中文摘要 |
進行全膝關節置換術個案有逐年增加情形,出院前除了面對身體的不適,對返家後傷口照護、日常活動及居家注意事項等訊息不清楚,常衍生不確定感等心理問題。每位個案都有個別性的身、心、社會需求,若需求未獲得滿足,會影響其復原情形。本研究之目的為針對全膝關節置換術個案,探討其出院需求、需求滿足、不確定感及其相關因素。採橫斷式量性研究設計,以立意取樣選取新竹二家區域級教學醫院進行全膝關節置換術個案為研究對象,以出院需求量表及不確定感視覺類比量表等問卷收集資料,有效問卷共67份。結果顯示全膝關節置換術個案的整體出院需求偏向需要,需求程度依序為生理照護需求(2.03±0.29),其次為社會照護需求(1.73±0.51),最後為心理照護需求(1.56±0.54),女性的生理照護需求顯著高於男性(t = -2.25,p = .03)。整體出院需求滿足介於部分滿足到已滿足之間,需求滿足程度依序為心理照護需求滿足(2.84±0.29),其次為社會照護需求滿足(2.80±0.32),最低的為生理照護需求滿足(2.65±0.24)。有工作之全膝關節置換術個案,其心理及社會照護需求滿足顯著高於沒有工作者(t = 2.61, p = .01;t = 3.91, p < .001);個案年齡愈高,社會照護需求滿足則愈低(r = -.24, p < .05)。而不確定感是整體出院需求(β= .31, p = .01)及整體出院需求滿足(β= -.42, p < .001)的影響因子。個案出院前之不確定感屬於輕度,不確定感愈高,出院需求就愈高(r = .26, p < .05),而出院需求滿足則愈低(r = -.43, p < .001)。全膝關節置換術個案以生理照護需求最高,但是被滿足的情形卻是最低,且均受到不確定感的影響。因此期望相關單位能依照個案需求及未被滿足的項目,制定完整且明確的出院衛教內容,以滿足個案之需求及降低不確定感。 |
英文摘要 |
The number of patients undergoing total knee replacement is increasing year by year. In addition to facing physical discomfort before discharge from the hospital, unclear information after returning home about wound care, daily activities, and precautions at home often leads to psychological problems, such as uncertainty. Each patient has individual physical, mental, and social demands. If the needs are unmet, their recovery condition will be affected. This study aimed to investigate the discharge needs, the satisfaction of needs, uncertainty and related factors for patients undergoing total knee replacement. This study was a cross-sectional and quantitative design. Purposive sampling was used to recruit patients with total knee replacement at two regional teaching hospitals in Hsinchu. The instruments including the discharge needs scale and the uncertainty visual analogue scale were used to collect data. The total number of valid questionnaires was 67. According to the study results, the overall discharge needs of patients who underwent total knee replacement tended to the degree of demand. Of the all dimensions, the physical care needs exhibited the highest mean score (2.03±0.29), followed by the social care needs (1.73±0.51) and the psychological care needs (1.56±0.54). Female patients demonstrated a greater demand for the physical care needs than male patients (t = -2.25, p = .03). Examining patients’satisfaction with their discharge needs, the results revealed that an overall discharge needs level was between partially satisfied and satisfied. Of the all dimensions, the satisfaction of psychological care needs (2.84±0.29) exhibited the highest mean score, followed by the satisfaction of social care needs (2.80±0.32) and the satisfaction of physical care needs (2.65±0.24). The psychological and social care needs satisfaction of employed patients was significantly higher than that of unemployed patients (t = 2.61, p = .01; t = 3.91, p < .001). The older the patients with total knee replacement were, the lesser extent to which their social care needs were satisfied (r = -.24, p < .05). Uncertainty was identified as a predictive factor for the overall discharge needs (β= .31, p = .01) and the overall discharge needs satisfaction (β= -.42, p < .001). The level of uncertainty experienced by patients was generally mild before discharge. Patients who experienced high uncertainty prior to discharge demonstrated high discharge needs (r = .26, p < .05) and low discharge needs satisfaction (r = -.43, p < .001). Patients undergoing total knee replacement had the highest needs for physical care, but the lowest level of satisfaction, and they were all affected by uncertainty. Therefore, it was expected that relevant departments could formulate integrated and clear contents of discharge health education according to patients’needs and unmet needs to meet the needs of patients and reduce the sense of uncertainty. |