運用音樂協助呼吸器依賴病人胸腔復健運動

Applying Music Program to Assist the Pulmonary Rehabilitation Exercise on Ventilator- Dependent Patients

胸腔復健運動能減少長期臥床病人肌肉萎縮、增加肌耐力，而有助呼吸器脫離及縮短住院天數。因臨床發現病人執行胸腔復健運動與指導不完整，故引發改善動機。現況分析發現呼吸器依賴病人執行胸腔復健運動完整性72.2%及護理師對胸腔復健運動認知正確率76.7%。分析原因以胸腔復健運動認知不足、缺乏胸腔復健照護標準及運動輔助工具不足問題，透過運用音樂輔助策略，擬定胸腔復健運動、舉辦在職教育訓練與運用多元教材以結合音樂輔助胸腔復健運動等活動實施，呼吸器依賴病人執行胸腔復健運動完整性提升達96.4%（↑24.2%），也有效提升主要照顧者對胸腔復健指導滿意度由65.7%提升至88.2％（↑22.5%），達專案目標且提升呼吸器依賴病人照護品質。

Pulmonary rehabilitation exercise can reduce muscle atrophy, increase muscle endurance, help ventilator detachment, and shorten the number of hospital days for those long-term bedridden patients. Rehabilitation exercise was not completely given to some of the patients. We were motivated to improve this situation. We found that the completion rate of the rehabilitation exercise among ventilator- dependent patients was only 72.2%, and the accuracy rate of nurses' knowledge was 76.7%. We found the insufficiency knowledge about chest rehabilitation exercise, lack of guidelines and aids for the rehabilitation exercise. After rehabilitation exercise along with rhythm and in-service education programs with multiple teaching were implemented. The completion rate of the rehabilitation exercise has increased up to 96.4% (↑24.2%), and the satisfactory rate of giving rehabilitation guidance to caregivers by nurses has improved from 65.7% to 88.2 (↑27.2%). The aim of this project is reached and the quality of care for ventilator depend patients is improved.