中風防治識能衛生教育介入效果研究-以台北市某國小六年級學生為例

Abstract

腦中風是國人的主要死亡原因之一，在前人努力下死亡率持續下降，但隨著高齡社會來臨，腦中風病人的數目也將會大幅增加。腦中風的危險因子是可以透過教育去改變的。當中風發生時，迅速認知中風症狀，立即就醫。靜脈注射血栓溶解治療是目前唯一的治療急性梗塞型中風的方法，但許多病患無法於3小時內趕到醫院，錯失接受治療的良機。提升治療比率最有效的方法就是減少到院前延誤，教育介入就是最有效方式。現今醫師工作場域已經從醫療場所進入社區，推動全人醫療，而學校就是社區一部分。本研究是以六年級學童及家長為目標，透過創新傳播介入課程介入課程去改善學童中風防治識能。希望可以教導學童腦中風的危險因子、症狀及治療，培養學生健康行為，並透過親子共學，影響家長一起去實踐健康生活。本研究証明實驗介入組的學生及家長有良好「中風防治識能」提升程度上達到顯著統計意義，其中實驗介入組的「中風危險因子」、「中風症狀」、「正確指出腦部是受損器官」及「正確中風處理」等變項均達統計學上顯著意義。本研究設計介入課程可以有效提升中風正確處理方式，糾正不正確的處理觀念。實驗介入組不論在「中風危險因子」或「症狀知識上進步成為早期採納者或創新者」的人數在實驗結束後均有增加。在教學成效問卷中，課程內容為大多數學生及家長所接受，此介入課程亦可誘發學生回家後與家長持續討論中風的症狀、預防及其治療方式，也能改變學生及家長的健康行為。

Although the mortality rate of stroke is keep decline, stroke is still the one the major cause of death in Taiwan. With the era of ageing country, the victim of stroke is keeping increasing. The risk factors of stroke can be altered by health education. Early recognition of the stroke symptom can prompt rapid treatment. Intravenous thrombolysis is the only approved treatment in acute ischemic stroke onset within three hours, however, most of the stroke patients cannot reach the hospital within the golden three hours. Education is the most useful method to reduce the prehospital decreased and increase the treatment rate of intravenous thrombolysis. The working place of the modern physician is changing from hospital to community, and school is part of the community to achieve the patient centered care. Our study target is to use the innovative educational program to improve grade six student’s stroke literacy, including stroke risk factors, symptoms and treatment, to establish their health behavior. Via the co-learning, their parents can also improve their health behavior. Our study proved that the stroke literacy, risk factors, symptoms and treatment recognition in both the student and parent had significantly improved after intervention program. The program not only improved the correct treatment behavior, but also corrected the wrong behavior. The numbers of innovators and early adopters had been increased after the program. In the post-intervention survey, we had a high program satisfaction in both the students and parents. The program had successfully created a topic in stroke among students and their parents, which will lead to health behavior.