互動式多媒體介入策略於腎癌存活者健康知識、態度、自我效能及行為之成效

Abstract

背景：腎癌存活者於腎臟腫瘤手術後，常詢問與健康飲食及身體活動相關議題。但至今鮮少有專為腎癌存活者設計之衛教教材，以做為健康促進之參考依據。目的：本研究以行為理論及多媒體學習論為基礎，設計互動式多媒體教材，並探討「互動式多媒體衛教」與「口語衛教」兩種不同衛教方式，對腎癌存活者健康知識、態度、自我效能及行為之成效。方法：採類實驗設計，於北部某醫學中心泌尿科門診收案，依病歷號隨機分派，實驗組(n=38)以互動式多媒體衛教，對照組(n=39)採口語衛教，於介入後立即實行後測，6週後進行延宕測，並以廣義估計方程式及成對樣本t檢定進行分析。結果：兩組研究對象在介入後，健康知識、自我效能及身體活動量，於組內皆有進步，並達顯著差異，且實驗組進步幅度優於對照組。而實驗組於健康態度之成效，無論在組間後測(β=2.079, ρ=0.027)，或組內後測(ρ<0.001)及延宕測(ρ=0.004)均達顯著差異。 結論：互動式多媒體教材因運用理論編排設計，能有效提升腎癌存活者健康行為之態度，且透過圖文說明，可輕鬆學習，提升學習效果，並能依個人需求反覆閱讀，另有行動策略可做為實行健康行為之參考，不僅適合腎癌存活者，亦可供案家成員共同使用。因此，可將本教材設計概念推廣於臨床實務中加以應用。Background: Following kidney tumor surgery, individuals who have survived kidney cancer often seek guidance on maintaining a healthy diet and engaging in physical activity. Unfortunately, there is currently a lack of educational materials specifically tailored for kidney cancer survivors, serving as a comprehensive reference to promote their overall health.Objective: This study is designed based on behavioral theory and multimedia learning theory to create interactive multimedia materials. Its objective is to investigate the impact of two different educational methods, namely"interactive multimedia education" and "verbal education," on the health knowledge, attitudes, self-efficacy, and behaviors of kidney cancer survivors. Methods: Employing a quasi-experimental design, participants were recruited from the urology outpatient department of a medical center in northern Taiwan. Random assignment was conducted based on medical record numbers. The experimental group (n=38) received interactive multimedia education, while the control group (n=39) received verbal education. Post-tests were administered immediately after the intervention, with follow-up assessments conducted 6 weeks later. Data analysis was performed using Generalized Estimating Equations (GEE) and paired-sample t-tests.Results: After the intervention, both groups demonstrated improvement in health knowledge, self-efficacy, and physical activity, with significant differences observed within each group. Additionally, the experimental group showed a significantly greater improvement compared to the control group. As for the effectiveness of health attitudes, significant differences were observed in both inter-group post-tests (β=2.079, p=0.027) and intra-group post-tests (p<0.001) and delayed tests (p=0.004). Conclusion: The interactive multimedia educational materials, designed based on theoretical principles, effectively enhance the attitudes towards health behavior in kidney cancer survivors. Through visual and textual explanations, learning becomes more easily understood, improving overall learning effectiveness. Additionally, these materials allow for repeated readings based on individual needs. They also provide practical strategies as a basis for implementing healthy behaviors. These materials are not only applicable to kidney cancer survivors but can also be used collaboratively by family members. Therefore, the design concept of this educational material can be promoted and applied in clinical settings.