心導管檢查之冠心病患者衛生教育的成效

Effectiveness of Health Education on Patients with Coronary Artery Disease Undergoing Cardiac Cathterization

本研究目的在探討不同因應形式、衛教方案之交互作用對冠心病患接受衛教前後之情緒反應、心導管知識瞭解程度、衛教後滿意度的影響，並檢驗鈍化假說（ blunting hypothesis），應用在冠心病患個別衛教上的適用性。本研究以因應形式量表、情緒量表、心導管知識量表及滿意度量表收集資料，共得60位第一次接受心導管檢查，平均年齡66歲（sd=5）之冠心病患全程參與研究。研究結果顯示，就減輕衛教後的負向情緒反應而言，監測基冠心病患較適接受心導管衛教方案；鈍化基冠心病患則較適合接受心血管疾病衛教方案。心導管檢查前不管是提供心導管衛教方案或是心血管疾病患為高。本研究結果提供給臨床照護者的啟示為，衛教開始於評估，護理人員應該評量病患面對壓力事件時所慣用的因應形式，才能正確分析病患個別需求，進而擬定衛教目標，有計劃的教導衛教內容，達到衛教成效。

The purpose of this study is to text the blunting hypothesis by examining the interaction effects of coping styles and types of health education for patients with coronary artery disease (CAD) who underwent cardiac catheterization. Based on blunting hypothesis, people who tend to threatening information are classified as 'monitors'. While the 'blunters' try to avoid such information. Outcome variables examined in this study include emotional responses, knowledge about cardiac catheterization and patients' satisfaction to health education. Sixty CAD patients who received first cardiac catheterization were enrolled in this study. The mean age was 66 (sd=5) years old. Analyzing the parameters we found that CAD patients who were categorized as monitors and received the cardiac catheterization health education reported less significant reduction than those who were categorized as blunters and received the CAD health education, who reported more significant reductions in negative emotional responses after the health teaching. The types of health education did not correlate with affect patients' satisfaction to health education than those who were blunters. These findings suggest that nurses should pay attention to the copying styles of CAD patients in order to accurately assess their individual needs, set realistic goals, implement strategic health education intervention so that beneficial effects can be achieved.