提升肝臟移植術後病人復健運動執行成效之專案

Effectiveness of Rehabilitation Exercise Program for a Patient After Liver Transplantation

肝臟移植術後病人因身體功能下降，為協助病人重建生活功能進行改善。現況問題制度面未舉辦復健運動教育訓練及無標準流程；工具面缺乏復健運動衛教工具及查檢表；人員面對復健運動認知待加強，無法掌握病人進度；病人面不熟悉復健運動步驟、觀念不正確。解決辦法制定跨團隊復健運動照護流程、建置照護標準、個人化運動日誌、錄製數位媒體影音及圖文本、舉辦教育訓練、制定監控機制。結果護理人員對肝臟移植術後病人復健運動認知及指導評值，認知達95.4%，指導完整達92.3%；病人ADL由70.3提升至94.5分，滿意度由54.4提升至94.4%。結論復健衛教和訓練指引強化病人對運動的觀念和信心，減少照顧的負擔，提升照護品質。

An improvement project was implemented for a patient following liver transplantation to address declines in physical function and assist in the reconstruction of daily activities. The current system lacked rehabilitation exercise education and training, as well as a standard procedure. Additionally, there was no health education tool or checklist for rehabilitation exercises. Nursing personnel needed to improve their understanding of rehabilitation exercises, as they were not fully aware of the patient’s condition. The patient, in turn, was unfamiliar with the steps of the rehabilitation exercises and had misconceptions about the process. The improvements included the establishment of an interdisciplinary team to design a rehabilitation exercise care process, the development of care standards, and the introduction of personal exercise logs. Digital media videos and illustrated texts were created for education, educational training sessions were held, and a monitoring system was implemented. The results showed that nursing personnel's knowledge reached 95.4%, and the completion rate of nursing instructions on rehabilitation exercises for the patient increased to 92.3%. The patient’s Activities of Daily Living score improved from 70.3 to 94.5, while the patient satisfaction rate increased from 54.4% to 94.4%. Rehabilitation health education and training guidance significantly improved the patient's understanding and confidence in exercise, reduced the burden on healthcare providers, and enhanced the overall quality of care.