網路媒體衛教對脊髓損傷患者自我照顧能力之影響

Effects of the Health Education through Internet on the Self-Care Ability of Patients with Spinal Cord Injury

本研究採縱貫式兩組前後測時間序列之類實驗性設計，目的在探討藉由網路媒體衛教方式對脊髓損傷患者自我照顧能力之影響。研究對象以便利取樣北部某醫學中心位脊髓損傷病患，以Hoenig 1998年之自填式功能程度量表(Self-Reported Functional Measure,SRFM)收集資料。實驗組透過電腦給予網路媒體衛教，控制組則維持一般傳統方式予以衛教。本研究期望透過不同的衛教方式及研究設計，瞭解脊髓損傷患者於衛教前、衛教後四週及八週之自我照顧能力之變化程度。結果發現由於研究對象平均受傷時間為2.5年，且43.3%病患屬於完全損傷，導致其功能程度長期停留在某階段，故脊髓損傷病患接受網路媒體衛教或傳統一般衛教方式，對其自我照顧之能力無影響性改變。因此，衛生教育在短時間內對脊髓損傷患者之自我照顧能力影響甚為有限，建議未來研究應延長收案時間、增加個案數量及受傷時間不久的病患，且可設計互動式溝通的網路媒體衛教方式，以追蹤個案使用網路衛教之頻率，並達到與個案進行雙向溝通及適時解答疑問之目的。

The purpose of this study was to examine the effects of health education through internet on self-care ability of patients with spinal cord injuries. A pre-test post-test time and control-group quasi experimental study design were implemented in a medical center in northern Taiwan. Thirty patients with spinal cord injury were selected for the study by a convenient sampling technique. Hoening's (1998) Self-Reported Functional Independence Measurement (SRFM) was used to collect data. The experiment group intervened with health education via the internet, while the control group held the traditional health education methods. It was expected that we could acquire a better understanding of the effects of health education on the patients' self-care abilities and also that would understand the effects on the 4th and the 8th week before and after intervention. The result showed that the average injury time of the subjects was 2.5 years, and 43.3% of them were severely injured, resulting in a long-term stay at a certain functional level. Findings indicated that whether implemented health education was via internet or traditional method, no significant differences were found in the subjects' self care abilities. Health education via internet still has its limitation, and cannot replace traditional methods which emphasize human touch. It is suggested that future studies could extend the period of data collection, increase the number of sample, and recruit subjects with recent spinal cord injuries. By utilizing modern computerized technology, a health education system of emphasizing a two-way communication is needed to follow the trail on the frequency of patient's using the internet to solve their problems.