A Project of Improving Self-care Knowledge of Patients with Peripheral Blood Stem Cell Transplantation

背景：本院自2008年成立骨髓移植病房至今已移植32人，2011年調查15位接受周邊血液幹細胞抽取者之自我照護認知僅67.9％，分析認知原因低的原因包括無提供衛教手冊、內容繁多不易理解、衛教時間短促及無衛教標準流程與追蹤制度。因移植後重建免疫功能需長達一年，居家自我照護能力著實重要，故引發本專案研討動機。目的：提升周邊血液幹細胞移植病人自我照護認知，降低感染風險。本院護理認知監控閾值為85％，專案目的為提升周邊血液幹細胞移植病人居家自我照護認知達85％。方法：訂定標準衛教流程，提供雙語多媒體影音光碟，製作手冊及醫療識別卡、建立個案管理及電訪追蹤制度。結果：專案實行後病人自我照護認知提升至98.9％，電訪關懷滿意度高達4.9（5分法），顯示病人自我照護認知有其顯著成效。結論：藉由多媒體影音光碟播放易理解並加深印象，引發病人學習動機；增設個管關懷追蹤制度，與病人保持密切聯繫並提供緊急處理流程，進而提升居家自我照護認知及醫療服務滿意度。

Background: Thirty two patients have been successfully treated by Peripheral Blood Stem Cell Transplantation (PBSCT) since 2008 till now. An investigation of 15 patient's self-care knowledge of PBSCT were extracted from the 32 patients that the correct rate of knowledge was only 67.9%. The possible causes of low self-care knowledge were lack of health education bulletins, complicated knowledge about PBSCT care lack of time and standardized process for health education, and insufficient follow-up strategies. In order to rebuild the patient's immunization functions in the duration of approximately one-year-period of time. It would be very important for patients to have sufficient knowledge of self-care. Purpose: The purpose of this project was to improve the self-care knowledge of patients with PBSCT and to decrease risks of infections. The cognition control threshold was 85%, the goal of this project was to achieve 85% regarding self care knowledge while patients with PBSCT when they went home. Methods: It included establishing a standardized operating protocol to provide bilingual multimedia CDs in health education and self-care, making pamphlets and medical treatment identification cards, building following-up and consulting phone services to support and equip patients' self-care needs. Results: The correct rate of patient's self-care knowledge was improved to 98.9%. Satisfactions of phone-services gained the score of 4.9 in a 5-point scale. The results showed a great improvement in the knowledge of self-care for patients with PBSCT. Conclusions: Teaching the knowledge of PBSCT was complicated. However, applying animation presentation CDs can arise patients' learning motivations and can make it easy to understand. In addition, it is important to provide caring system by keeping close relationship with patients and provide emergency situations in case of accidents. It can also improve patients' knowledge of home care and satisfactions of professional care.