题名

運用多元教學方案改善腹膜透析病人鈣磷乘積專案

并列篇名

Using Multiple Teaching Programs to Improve Calcium-Phosphorus Product in Peritoneal Dialysis Patient

DOI

10.3966/172674042022062002001

作者

王郁薇(Yu-Wei Wang)；吳佩蓉(Pei-Jung Wu)；陳雯君(Wen-Chun Chen)；張麗梅(Li-Mei Chang)

关键词

多元教學方案 ； 腹膜透析 ； 鈣磷乘積 ； multiple teaching programs ； peritoneal dialysis ； calcium-phosphorus products

期刊名称

臺灣腎臟護理學會雜誌

卷期/出版年月

20卷2期（2022 / 06 / 01）

页次

1 - 14

内容语文

繁體中文
中文摘要

背景：透析病人鈣磷乘積增加會導致副甲狀腺機能亢進、血管鈣化並提高死亡率。統計2018年1至6月腹膜透析病人鈣磷乘積小於60 mg^2/dL^2的比率平均為73.2%，未達閾值且低於健保監測標準故引發動機。目的：本專案旨在降低腹膜透析病人鈣磷乘積以達標準75%。解決方案：分析確立問題為病人對疾病認知不足、飲食攝取知識不足、藥物服用遵從性不佳、輔助工具不足。運用介入措施包括提供血磷檢驗趨勢圖、小組團體衛教、高磷影音教學、手機查詢APP及成立專案衛教Line群組等方案。結果：專案推動後，病人鈣磷乘積小於60 mg^2/dL^2的比率，由2018年6月72.8 %至2019年1月提高到82.2%，已達閾值及健保監測標準。結論：此專案運用團體衛教、影音教學及行動裝置，加強病人自我照顧能力，確實能有效提升護理指導成效，改善照護品質。
英文摘要

Background: The increased calcium - phosphorus product in dialysis patients will lead to hyperparathyroidism, vascular calcification and increase mortality. Statistics from January to June 2018, the ratio of calcium - phosphorus products less than 60 mg^2/dL^2 averaged 73.2% of patients with peritoneal dialysis, which did not reach the threshold and was lower than the health care monitoring standard, so the engine was cited. Purpose: This project aims to reduce the calcium - phosphorus product of peritoneal dialysis patients to reach the standard 75%. Resolution: We analyzed and established that the problems were inadequate patient awareness of the disease, insufficient knowledge of dietary intake, poor compliance with medication, and insufficient aids. The intervention measures include providing trend chart of blood phosphorus test, group health education, high phosphorus audio-visual teaching, mobile phone query APP and establishment of Line group. Results: After the promotion of the project, the ratio of calcium-phosphorus product less than 60 mg^2/dL^2 increased from 72.8% in June 2018 to 82.2% in January 2019, which has reached the threshold and health care monitoring standards. Conclusion: This project uses group health education, audio-visual teaching and mobile devices to strengthen patient's self-care ability, which can effectively improve of nursing guidance to improve the quality of care.
主题分类 醫藥衛生 > 內科
醫藥衛生 > 社會醫學
参考文献
  1. Hsueh, F. C.,Chen, C. M.,Sun, C. A.,Chou, Y. C.,Hsiao, S. M.,Yang, T.(2016).A study on the effects of a health education intervention on anxiety and pain during colonoscopy procedures.Journal of Nursing Research,24(2),181-189.
    連結：
  2. 李佳蓉(2015)。提升教學成效－影片融入教學之探討與策略。科技與人力教育季刊，1(4)，1-13。
    連結：
  3. Bobrow, K.,Farmer, A. J.,Springer, D.,Shanyinde, M.,Yu, L. M.,Brennan, T.,Levitt, N.(2016).Mobile phone text messages to support treatment adherence in adults with high blood pressure (SMS-Text Adherence Support [StAR]): A single blind, randomized trial.Circulation,133(6),592-600.
  4. Fernández-Martín, J. L.,Dusso, A.,Martínez-Camblor, P.,Dionisi, M. P.,Floege, J.,Ketteler, M.,Bos, W. J.(2018).Serum phosphate optimal timing and range associated with patients survival in haemodialysis: the COSMOS study.Nephrology Dialysis Transplantation,34(4),673-681.
  5. Wang, Y. C.,Kao, T. W.,Lu, K. C.,Chu, P. L.(2018).Gold-streaked small intestine as calcifying peritonitis in a peritoneal dialysis patient with hyperphosphatemia and secondary hyperparathyroidism.輔仁醫學期刊,16(3),147-152.
  6. 吳紅蓮(2014)。腹膜透析病患高血磷飲食治療之策略－黃豆蛋白之應用。腎臟與透析，26(4)，269-275。
  7. 吳振鋒,李泓緯(2019)。結合地理資訊於主動式行動適地旅遊多媒體導覽 APP 雲端服務。觀光與休閒管理期刊，7(1)，27-35。
  8. 李建德,李岳庭,吳家兆,劉文治(2015)。礦物質與骨病變。2015 臺灣慢性腎臟病臨床診療指引，苗栗縣:
  9. 林彥仲,陳錫賢,吳麥斯(2015)。慢性腎臟病患中鈣磷異常的流行病學。腎臟與透析，27(3)，103-106。
  10. 國家衛生研究院、台灣腎臟醫學會（2020，9 月 30 日）．台灣腎病年報．取自 https://www.tsn.org.tw/UI/L/TWRD/ebook_2018%E5%B9 %B4%E5%A0%B1.pdf
  11. 黃文德,朱柏齡,許育瑞(2014)。磷結合劑在慢性腎臟疾病病人運用的新進展。內科學誌，25(3)，184-194。
  12. 衛生福利部中央健康保險署（2018，10月 17 日）．全民健保服務品質提升勵計畫．取自 https://www.nhi.gov.tw/Content_List.aspx?n=0404F75C81EB1977&topn=D39E2B72B0BDFA15 0404F75C81EB1977&topn
  13. 衛生福利部食品藥物管理署(2018)。衛生福利部食品藥物管理署（2018，12 月 7 日）．食品營養成分資料庫．取自 https://consumer.fda.gov.tw/Food/TFND.aspx?nodeID。https://consumer.fda.gov.tw/Food/TFND.aspx?nodeID=178
print cancel