運用圖像化及遊戲式教學提升血液科病人飲食認知正確率

Enhancing Dietary Awareness Accuracy in Hematology Patients Using Visualization and Game-Based Learning

背景：血液科病人於抗癌治療期間，容易因飲食攝取不當或營養攝取不足，導致治療中斷、降低治療耐受性進而增加發病率，影響生活品質，嚴重時更會提高死亡率。本專案經現況調查分析後，血液科病人飲食認知正確率僅66.3%，確立問題導因為：護理人員忽視飲食衛教重要性、未落實飲食衛教且衛教方式不一致；缺乏飲食認知評估及合適的衛教工具導致病人容易忘記衛教內容；院方無提供衛教的流程及相關稽核制度；營養師因收案條件限制，未能關懷每位病人飲食衛教。
目的：（1）提升血液科病人飲食認知正確率、（2）護理人員能主動提供血液科病人飲食衛教率。
解決方案運用雲端科技QR code結合衛教海報及單張、遊戲式教具（水果紅綠燈、營養對對碰）、病友分享會、團體衛教及在職教育。
結果：血液科病人飲食認知正確率由66.3%提升至91.2%、護理人員主動提供血液科病人飲食衛教率提升至90%，達專案目的。
結　論本專案可有效提升血液科病人飲食認知正確率，成效良好，故將此專案納入單位團體衛教活動中，每三個月執行一次，除了益於病人飲食選擇，更可有效減少護理人員於臨床進行飲食衛教的時間。

Background & Problems: During cancer treatment, hematology patients often experience treatment interruptions, reduced tolerance, and increased morbidity due to improper or insufficient dietary intake, which negatively impact their quality of life and, in severe cases, increase mortality rates. A situational analysis revealed the accuracy rate of dietary knowledge among hematology patients in our hospital to be only 66.3%. The factors affecting this low rate of accuracy were identified as: nursing staff underestimating the importance of dietary education, inconsistent and poorly implemented dietary education, and the absence of dietary knowledge assessments and appropriate educational tools necessary to reinforce patient understanding. Moreover, the hospital lacked a standardized educational process and audit system. Furthermore, due to case selection criteria, dietitians were unable to provide nutritional counseling to every patient.
Purposes: A project was developed and implemented to increase the correct dietary knowledge rate among hematology patients from 66.3% to above 87.9%, and to raise the completion rate of dietary education by nursing staff for hematology patients from 58.3% to above 85%.
Resolutions: The project utilized cloud technology with QR codes combined with educational posters and leaflets, game-based teaching tools (such as the fruit traffic light and nutrition-matching games), patient sharing sessions, group health education, and on-the-job training.
Results: The accuracy rate for dietary knowledge among the hematology patients increased from 66.3% to 91.2%, and the completion rate for dietary education by nursing staff increased from 58.3% to 90%, achieving the objectives of this project.
Conclusion: This project effectively improved the overall rate of dietary knowledge accuracy among hematology patients, demonstrating positive outcomes. Based on this success, the program will be incorporated into the unit’s group health education activities and conducted every three months. In addition to benefiting patient dietary choices, the program should reduce the time nurses spend on dietary education in clinical settings significantly.