接受動靜脈廔管手術病患護理照護認知與需求之探討

Exploration of the Knowledge and the Needs of Arterio-venous Fistula Operation Patients

本研究目的在瞭解動靜脈廔管手術病患對照護認知與照護需求，採立意取樣法，對象為南部某醫學中心，年滿18歲接受動靜脈廔管手術病患，採局部麻醉者，共104位。以自擬結構式問卷並以照護認知量表與照護需求量表為研究工具，以Likert五分法計分，分數愈高代表照護認知與照護需求愈高。資料以描述性統計、t檢定、單因子變異分析及皮爾遜積差相關等進行分析。結果顯示：1.動靜脈廔管手術病患，其照護認知程度介於「尚可」與「了解」之間（平均3.56分），其中認知程度以「手術部位禁止抽血，注射及量血壓」之照護認知為最高。而照護需求情形是需要的，病患對照護之需求程度介於「需要」與「非常需要」之間（平均4.05分），而以「安全的完成手術」之需求居高。2.照護認知與照護需求之影響因素中，有顯著相關者，照護認知方面，包括年齡、婚姻狀況、有無子女、教育程度、局麻開刀經驗、動靜脈廔管手術經驗、是否住院及接受過護理指導等。3.照護需求方面包括年齡、有無子女、教育程度、工作情形、局麻開刀次數及曾接受過護理指導等。本研究結果可以作為動靜脈廔管手術全期照顧之參考依據。

The purpose of this study was to explore the knowledge and the needs of arteriovenous fistula operation patients. A sample of 104 patients receiving arteriovenous fistula operation with local anesthesia was recruited from a medical center in southern Taiwan. The structural questionnaires were used to measure the knowledge and the needs on the Likert 5-point scale. Data were analyzed with descriptive statistics, t-test, one-way ANOVA, and Pearson correlation. The results showed that: (1) patients’ knowledge level ranked between “acceptable” and “understanding” (3.56 points). “Avoid taking blood pressure, performing injection, and drawing blood on the operation limb” was ranked as the highest item. The scone of needs was locatd in “needs” (4.05 points) and safety during operation procedure was the patients’ first concern. (2) The needs were significantly associated with age, number of children, education levels, and experience in surgery with local anesthesia. (3) The age, marital status, number of children, employment status, and experience in surgery with local anesthesia were associated with knowledge. This study provided nurses with a reference for taking care of arteriovenous fistula operation patients during the perioperative period.