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研究生:吳枝容
研究生(外文):Wu-Chih Jung
論文名稱:多媒體輔助性衛教方案對婦科腹腔鏡手術病人手術自我效能.焦慮.疼痛及衛教滿意之成效
論文名稱(外文):The effects of a multimedia teaching program on surgical self-efficacy, anxiety, pain, and health education satisfaction in gynecological patients with laparoscopic surgery
指導教授:謝秀芳謝秀芳引用關係
指導教授(外文):Hsieh-Hsiu Fang
學位類別:碩士
校院名稱:輔英科技大學
系所名稱:護理系碩士班
學門:醫藥衛生學門
學類:護理學類
論文種類:學術論文
論文出版年:2008
畢業學年度:96
語文別:中文
論文頁數:151
中文關鍵詞:多媒體婦科病人腹腔鏡手術手術自我效能焦慮疼痛衛教滿意度健康控制歸因
外文關鍵詞:health locus of controlhealth education satisfactionpainsurgical self-efficacylaparoscopic surgerymultimediagynecological patientsanxiety
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本研究目的是在瞭解婦科腹腔鏡手術病人衛教前之自覺健康控制、術前訊息、手術自我效能、焦慮及疼痛狀況與多媒體衛教方案介入後之成效。本研究對象來自南部某一醫學中心之婦科腹腔鏡手術病人(N = 84),採類實驗兩組前後測研究設計,以個人基本資料、自覺健康控制、術前訊息、婦科手術自我效能、焦慮與疼痛數字及衛教滿意度之量表為研究工具收集資料,並進行描述性及推論性統計分析及處理。
研究結果顯示:(一)研究對象年齡20~63歲,衛教前研究對象之自覺健康控制為內控型、對於術前訊息內容之看法介於「普通重要」與「重要」間、焦慮為輕度、疼痛為極輕度。(二)衛教後經重複量數單因子變異數檢定,各組之焦慮顯著降低(實驗組p < 0.001;對照組p < 0.001)、疼痛顯著增加(實驗組p < 0.001;對照組p < 0.001),經配對樣本t檢定,各組之手術自我效能無顯著差異。(三)實驗組在多媒體輔助性衛教方案介入後,經獨立t樣本檢定,實驗組衛教滿意度顯著比對照組高(p = 0.040);但在多媒體輔助性衛教方案後,兩組經由單因子共變數檢定,在手術自我效能、焦慮及疼痛則無顯著成效。
本研究結果顯示目前婦科腹腔鏡手術病人照護中需加強改善之處,主要在於衛教環境的改善及手術後疼痛的緩解。以此作為醫護人員臨床照護之參考,期能增進婦科腹腔鏡手術婦女之手術前後的照護品質
The purpose of this study was to explore the effects of a multimedia teaching program on the health locus of control, preoperative information, surgical self-efficacy, anxiety, and pain in gynecological patients with laparoscopic surgery. Eighty-four hospitalized women who were diagnosed gynecological diseases and were scheduled to have laparoscopic surgeries were recruited from a medical center in the southern Taiwan. The study used a quasi-experimental design with two groups for pre- and post-intervention tests comparison. The research instruments used included the structured demographic questionnaire, the Multidimensional Health Locus of Control-Form C, the Preoperative Information Scale, the Self-Efficacy Scale of Gynecological Surgery, the Verbal Numeric Anxiety Scale, the Verbal Numeric Pain Scale, and the Satisfaction Scale of Health Education. Descriptive and inferential statistical analyses were utilized to analyze data.
The main results included: (1) the participants’ age ranging from 20~63 years olds, the participants tending to be internal health locus of control, the majority of the participants reporting the preoperative information was somehow important and important, and all the participants reporting a mild-level of anxiety and low intensity of pain before the operation. (2) Using the repeated measures analysis of variances (ANOVA), there were significant differences within group analysis over time. The participants regardless being in either the experimental or control group reported a lower level of anxiety (experimental group p < 0.001; control group p < 0.001) and an increase in pain intensity after the surgery (experimental group p < 0.001; control group p < 0.001). Using the paired sample t test for within group analysis, neither the experimental nor the control group had a significant change in surgical self-efficacy, (3) Using the independent sample t test for two groups analysis, comparing with the participants in the control group, those in the experimental group reported higher level of satisfaction regarding to health education (p = 0.040). However, using an analysis of covariance (ANCOVA), there were no significant differences in surgical self-efficacy, anxiety, and pain observed between two groups.
