臺灣博碩士論文加值系統

面對心臟衰竭病患，提供有效的護理措施可使病人感到舒適，並且使症狀得到有效的控制。護理理論家Rogers認為，人和環境都是能量場，且兩者之間一直在持續的互動，經由能量的交流產生波形的改造。國外許多研究也都支持按摩可以降低生理症狀。然而國內罕見有關此類介入措施的探討，因此，本研究目的在於應用Rogers理論以探討施行背部按摩對心臟衰竭病患焦慮、舒適及相關生理指標的成效。採用類實驗法單組前後測設計，於南部某醫學中心心臟內科病房收案，研究對象於入院後72小時，施予每天一次，每次十分鐘共三天的背部按摩，收案人數68人，研究工具包括情境焦慮量表、舒適視覺類比量表、電子血壓計、聽診器以及血氧飽和度測定裝置等生理指標測試工具。經由配對t檢定分析結果，顯示心臟衰竭個案在接受背部按摩後，其焦慮、舒適以及血壓、心跳次數、呼吸次數、血氧飽和濃度等生理指標均有顯著的成效。此外本研究也發現病患在接受背部按摩之後，可促進其睡眠狀態。因此，背部按摩護理措施，應該在臨床上加以推廣，以促進心臟衰竭病患的身心舒適。

目 錄
頁次
第一章 緒 論
研究動機及重要性…………………………………………….1
研究假設………………………………………………………. 4
名詞解釋……………………………………………………….. 5
第二章 文獻查證
Rogers 護理理論簡介………………………………………. 7
心臟衰竭………………………………………………………. 12
焦慮之相關概念………………………………………………. 15
舒適之相關概念………………………………………………. 18
背部按摩療法…………………………………………………. 20
按摩療法之生理指標…………………………………………. 25
按摩與焦慮、舒適之關係……………………………………. 27
背部按摩相關研究……………………………………………. 29
第三章 研究方法
研究設計及場所……………………………………………… 31
研究對象及樣本數…………………………………………. 33
倫理考量……………………………………………………… 35
研究工具及信度及效度檢定………………………………. 36
研究步驟……………………………………………………. 41
資料的統計分析……………………………………………. 44
第四章 研究結果
預試階段…………………………………………………… 45
正式施測階段………………………………………………… 47
背部按摩對心臟衰竭病患焦慮程度之效果………………… 51
背部按摩對心臟衰竭病患舒適程度之效果………………… 55
背部按摩對心臟衰竭病患生理指標之效果………………… 57
第五章 討 論
背部按摩對心臟衰竭病患焦慮程度之效果………………… 62
背部按摩對心臟衰竭病患舒適程度之效果………….…… 64
背部按摩對心臟衰竭病患生理指標之效果………………. 66
結 論…………………………………………………………. 69
對護理的運用及建議………………………………………… 71
研究限制……………………………………………………… 73
參考資料
中文部分……………………………………………………… 74
英文部分……………………………………………………… 78
附 錄
附錄一 研究同意書……………………………… 85
附錄二 個案基本資料……………………………. 86
附錄三 情境焦慮量表…………………………… 87
附錄四 研究工具使用同意書…………………… 88
附錄五 視覺類比量表……………………………. 89
附錄六 生理指標測量評核表……………………. 90
附錄七 按摩手法…………………………………. 91
表 次
表一 背部按摩相關研究………………………. 29
表二 研究對象基本屬性……………………… 49
表三 背部按摩前後情境焦慮量表得分之比較. 53
表四 舒適程度於接受背部按摩前後差異之比較
…………. 56
表五 生理指標在接受背部按摩前後之比較…. 58
圖 次
圖一 研究架構……………………………… 11
圖二 研究設計圖…………………………….. 32
圖三 研究步驟……………………………….. 41
圖四 背部按摩前、後焦慮總得分改變趨勢圖 54
圖五 背部按摩前、後焦慮各題得分改變趨勢圖54
圖六 背部按摩前、後舒適情況改變趨勢......56
圖七 背部按摩前、後收縮血壓改變趨勢圖……58
圖八 背部按摩前、後舒張血壓改變趨勢圖… .60
圖九 背部按摩前、後心跳次數改變趨勢圖… 60
圖十 背部按摩前、後呼吸次數改變趨勢圖……61
圖十一 背部按摩前、後血氧飽和濃度改變趨勢圖61

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