心臟病患對心臟復健工作的認知與實施需求之探討

Knowledge and the Needs of Cardiac Rehabilitation Service in Cardiac Patients

冠狀動脈疾病會對病患之身心造成很大的衝擊，因此，病患於治癒出院後需有一套系統性的復健計畫，以協助病患增進身心功能，控制罹病危險因子，預防疾病再度復發，因此從事心臟復健相關研究是非常需要的。本研究主要是藉由評估冠狀動脈病患罹病之危險因子及症狀出現之狀況，了解病患對心臟復健工作之認知，及探討病患對心臟復健醫療服務之需求，期能提供國內心臟復健工作推展之方向。 研究者以立意取樣法選取 105 位冠狀動脈病患為研究對象，並以四份結構式問卷來收集資料，包括；冠狀動脈疾病危險因子測量表、病患症狀量表、心臟復健認知程度量表、及病患心臟復健實施需求調查表。病患平均年齡為 69.8 歲，平均住院 2.9 次， 有 103 人（ 98.1% ）具中度以上之罹病危險性。危險因子中除年齡及性別以外，主要為情緒壓力及缺乏運動。病患出現頻率最高之症狀為疲倦，其次為胸悶及氣促，然以胸悶症狀嚴重程度最高，對病患日常生活影響也最大。病患對於心臟復健普遍具良好之認知，但對於出院後性生活之進行、從事規律運動、及飲食上之注意事項則較缺乏正確知識，而這些也是患者認為最須要醫療人員提供指導之項目。本研究之結果可協助醫療人員擬訂病患復健計劃及衛教之方向，並可為日後籌設心臟復健機構之參考。Coronary artery disease (CAD) can have an impact on a patient'sphysical functions. In general, Patients still need a continuing rehabilitationprogram after they are discharged from the hospital. As the development ofcardiac rehabilitation is still in its infancy in Taiwan, we need more researchin this field. Therefore, there are four purposes for this study: (1) toexamine risk factors of the patients, (2) to measure cardiac symptoms of thepatients, (3) to evaluate patients' knowledge of cardiac rehabilitation, and (4)to explore the needs of the patients for cardiac rehabilitation service. Onehundred and five CAD patients were selected from a teaching hospital. Eachpatient was asked to complete the following four questionnaires: (1) CardiacRehabilitation Knowledge Scale , (2) Cardiac Rehabilitation Scale for the Needs, (3) the Symptom Scale, and (4) Risk Factor Identification Index. The resultsindicated that 103 (98.1%) patients had moderate or higher degrees of risk forCAD. Fatigue was the symptom most frequently reported by the patients. Chestpain symptoms had the most severely degree of impact on the patient's dailylife. On the average, patients had good knowledge of cardiac rehabilitation.However, more education on sexual activity, home exercise, and diet modificationduring patient recovery are needed. Results of this study are expected to helphealth providers to plan a cardiac rehabilitation programs and to improve thequality of care for cardiac patients.