髖關節置換術病患接受日常活動衛教計畫之成效

The Effects of an ADL Educational Program on Patients with Hip Replacement

本研究的目的在探討日常活動衛教計畫對接受髖關節置換手術後病患之冒常活動功能、病患衛教滿意度及使用輔具的成效；採類實驗研究設計，以方便取樣方式依接受手術先後順序收案，首先收集對照組，再收集實驗組，共有63位病患，其中實驗組30位及對照33位。對照組接受病房常規護理，實驗組於住院期間接受病房常規護理及為期四次的日常活動衛教介入措施，每次20至30分鐘。以結構式問卷收集資料。結果顯示實驗組術後第五天日常活動功能下降程度顯著少於對照組，出院兩週後日常活動功能程度顯著高於對照組；實驗組病患的衛教滿意度顯著高於對照組病患。於輔具使用方面，術後第五天實驗組使用長柄穿褲勾子及便盆抬高架的比率顯著高於對照組。依研究結果建議將日常活動衛教計畫具體整合入病患照護的臨床路徑中，以提昇接受髖關節置換術病患的照護品質。

The purpose of this quasi-experimental study was to explore the effects of an educational program designed to help hip replacement patients improve the quality of their activities of daily living (ADL) in terms of their ADL functioning and their satisfaction with the use of assistive devices and with the education they received regarding the use of those devices. Sixty-three hip replacement patients were recruited by convenience sampling according to operative schedules. Thirty-three of these patients were assigned to a control group who received routine nursing care, and 30 were assigned to the experimental group who received the routine nursing care plus ADL education. The ADL educational program consisted of four 20 to 30-minute educational classes that took place while the patients were in the hospital. The results showed that the experimental group had significantly higher ADL functional levels than the control group on the 5th postoperative day and that the experimental group's ADL functional levels had continued to increase to two weeks after discharge. The patients who received ADL education were also significantly more satisfied with the use of assistive devices and the education they received than the control group. The subjects in the experimental group were also found to be more willing to use long-handled dressing sticks and commode chairs than the control group on the 5th postoperative day, and a significantly higher percentage of them were found by home visitation to be using long-handled dressing sticks, commode chairs, long-handled bathing brushes and abduction pillows two weeks after discharge than the patients in the control group. Based upon our findings, we suggest that an ADL educational program be made a necessary part of the clinical pathway for patients requiring hip replacements.