運用概念圖提升護理人員執行胃腸造口管路留置病人衛教完整性之改善專案

Using Concept Maps to Improve the Integrity of the Nursing Instruction for Gastrointestinal Tube Patients

10.6880/TJON.202212_22(2).04

高玉鳳(Yu-Feng Kao)；周家瑜(Chia-yu Chou)；雷涵詅(Han-Ling Lei)；侯宜均(Yi-jun Hou)

概念圖 ； 胃腸造口管路 ； 衛教完整性 ； concept maps ； gastrointestinal tube ； integrity of the nursing instruction

腫瘤護理雜誌

22卷2期（2022 / 12 / 01）

49 - 63

英文

本專案主旨為提升腫瘤科護理人員執行胃腸造口管路留置病人衛教完整性。現況：本病房頭頸癌及食道癌病人因無法獲得正確且完整的胃腸造口管路衛教指導內容，致產生困難決策及放置後滿意度低，影響治療計畫及疾病預後。分析原因為：護理人員對胃腸造口管路留置照護認知和指導內容不足、衛教單張多文字少圖片及內容不符合病人需求。透過專案改善方案：制定以概念圖為架構的胃腸造口管路留置照護指引及教育訓練、製作胃腸造口管路留置衛教輔助工具、舉辦病人及家屬座談會。經方案實施後護理人員對胃腸造口管路留置照護認知提升至91.6%、衛教指導完整性提升至91.2%，不僅達到專案設定目標外，也預計將衛教內容發展為網路教材來維持專案成效，並推展至有放置胃腸造口管路需求之護理單位，不僅可提升護理人員執行胃腸造口管路留置之衛教指導完整性，亦達到病人自我照護能力及生活品質。

The purpose of this project is to enhance the integrity of the nursing instruction for patients with a gastrointestinal tube. In the current practice, patients with head and neck cancer and esophageal cancer usually do not obtain the correct or complete gastrointestinal tube health education guidance, resulting in difficult decision-making and low satisfaction after placement, thus influencing treatment plan and disease prognosis. The reasons were poor understanding on knowledge related to nursing instruction for gastrointestinal tube care. Wordy health education tools with few illustrations do not fulfill the needs of patients in learning about the gastrointestinal tubes. Through this project, a system was set up to "develop guidelines for education and training for patients with gastrointestinal tube care based on the concept maps", "construct health education tools on gastrointestinal tube", and "hold seminars for patients of a gastrointestinal tube and their families". After the implementation of the plan, the nurses' understanding about gastrointestinal tube care increased to 91.6%, and the integrity of providing health education following guidance increased to 91.2%. Not only were the project outcomes achieved, but the health education content was expected to be further developed for online accessibility. The effect of the project has been maintained and extended to other nursing wards having patients on gastrointestinal tubes. This can improve the integrity of nursing instruction for patients and improve patients' self-care ability and quality of life.

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