互動式冠狀動脈心臟病患自我照護手冊之研發與測試研究
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Date
2005/1-2005/12
Authors
郭鐘隆
黃久美
陳富莉
黃心苑
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Abstract
本研究為兩年期計畫，第一年旨在設計「互動式冠狀動脈心臟病自我照護手冊」及發展手冊形成性評價，係根據研究目的及Orem自我照護及Leventhal自我調節模式等理論設計出自我照護手冊初步的內容及型式。且針對手冊的使用群，包含使用手冊的醫療院所護理人員及罹患冠心病的中老年人，實施焦點團體，並邀請相關專業領域的專家顧問團召開「專家會議」，擬透過這兩種形式廣徵各方重要意見以進行「媒體形成性評價」，作為媒體修正的重要參照，以完成手冊初稿。 第二年則擴大自我照護手冊使用對象的數目，上半年將至1-3所醫療院所，進行先驅性研究的研究對象召募，預定進行準實驗研究設計，實驗I組為手冊發放＋newsletter＋學後測驗，實驗II組為手冊發放＋提醒、指導或回饋的介入，並設立控制組，接受原有一般性照護，沒有任何介入，收案時間預估為三至六個月，各組預定招收30-50人。此外，並進行手冊內容的形成性評價，評價內容包括：1）自我照護手冊是否清楚易讀？（如：情境判斷指引容易理解、與相對應的處理原則清楚等）；2）自我照護手冊是否對患者的有幫助？（如：節省不必要的醫療服務利用、金錢及時間花費、減低憂鬱或焦慮等）；3）自我照護手冊是否方便好用？（如：發生狀況時能很快找到符合的情境並強化與個人經驗結合、能配合個人需求融入日常生活中等）；4）自評持續使用自我照護手冊的可能性。下半年先針對上半年先驅性的研究結果，進行手冊內容的適度增刪與介入方式的修正，公開召募有意願的醫療院所，擴大上半年的樣本數，各組預定招收180-250人。以證據醫學（evidence-based medicine）的角度進行大規模介入，以提高外在效度。造福冠心病患，並達到有效使用手冊的效果，並持續對於上半年的先驅性研究病患進行追蹤後測（後後測），以評估其自我照護能力與醫療服務利用的長期狀況。 期望此一實際可用的「互動式冠心病自我照護手冊」能成為患者可以利用的護身法寶，加強中低階層的中老年人對於冠心病的自我照護素養及行為，進而培養中低階層的中老年人對「健康自我管理」之生活型態及能力，以減少國家醫療資源及社會成本負擔，增加中老年冠心病患生活品質的最終目標邁進。
The two-year study is designed to develop and evaluate the effectiveness of an interactive CAD self-care handbook. A quasi-experimental will be applied to examine the intervention effects of knowledge, attitude and behavior intension between control and experimental groups. Possible interventions include handbook, newsletter and learning test for experimental group 1, and handbook, reminder and feedback for groups 2. Thirty to fifty participants will be recruited for each group. The intervention period will take 3 to 6 month. Formative evaluation will be implemented as well at post test. The participants will be asked to evaluate the clearness, helpfulness, convenience and usability of the handbooks. The results of this study will assist CAD patients to enhance their self-care ability, and improve health management. The handbook is expected to be a useful and powerful tool for CAD patients and their family.
The two-year study is designed to develop and evaluate the effectiveness of an interactive CAD self-care handbook. A quasi-experimental will be applied to examine the intervention effects of knowledge, attitude and behavior intension between control and experimental groups. Possible interventions include handbook, newsletter and learning test for experimental group 1, and handbook, reminder and feedback for groups 2. Thirty to fifty participants will be recruited for each group. The intervention period will take 3 to 6 month. Formative evaluation will be implemented as well at post test. The participants will be asked to evaluate the clearness, helpfulness, convenience and usability of the handbooks. The results of this study will assist CAD patients to enhance their self-care ability, and improve health management. The handbook is expected to be a useful and powerful tool for CAD patients and their family.