| 中文摘要 |
本研究目的描述外科加護病房氣管內管使用病人不適症狀之經驗，並探討術前護理指導及給予約束與否和不適症狀之關係。採橫斷式研究設計，以方便取樣於南部某醫學中心，使用Samuelson學者（2011）所發展之加護單位壓力經驗問卷（ICU Stressful Experience Questionnaire, ICU-SEQ）為研究工具進行資料收集。結果發現：291位研究對象中有60.8%接受手術前護理指導，71.5%醫囑給予約束。氣管內管留置期間最不適症狀為因呼吸管而無法說話，拔管後最不適症狀為吞嚥疼痛。被約束者比未被約束者無論在插管期間或是拔管後，症狀發生頻率較多（p＜.001），症狀困擾強度較強（p＜.001）；且約束可以預測插管時不適症狀頻率（p＜.001）與困擾強度（p＜.001），也可以預測插管後不適症狀困擾強度（p＜.001）。而接受術前護理指導比未接受者僅在心理擔憂層面之憂鬱發生頻率有顯著下降（p = .039）。本文建議醫護團隊能及早評估移除管路時機與約束必要性，並重視有約束者病人之拔管後症狀處理，以協助病人減低氣管內管留置帶來的不適症狀。
The purpose of this study was to describe the uncomfortable symptoms among patients in using endotracheal tubes in surgical Intensive Care Units, and examine the relationships between these symptoms, preoperative education and ordered restraint. A cross-sectional design with convenience samples was used to recruit participants from a medical center in southern Taiwan. Intensive Care Unit Stressful Experience Questionnaire developed by Samuelson (2011) was administered for data collection. A total of 291 participants who received preoperative education and restraint, were 60.8% and 71.5% respectively. The common pre-extubating symptom was unable to talk due to endotracheal tube. The common symptom after extubation was painful swallowing. Patients with ordered restraint reported uncomfortable symptoms more frequently (p＜ .001) and stronger (p＜ .001) than those without it. In addition, restraint not only predicted the frequency and the intensity of symptoms before extubation, but also the intensity of symptoms after extubation. In addition, patients receiving preoperative education experienced lower frequency of depression (p= .039). These findings suggest that health care professionals should evaluate the removal of endotracheal tube earlier to reduce unnecessary restraint. Providing active care for patients, arranging flexible visitor time for caregiver and emphasizing symptoms management to reduce the uncomfortable symptoms is also important. |
本站僅提供期刊文獻檢索。
