探討腹膜透析病人接受「換液步驟認知衛教單」後認知及行為之差異

Differences in Cognition and Behavior after Receiving "Cognition Education Tool" in Peritoneal Dialysis Patients

目的：本專案研究旨在探討腹膜透析病人接受「換液步驟認知衛教單」後，對於腹膜透析換液認知及行為之差異。 方法：本研究採用橫斷性研究，於2015 年1 月1 日∼2015 年12 月31 日期間，針對北部某醫學中心接受連續可活動性腹膜透析長期治療之門診病人，在病人接受腹膜透析護理師給予「換液步驟認知衛教單」前後，以自擬結構式問卷調查此衛教對病人的影響。問卷包括對於15 項腹膜透析換液關鍵項目病人的認知及實際操作行為，在衛教前與後分別予以調查，並以成對樣本t 檢定分析。 結果：本研究共收錄63 位病人，其中性別男女約50％，自行更換透析液占77.8％，接受的腹膜透析兩年以上有77.8％。結果顯示腹膜透析病人於接受「換液步驟認知衛教單」後，所有評估項目皆有進步，其中6 項的認知評估與5 項實際行為評估達到統計顯著的改善。 結論：腹膜透析病人可藉由衛教其換液的步驟，增強其在居家的換液認知及行為，對於執行換液有正向的幫助，即腹膜透析病人可藉由定期加強及訓練其透析的相關知識和技術，讓病人於居家換液操作時更為確實和標準化，進而減少其因執行腹膜透析時所衍生出的感染合併症。

 

Purpose:This study aimed to investigate the differences in cognition and behavior of PD patients for dialysis exchange after receiving education on the technique “cognition education tool”. Methods:This study used a cross-sectional design and structured questionnaire. Patients receiving chronic continuous ambulatory PD in a medical center at northern Taiwan between January 1st and December 31st, 2015 were enrolled. A standardized educational course of dialysate exchange technique, named “cognition education tool”, was introduced to enrollees by PD nurses. We used a structuralized questionnaire, consisting of dialysate exchange knowledge and procedures in the form of 15 items, to evaluate PD patients before and after the implementation of the educational course. A paired t-test was used for comparison. Results:A total of 63 PD patients were enrolled. Among these patients, 50% were females and 50% were males, and 77.8% performed dialysate exchange by themselves. 77.8% received PD for more than 2 years. All items of the questionnaires improved significantly after education. Of note, patients’ knowledge and their exchange procedure also improved significantly for key items 6 and 5, respectively. We suggested that the provision of the knowledge education tool could be beneficial for better PD dialysate exchange in these patients. Conclusion: Patient education about dialysate exchange technique, can ameliorate PD patients’ cognition and behavior at home. Knowledge and techniques of PD patients can be reinforced with regular “cognition education tool”, therefore patients’ self-awareness and dialysate exchange behavior could be improved. Furthermore, this tool may potentially reduce the incidence of PD-associated infectious complications.