電話衛教計畫對冠心病高危險群防治之認知、健康信念及預防行為之改善成效

The Effect ofTelephone Education Programs with Telephone Consultations on Improving Preventing Knowledge, Health Beliefs, and Behaviors among Coronary Artery Disease High Risk Population

本研究旨在探討電話衛教計畫對冠心病高危險群於防治冠心病之認知、健康信念及預防行為的改善成效。研究採類實驗性設計，以結構式問卷進行實驗組與控制組個案在冠心病認知、健康信念、預防行為之前測，實驗組給予衛教手冊及3次電話諮詢，10週後再收集個案後測資料。完成前後測的實驗組與控制組分別為43及41人（流失率27%），兩組個案在社會人口學變項具同質性。前測顯示個案冠心病認知屬中上程度（56.59±21.84）；且具正向之健康信念（易感性認知：2.46±0.70；嚴重性認知：3.39±0.60；有效性認知：3.31±0.57；障礙性認知1.52±0.72）；預防行為則仍有很大改善空間（2.33±0.72）。介入後：一、實驗組在冠心病認知（t=8.91， p<.001）、易感性認知（t=4.16， p<.001）、嚴重性認知（t=4.08， p<.001）、有效性認知（t=4.49， p<.001）與障礙性認知（t=-3.51， p<.01）及預防行為（t=7.27， p<.001）皆有顯著改善；二、實驗組在冠心病認知（t=5.25， p<.001）、易感性認知（t=4.60， p<.001）、有效性認知（t=2.97， p<.01）及預防行為（t=4.41， p<.001）等之改善情形顯著優於控制組。研究發現，電話諮詢合併衛教手冊介入可有效改善個案之冠心病防治認知、健康信念及預防行為，建議將本模式推廣至醫療衛生單位，期使高危險族群能被早期發現及追蹤。This study aimed to examine the effect of telephone education programs on improving knowledge of Coronary Artery Disease (CAD) prevention, health beliefs, and preventing behaviors among CAD high-risk population. The quasi-experimental design was conducted. The education brochure was mailed to subjects in the experimental group and the telephone consultations were offered in the first, fourth and tenth week. The structural questionnaire was used to collect pre- and post- test changes between groups. A total of 43 and 41 subjects in experimental and control groups completed the study (dropout rate: 27%). The 2 group difference analysis indicated homogeneous among samples. Results of the baseline analyses revealed that subjects had medium level of knowledge (56.59±21.84), positive attitude toward health belief (2.46±0.70 in perceived susceptibility; 3.39±0.60 in seriousness; 3.31±0.57 in benefits; 1.52±0.72 in barriers) and low level of performance in prevention behaviors (2.33±0.72). After intervention, the results were as follows: 1. The experimental group had significant improvement on CAD's knowledge (t=8.91, p<.001), perceived susceptibility (t=4.16, p<.001), seriousness (t=4.08, p<.001), benefits (t=4.49, p<.001) and barriers (t=-3.51, p<.01) in health beliefs, and preventing behaviors (t=7.27, p<.001). 2. The experimental group’s knowledge of preventing CAD (t=5.25, p<.001), perceived susceptibility (t=4.60, p<.001), perceived benefits (t=2.97, p<.01) and preventing behaviors (t=4.41, p<.001) were better improved than that of the control group. Results of this study indicated that education brochure combined with telephone consultations were effective in improving the subjects' knowledge of CAD prevention, health beliefs, and preventing behaviors. It is suggested that this health education program should be recommended to various health institutions to detect and manage CAD high-risk population at the early stage.