冠狀動脈繞道手術後病患之自我效能、社會支持與自我照顧行為之相關探討

The Relationship between Self-Efficacy, Social Support and Self-Care Behaviors in Post Coronary Artery Bypass Surgery Patients

冠狀動脈繞道手術雖為有效治療冠狀動脈疾病的方法，卻無法阻止冠狀動脈粥狀硬化的進展，病患必須加強自我照顧行為，以延緩疾病復發。許多文獻指出自我效能及社會支持可促進慢性病患的自我照顧行為，因此本研究的目的為探討冠狀動脈繞道手術後病患之自我效能、社會支持與自我照顧行為的相關性。筆者利用描述性相關性研究設計，採立意取樣收得冠狀動脈繞道手術後病患80名，以病患基本特性問卷表，自我效能、社會支持及自我照顧行為量表收集資料，以獨立樣本t-檢定、單因子分析及皮爾森相關等方法進行分析。結果顯示個案之自我照顧行為得分，最高及最低的項目分別為「按時回診」及「規則測量血壓」；獨居及術前已戒煙者之總自我照顧行為，得分較高達顯著意義。總自我照顧行為與總社會支持無顯著相關，但與總自我效能呈顯著正相關。因此，針對研究結果，臨床護理人員應提升冠狀動脈繞道手術後病患的自我效能，以促進其自我照顧行為，達到延緩疾病復發的目的。

Although coronary artery bypass surgery is an effective therapy for coronary artery disease, it could not stop the course of atherosclerotic change of coronary artery. Patients who have coronary artery bypass surgery must promote their self-care behaviors to postpone the recurrence of diseases. Previous studies have indicated that enhancing self-efficacy and social support could improve self-care behaviors of chronic disease patients. The researchers used descriptive correlation design and purposive sampling 80 subjects. Data was collected on patient characteristics questionnaire, self-efficacy, social support and self-care behavior scale. Independent t-test, ANOVA and Pearson correlation were used for data analysis. The results showed that the item of the highest and lowest score of total self-care behaviors was “return to clinics on schedule” and “check blood pressure regularly”. The total self-care behavior score is significantly higher in subjects who live alone and who quit smoking before surgery. The total self-care behaviors have no significant correlation with total social support, but have a significantly positive correlation with total self-efficacy. Therefore, according to the results, clinical nurses should increase self-efficacy of the patients who have coronary artery bypass surgery to promote their self-care behaviors and prevent recurrence of diseases.