臺灣博碩士論文加值系統

本研究目的旨在探討護理介入對心臟衰竭患者疾病知識、態度及自我照顧行為之影響。本研究採類實驗設計法(Quasi-experimental design)，於民國88年1月至民國88年4月止，在花蓮某區域教學醫院心臟內科門診進行研究，採立意取樣的方式選擇符合收案條件的心臟衰竭患者為研究對象。分為收取實驗組及控制組各為40人。實驗組患者接受研究使用自編《心臟衰竭患者居家自我照顧行為衛教本》進行護理介入措施，控制組則無接受實驗處置。以訪談方式收集前測資料並於一個月後個案回診時間收集後測資料。資料分析採用SPSS for Windows7.0統計套裝軟體，以描述性分析、卡方檢定、配對t考驗、單因子共變數分析及皮爾森積差相關係數等方法進行資料分析。
研究結果顯示兩組心臟衰竭患者疾病知識前測得分百分比皆為65%，普遍不理想，在疾病知識各項中以「活動」及「飲食」兩部份得分較高，「疾病及危險因子」及「藥物」兩部份得分較低。在疾病態度方面，兩組患者「對疾病感受」及「對自我照顧行為的看法」兩部份皆抱持中立偏正向的態度，而自我照顧行為則以「醫療行為」執行情形較好。實驗組患者接受護理介入後，在疾病知識、態度及自我照顧行為三方面得分皆顯著高於控制組患者。前後測改變量最多的部份，在知識方面以「疾病及危險因子」及「藥物」兩部份，態度方面則是「對自我照顧行為的看法」部份，而自我照顧行為方面則為「日常保健行為」。疾病知識、態度及自我照顧行為三者於護理介入後，彼此間呈顯著正相關。
根據研究結果顯示護理介入可增進患者疾病知識、改善疾病態度及增加自我照顧行為，故本研究者自編之《心臟衰竭患者居家自我照顧行為之衛教本》應可作為臨床護理人員提供護理指導之參考工具。
關鍵字：心臟衰竭、疾病知識、態度、自我照顧行為。

The purpose of this study was to evaluate the effects of nursing interventions on knowledge, attitude and self-care behaviors of patients with Heart Failure(HF). A quasi-experimental research design was appiled to this study. Subjects recruited from a cardiac medical outpatient of a regional hospital in Hualien city between January and April 1999. The total of 80 subjects, which include 40 HF in the experimental group and 40 HF in the control group, was selected by using of purposed sample method.
The experimental group received nursing interventions by the researchers using “The brochure for self-care behaviors of patients with heart failure”. The control group did not receive any nursing interventions. The pre-test and post-test, such as knowledge, attitude and self-care behaviors were measured by structured questionnaire. All data were analyzed by the SPSS for Windows 7.0 statistical software such as descriptive, pair-t, one way ANCOVA, and pearson’ correlation.
In the pretest, all subjects had a fair amount of knowledge. They had more knowledge about activity and diet for Heart Failure disease and less knowledge about medications and risk factor of disease for their disease. Their attitude toward disease was moderate positive, and their self-care behaviors were inadequate.
After nursing interventions, the score of the experimental group were higher than that of the control group especially about risk factor of disease and medications on knowledge, the opinion of self-care on attitude and daily health behavior on self-care behaviors. Moreover, their knowledge, attitude and self-care behaviors were significantly positive correlated to each other.
The findings of the study indicated that this nursing intervention could increase patients’ knowledge, improve their attitude and increase self-care behaviors. Therefore, “The brochure for self-care behaviors of patients with heart failure” could be supplied for the nurses in clinics .
Keyword: Heart Failure, Knowledge, Attitude, Self-care Behaviors

第一章 緒 論.………………………….1
第二章 文獻探討
第一節 心臟衰竭…………… ……………3
第二節 心臟疾病知識、態度及自我照顧行為相關研究 9
第三節 護理介入與心臟疾病之相關研究..11
第四節 文獻總結…………………..……..14
第五節 概念架....................... 15
第三章 研究方法
第一節 研究設計……………………………19
第二節 研究對象及場所…………………..20
第三節 研究工具…………………………..20
第四節 研究步驟……………………………23
第五節 研究對象權益保護…………………25
第六節 資料分析…………………………….25
第四章 研究結果
第一節 研究對象基本資料分佈………….27
第二節 心臟衰竭患者疾病知識、態度及自我照顧行為得分情形28
第三節 護理介入對心臟衰竭患者疾病知識、態度及自我照顧行為的影響34
第四節 護理介入疾病知識、態度及自我照顧行為三者之相關性…40
第五章 討論
第一節 研究結果之分析與討論……41
第二節 結論…………………………48
第三節 研究結果之應用……………49
第四節 研究限制與建議……………50
參考文獻
中文部份.......................52
英文部份…………………………...53
表………………………….........58
附錄目錄.......................82

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