These results were not conclusive on the effects of the multimedia health education program in psychological and physiological responses of women with gynecological laparoscopic surgery. In spite of this, the study results suggest that health care providers, especially nurses could become more proactive in their care of postoperative pain to improve the quality of nursing care.
目 錄
致 謝 i
中文摘要 ii
英文摘要 iii
表 目 錄 vii
圖 目 錄 viii
第一章 緒論 1
第一節 研究動機及重要性 1
第二節 研究目的 6
第三節 研究問題 7
第四節 名詞界定 8
第二章 文獻探討 12
第一節 內生殖器官手術對婦女之身心影響與護理需求 12
第二節 健康控制歸因 17
第三節 術前訊息 21
第四節 自我效能 24
第五節 焦慮 27
第六節 疼痛 30
第七節 成效與滿意度 32
第八節 病人衛生教育與影音多媒體衛教 35
第九節 概念架構 39
第三章 研究方法 41
第一節 研究對象及地點 43
第二節 倫理考量 44
第三節 研究工具及信、效度 45
第四節 介入措施 54
第五節 資料收集 55
第六節 資料分析 57
第四章 研究結果 59
第一節 婦科腹腔鏡手術病人之人口學屬性分佈及差異比較 61
第二節 婦科腹腔鏡手術病人衛教前自覺健康控制、術前訊息、手術自我效能、焦慮及疼痛之差異比較 68
第三節 衛教前後婦科腹腔鏡手術病人在手術自我效能、焦慮及疼痛之差異 76
第四節 多媒體輔助性衛教方案對婦科腹腔鏡手術病人手術自我效能、焦慮、疼痛及衛教滿意度之成效 82
第五章 討論 92
第一節 研究對象基本資料 92
第二節 研究對象自覺健康控制、術前訊息、手術自我效能、焦慮及疼痛之差異比較 94
第三節 多媒體輔助性衛教方案對婦科腹腔鏡手術病人手術自我效能之成效 99
第四節 多媒體輔助性衛教方案對婦科腹腔鏡手術病人焦慮之成效 102
第五節 多媒體輔助性衛教方案對婦科腹腔鏡手術病人疼痛之成效 104
第六節 多媒體輔助性衛教方案對婦科腹腔鏡手術病人衛教滿意度之成效 106
第六章 結論與建議 108
第一節 結論 108
第二節 研究限制 109
第三節 運用及建議 111
文獻參考 114
附錄一 研究同意書 135
附錄二 個人基本資料 136
附錄三 自覺健康控制量表 138
附錄四 術前訊息量表 140
附錄五 婦科手術自我效能量表(前測) 142
附錄六 婦科手術自我效能量表(後測) 144
附錄七 衛教滿意度量表 146
附錄八 研究問卷使用同意函-自覺健康控制量表 148
附錄九 研究問卷使用同意函-術前訊息量表 149
附錄十 研究問卷使用同意函-自我控制量表 150
附錄十一收案醫院-研究計畫審核表 151
表 目 錄
表一 研究對象施測時間與內容 56
表二 統計分析方法與內容 58
表三 實驗組與對照組人口學資料之比較 66
表四 婦科腹腔鏡手術病人自覺健康控制各題項之平均值及排序 69
表五 衛教前實驗組與對照組自覺健康控制、術前訊息、手術自我效能、焦慮及疼痛之比較結果 70
表六 婦科腹腔鏡手術病人術前訊息各題項之平均值及排序 72
表七 衛教前實驗組與對照組手術自我效能各題項之平均值及排序 74
表八 衛教前後各組手術自我效能之比較結果 77
表九 衛教前後各組焦慮與疼痛各次測量之比較結果 79
表十 多媒體輔助性衛教方案對婦科腹腔鏡手術病人手術自我效能之成效分析 83
表十一 多媒體輔助性衛教方案對婦科腹腔鏡手術病人焦慮之成效分析 85
表十二 多媒體輔助性衛教方案對婦科腹腔鏡手術病人疼痛之成效分析 87
表十三 實驗組與對照組衛教滿意度各題項之平均值及排序 90
表十四 多媒體輔助性衛教方案對婦科腹腔鏡手術病人衛教滿意度
之成效分析 91

圖 目 錄
圖一 衛教方案對婦科腹腔鏡手術病人手術自我效能、焦慮、痛
及衛教滿意度之成效 40
圖二 研究設計流程 42
圖三 研究對象收案流程圖 60
圖四 衛教前後實驗組與對照組手術自我效能之差異 77
圖五 實驗組與對照組焦慮剖析圖 79
圖六 實驗組與對照組疼痛剖析圖 80
圖七 實驗組與對照組衛教滿意度之差異 91
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