個別衛教對慢性腎衰竭患者疾病認知、態度、自我照顧之成效

Effectiveness of Individualized Health Education on Knowledge, Attitude and Self-Care Behavior of Patients with Chronic Renal Failure

慢性腎衰竭威脅國人健康甚鉅，患者的疾病認知、態度及自我照顧行為，對於疾病控制相當重要。研究顯示衛教對某些疾病患者的知識、態度或自我照顧行為有正向的成效，國外慢性腎衰竭衛教計劃之評價性研究甚少，且多以知識改變為評價指標，國內無此方面的文獻報告，本研究針對慢性腎衰竭病人的需求設計衛教方案，探討個別性衛生教育對慢性腎衰竭病人疾病認知、態度及自我照顧行為的成效及影響因素。研究採準實驗設計，收取68位個案為研究對象，包括對照組35位、實驗組33位，平均年齡57.4歲，男性43位，女性25位，結果發現個別性衛生教育能增進慢性腎衰竭病人的疾病認知及自我照顧行為，對疾病及自我照顧的態度也愈趨正向。研究中慢性腎衰竭患者的疾病認知改變量受個別性衛教、教育程度、症狀經驗數、參與慢性腎衰竭課程、疾病認知及態度前測成績等變項影響；疾病態度改變量則受個別性衛教、知道自己血清肌酸酐值、血清肌酸酐值及疾病態度前測成績等變項的影響；自我照顧行為改變量受個別性衛教及自我照顧行為前測成績的影響。本研究結果可供臨床醫療人員照護慢性腎衰竭患者及發展相關衛教計畫之參考。

Chronic renal failure (CRF) has a great impact on the quality of life of patients. Whether education can improve the knowledge, attitude, self-care behavior of these patients is not clear. We thus investigated the effectiveness of an individualized health education program on knowledge, attitude, and self-care behavior of patients with CRF. Factors influencing the effectiveness of the program were also analyzed. A quasi-experimental design was used in this study. Sixty-eight patients with CRF were recruited from nephrologic outpatient clinics in a teaching hospital. They were ramdomly assigned to the experimental or control group. Thirty-three patients in the experimental group underwent individualized health education, while thirty-five patients in the comparison group received only routine care. Significantly beneficial effects of individualized education on knowledge, attitude, and self-care behaviors were found in the experimental group. Influencing factors for the effectiveness of the education program on patients’ knowledge included individualized health education, education level, number of symptoms and signs, pre-test score of knowledge and attitude, and participation in the CRF education program. The effectiveness of the health education on the attitude of the patients was influenced by individualized health education, patients’ knowedge of their serum creatinine level program and serum creatinine level, and pre-test attitude. The effectiveness of health educntion on self-care behavior was influenced by individualized health education and the pre-test score of self-care behavior only. We conclude that an individualized health education program is effective in improving the knowledge, attitude and self-care behavior of patients with CRF. Findings of this study may help medical personnel to provide better care for patients with CRF.