多媒體光碟衛教對氣管內管留置病人焦慮成效探討

Examination of the Effectiveness of Multimedia Health Education on Anxiety in Patients with Endotracheal Tube Retention

目的：氣管內管留置對病人而言是極大的壓力源，若因陌生的環境、不確定的處置及無法說話等因素而產生害怕或焦慮，可能會造成自行拔管，甚至引發病安事件，因此透過自製多媒體光碟衛教探討氣管內管留置病人焦慮緩解之成效。方法：自製多媒體衛教光碟，以中部某區域教學醫院加護病房氣管內管留置之病人為對象，採單盲實驗性設計，以隨機分派為實驗組與控制組，每組各32位，實驗組採多媒體光碟衛教，控制組採傳統衛教，比較兩組研究對象於介入之前、後之焦慮成效指標中生理指標及心理指標之差異程度。結果：兩組病人前測資料分析結果，其生理指標及心理指標屬同質性，無顯著差異。實驗組介入多媒體光碟衛教6分鐘後其生理指標之收縮壓、舒張壓、平均血壓及血氧濃度皆達顯著差異p＜0.05，而指溫上升1.16℃，亦達顯著差異p＜0.001，而心跳及呼吸次數未達統計差異；心理指標之焦慮程度為45.25分屬中度焦慮，介入後焦慮下降9.28分，p＜0.001，達顯著差異。結論：多媒體光碟衛教，可有效降低氣管內管留置病人之焦慮，改善病人生理指標及心理指標，因此可推廣於護理衛教中，提供臨床實務運用。 Purposes: Endotracheal tube retention causes tremendous stress for patients. Due to the unfamiliar environment, their uncertainty about medical treatments, and the loss of speaking ability, patients may feel fear or anxiety, which may cause unplanned extubation or even lead to patient safety incidents. Therefore, this study investigates the effectiveness of a multimedia health education program to reduce anxiety in patients with endotracheal tube retention. Methods: This study uses health education multimedia compact discs developed by the author(s) and colleagues. The subjects were patients who were admitted to ICU and underwent endotracheal intubation at one a teaching hospitals in central Taiwan. A single- blind experimental design was employed in which patients were randomly assigned to experimental and control groups. Each group included 32 subjects. Multimedia compact discs were used for health education in the experimental group, while the control group received traditional health education. We compared the differences in subjects' anxiety scores reflected in pre-and post-intervention physiological and psychological indices. Results: Pre-education physiological and psychological indices showed similar values for the two groups, and there were no significant differences. In the experimental group, after receiving six minutes of education, measurements of systolic and diastolic blood pressure, mean blood pressure, and blood oxygen saturation showed statistically significant differences (p＜0.05), while finger temperature increased by 1.16 °C, which was a statistically significant difference (p＜0.001). There were no statistical differences in heart rates and respiratory rates. Regarding subjects' psychological indices, the anxiety score decreased from 45.25 (moderate anxiety) by 9.28 points to 35.97(p value ＜0.001) post-intervention, which is a statistically significant difference. Conclusions: This study shows that multimedia compact disc health education is effective in reducing stress and improves the physiological and psychological indices of patients with endotracheal tube retention. Therefore, we can promote multimedia health education in clinical practice.