醫院病人接受抗生素團體衛生教育成效之評估

Evaluation of the effect of an antibiotic use education program for hospital patients

近20年來的研究顯示，醫院常有過度使用抗生素的情事，因此如何降低抗生素的不當使用，已成為各國及台灣政府應注意的項目之一。本研究目的為評估醫院病人接受抗生素團體衛生教育後，其對抗生素認知改變情形。本研究以參與團體衛教之466位門診病人為研究對象，並以一15題之試卷進行團體衛教實施成效之評估。結果顯示，於醫院門診實施團體衛教後，研究對象對抗生素的瞭解由前測的9.5分（總分為15分），提昇至後測的13.8分，每題的平均分數都有提昇，且以Paired-Samples TTest檢定其均達統計上顯著差異(p< 0.05)。另由因素分析確定「保健觀念」、「效果」、「遵從用藥」與「使用習慣」等四因素之適合性後，再將研究資料依此四分類進行歸納，發現雖然衛生教育的介入確可提升病人對抗生素認知，且皆達到統計學上顯著水準(p< 0.05)，但在使用習慣因子部份提升的幅度較小。同時，由本次研究可知，國內病人對「抗生素」這個名詞已不陌生，但觀念仍非完全正確，故建議未來應持續加強病人衛教宣導，使所有病人都能具有充分的知識，再輔以醫療上的管制措施，當可減少國內抗生素濫用事件的發生率。

Several researchers have suggested that antibiotic overuse has happened frequently in Taiwan hospitals over the past two decades. The question of how to decrease the incidence of antibiotics overuse has concerned the Taiwan government and also the governments of other countries. The purpose of this study was to evaluate the effect of changes in outpatients' concepts of antibiotics use after a health education quality improvement program. The subjects were made up of 466 outpatients from 9 different hospitals in Taiwan, and they were asked to complete a questionnaire containing 15 questions. After the completion of health education activities at outpatient services, the scores obtained from the survey had increased from 9.5 to 13.8 points, which was statistically significant by Paired-Sample t-test. Factor analysis was carried out to evaluate the influence of various aspects of the program including health care concepts, effects of antibiotics, following the doctor's instructions, and antibiotic use habits. A significant influence was detected for effects of antibiotics, but there was little influence from antibiotic use habits. According to our study, outpatients use common sense when taking antibiotics, but this is not always correct. In order to increase their knowledge of antibiotics and to decrease the incidence of antibiotic overuse in Taiwan, we suggest that, in the future, there should be augmentation of health education aimed at outpatients, and restraints placed on the use of antibiotics by health care workers.