中風病人足部健康照護之改善專案

Improving Foot Health Care in Stroke Patients

10.6386/CGN.201803_29(1).0006

林淑瓊(Shu-Chung Lin)；曾素美(Su-Mei Tseng)；鄭秋燕(Chiu-Yen Cheng)；王玉眞(Yu-Jen Wang)

中風 ； 足部健康照護 ； 足浴 ； 穴位按壓 ； stroke ； foot health care ； footbath ； acupressure

長庚護理

29卷1期（2018 / 03 / 01）

60 - 73

繁體中文

中風後因血管運動調節系統失常造成病態肢體慢性缺血及冰冷，且在制動下氣血運行衰退導致水腫。本專案旨在提升中風病人足部健康照護品質，透過問卷、查檢表、實地觀察及訪談收集資料及分析現況。結果發現護理人員對足部健康照護認知不足、足部健康照護執行完整率低，以及主要照顧者對足部健康照護滿意度低。經本專案制訂足部健康照護標準作業規範、書面參考資料、足部健康照護評估表、衛教單張、品質監控作業及舉辦在職教育，護理人員足部健康照護認知正確率提升至100%、足部健康照護執行完整率提升至95.4%、主要照顧者對足部健康照護滿意度之改善成效提升至4.9分。期此專案經驗可作為提升中風病人照護品質之參考。

After stroke, chronic ischemia and actual coldness in diseased limbs is caused by dysfunction of vasomotor regulation system. Insufficiency of qi (life energy) and blood in conditions of limited mobility results in edema. This study aimed to investigate nurses' and caretakers' levels of knowledge and satisfaction in providing foot health care and to evaluate a program designed to improve the quality of foot health care in stroke patients. We collected and analyzed data using questionnaires, checklist, observations, and interviews. The baseline findings before introducing the program to improve foot care showed that nurses had both knowledge deficits and low completion rates in foot health care, and primary caregivers had a low satisfaction level in providing foot health care. We developed a standard care program for foot health care, including foot health care reference materials, a checklist for performing foot health care, foot health care pamphlets, and quality monitoring of foot health care. We also conducted in-service education for nurses. Study results revealed that nurses' knowledge of foot health care increased to 100% compared to baseline knowledge and their completion rate of foot health care increased to 95.4% after they received in-service education and were instructed in the standard care program for foot health care. Primary caregivers' satisfaction level for foot health care increased by 4.9 points compared to baseline. Results of this study may serve as a reference for enhancing the quality of nursing care for stroke patients.

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