提昇護理人員對肝硬化病患飲食護理指導成效之改善專案

Evaluation of the Nurses’ Dietary Instructions to Liver Cirrhosis Patients

本專案的目的為改善護理人員對肝硬化病患飲食護理指導作業，藉以提昇肝硬化病患對飲食攝取的認知，期望能讓病患出院後飲食之攝取正確。此改善專案係以某醫學中心肝膽胃腸科病房之肝硬化病患及護理人員為收案對象，自91年4月至7月以問卷調查表、實地訪談、查閱護理記錄等方式收集到之問題有：護理人員對肝硬化病患飲食認知程度5.6分（滿分10分）、正確率56％，肝硬化病患對飲食認知3.9分（滿分9分）、正確率43.3％，護理人員對肝硬化病患飲食護理指導執行率為46.7％。經由專案介入措施包含加強護理人員在職教育、製訂「肝硬化病患飲食護理指導標準」、進行「肝硬化病患飲食護理指導」之監控，以強化人員正確執行飲食護理指導作業，結果顯示護理人員對肝硬化飲食認知程度提昇至9.2分、正確率達92％，護理人員對肝硬化病患飲食指導執行提昇率至100％，病患經由護理人員指導後飲食之認知程度提昇至8分、正確率達88.1％，護理人員及肝硬化病患於飲食之認知均有顯著差異(p< .001)，由此可見強化護理人員認知及落實護理指導確實有助於提昇肝硬化病患對正確飲食攝取之認知。

This program was designed to improve the nursing staffs’ dietary instructions to liver cirrhosis patients and improve the dietary intake knowledge of the liver cirrhosis patients. Hence, the patients could keep proper dietary habit after being discharged from the hospital. Liver cirrhosis patients and the nursing staffs in a gastrointestinal medical ward of a medical center were enrolled into this dietary instruction improvement program. From May to July in 2002, data were collected by on-site observations, interviews, and questionnaires. The data were analyzed and reported by a dietary cognitive scoring system with a scaled score from 0 to 10 in the nursing staffs and 0-9 in the patients. Before the implementation of the dietary instruction program, the dietary cognitive score of the nursing staffs and the patients were 5.6 (56%) and 3.9 (43.3%), respectively. The implementation of dietary instruction by nursing staffs was 46.7%. The program involved nursing staffs’ education, standardization and quality control of the dietary instructions on liver cirrhosis. Study was focused on strengthening the correct dietary instructions by the nursing staffs. After the implementation of the program, the dietary cognitive score increased from 5.6 (56 ) to 9.2 (92 ) (p ≤ .001) and from 3.9 (43.3 ) to 8 (88.1 ) (p ≤ .001) in nursing staffs and patients, respectively. The implementation rate of the nursing staff on the dietary instruction of the liver cirrhosis patients increased to 100%. Thus, strengthening the cognition of the nursing staffs and reinforcing the nursing instructions are effective in improving the dietary cognition of the liver cirrhosis patients.