急性骨髓性白血病化學治療護理指引訓練成效

Effect of Chemotherapy Nursing Guideline Education Program for Patients With Acute Myelogenous Leukemia

本研究之目的為比較急性骨髓性白血病化學治療護理指引介入前、後，護理人員執行護理措施正確率之差異。採類實驗法之雙組前、後測研究設計，以中部某醫學中心血液腫瘤病房，照顧接受化學治療之急性骨髓性白血病患者之護理人員20名為研究對象，自願接受護理指引訓練者為實驗組10名，未上課者為對照組10名。由二位護理人員於96年3月至9月以「急性骨髓性白血病化學治療護理指引執行評值表」，查核護理記錄中病人症狀及護理處置，收集兩組前測資料，實驗組於96年9月以課堂講授方式(1小時)介紹急性骨髓性白血病病患化學治療護理指引並實地示教，10月至12月收集兩組後測資料。研究架構中有六個干擾因素，經t test及Fisher'stes t檢定，兩組控制變項無顯著差異。經GEE統計後，實驗組後測整體護理措施之正確率較前測進步幅度未顯著大於對照組。有關急性骨髓性白血病各症狀之護理措施正確率，僅口腔炎護理措施為實驗組的後測正確率較前測進步幅度顯著大於對照組(p<.05)。建議未來可增加隨機抽樣病人數，或以觀察員觀察病人症狀及護理人員執行護理措施情形，以能更正確評值正確率。

The purpose of this studywas to investigate the effect of chemotherapy nursing guideline program for patients with acute myelogenous leukemia.The two-group quasi-experimental research designwas adapted for this study.Twenty nurses working in a hematologyward of amedical centerwere selected by random sampling.Ten nurses were assigned to an experimental group, inwhich they received a group lecture training program, and ten nurses without trainingwere assigned to a control group.Datawere collected before and after the training program. The results indicated that there was no significant difference between the two groups inthe accuracyof totalnursingintervention.But there was a significant difference between two groups in the accuracy ofnursing intervention of mucotitis (p<.05).Subjects who received the training program had better improvement in skills managing mucotitis than those without training.