運用多媒體光碟合併衛教手冊對新住民產婦於新生兒照顧之成效

The Effects of the Combination of Multimedia Videos And Health Pamphlet on Neonate Care Among New Immigrant Mothers

謝慧雯(Hui-Wen Hsieh)；梁蕙芳(Hwey-Fang Liang)；樓美玲(Mei-Ling Lou)

多媒體介入 ； 衛教手冊 ； 新住民產婦 ； 新生兒照顧 ； multimedia intervention ； health pamphlet ； immigrant mothers ； neonate care

嘉基護理

19卷2期（2019 / 12 / 01）

1 - 14

繁體中文

背景：跨國婚姻的新住民女性來台，除面臨生活與文化衝擊之外，亦擔負生養兒女的職責，國內少有針對此群體進行多媒體衛教之介入研究。目的：旨在運用多媒體光碟合併衛教手冊方式，對新住民產婦於照顧新生兒的知識、態度與技能之成效。方法：研究採方便取樣及雙組前後測之類實驗設計，研究對象為新住民初產婦，採自擬之結構式問卷，包含:「基本資料」、「新生兒照顧知識量表」、「新生兒照顧態度量表」、「新生兒照顧技能評值量表」，先收集對照組（n＝20）資料，再收集實驗組（n＝20）資料。兩組個案皆於生產前一週收集基本資料、知識與態度之前測資料。產後三天內，對照組接受醫院常規衛教，實驗組則接受多媒體光碟與衛教手冊之指導；兩組個案皆於出院前收集後測資料，並於產後一週內以電訪方式檢視其效果。以獨立樣本t檢定和單因子共變數分析比較兩組之介入成效。結果：實驗組於新生兒照顧的知識與態度之後測分數，均較對照組之後測分數高。多媒體光碟合併衛教手冊方式雖未於產婦出院前有效的改變照顧技能，但可顯著增加產婦於新生兒照顧的知識（F＝9.972，p＜.05）與態度（F＝7.098，p＜.05）。結論／實務應用：本研究成果能提供未來護理人員對新住民女性執行新生兒照顧的護理指導依據，透過新住民產婦的個別化需求，提供多媒體衛教內容與技術回覆示教，建立標準化的產後護理指導模式，亦能協助新住民女性扮演母親照顧者的角色。

Background: Transnational marriage women who immigrant to Taiwan not only suffer from life adjustment and culture shock, but also take responsibilities of childbearing. Only few researches focused on the effect of multimedia-videos for learning on the new immigrant mothers in Taiwan. Purposes: The aim of the study was to investigate the effect of the combination of multimedia videos and health pamphlet on the knowledge, attitude and skills of neonate care among new immigrant mothers. Methods: This is a quasi-experimental study design with purposive sampling and pre-and post-test. The participants were primiparas who were newly immigrant to Taiwan. Participants were allocated to experimental (n=20) and control group (n=20) according to the delivery sequence. Pre-test data including demographics, questionnaires of knowledge and attitude were collected one week before delivery. Post-test data were collected before discharge and telephone follow-up one week after delivery to examine the long-term effect. The control group receive routine care. The experimental group receive instructions with the combination of multimedia videos and health pamphlet within 3days after delivery. Independent sample t test and Analysis of variance (ANOVA) were performed to analyze the effect. Results: Comparing to control group, the post-test scores of knowledge (F=9.972; p＜.05) and attitude (F=7.098; p＜.05) in experimental group were significantly higher. However, the combination of multimedia videos and health pamphlet did not significantly improve the skill before discharge. Conclusions and Implications for Practice: This study can provide the reference for nurses to execute nursing instruction of neonate care and reinforce new immigrant women's ability in maintaining motherhood role.

1. Hung, Y. L.,Chen, K. R.,Stones, C.,Cassidy, T.(2015).Development and evaluation of healthcare media for new immigrants: a case study of the design of children’s allergy healthcare media for new immigrants in Taipei, Taiwan.Taiwan Journal of Public Health,34(1),74-85.
   連結：
2. Lee, W. L.,Sung, H. C.,Huang, L. C.,Smith, G. D.(2012).Anxiety of outpatients prior to magnetic resonance imaging procedures: The effectiveness of a multimedia patient education intervention.Taiwanese Journal of Psychiatry,26(4),271-277.
   連結：
3. Wang, L. M.,Chiou, C. P.(2011).Effectiveness of interactive multimedia CD on self-care and powerlessness in hemodialysis patients.Journal of Nursing Research,19(2),102-111.
   連結：
4. 陳秓美, C. M.,柯淑華, S. H.(2001)。比較不同生產方式之初產婦於產後初期的關注內容及衛教需求。弘光學報，38，11-21。
   連結：
5. Duong, D. V.,Binns, C. W.,Lee, A. H.(2004).Breast-feeding initiation and exclusive breast-feeding in rural Vietnam.Public Health Nutrition,7(6),795-799.
6. Faul, F.,Erdfelder, E.,Lang, A. G.,Buchner, A.(2007).G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences.Behavior Research Methods,39,175-191.
7. Fischer, T. P.,Olson, B. H.(2014).A qualitative study to understand cultural factors affecting a mother's decision to breast or formula feed.Journal of Human Lactation,30,209-216.
8. Hayden, J.(2014).Introduction to health behavior theory.Burlington:Jones &Bartlett Learning.
9. Rayment-Jones, H.,Butler, E.,Miller, C.,Nay, C.,O’Dowd, J.(2017).A multisite audit to assess how women with complex social factors access and engage with maternity services.Midwifery,52(2017),71-77.
10. Skafida V.(2009).The relative importance of social class and maternal education for breast-feeding initiation.Public Health Nutrition,12(12),2285-2292.
11. Winston, K.,Grendarova, P.,Rabi, D.(2018).Video-based patient decision aids: a scoping review.Patient Education and Counseling,101(4),558-578.
12. Yazng, Y.M.,Wang, H. H.(2011).Acculturation and health-related quality of life among Vietnamese immigrant women in transnational marriages in Taiwan.Journal of Transculture Nursing,22(4),405-413.
13. 內政部統計處（2017）‧內政統計週報-105年新生嬰兒生母狀況分析‧取自 http://sowf.moi.gov.tw/stat/week/week10632.pdf [Department of Statistics, Ministry of Interior, Taiwan, ROC. (2017). 2016 weekly statistical report. Retrieved from http://sowf.moi.gov.tw/stat/week/week10632.pdf]
14. 何巧琳, C. L.,張綠怡, L. I.(2013)。臺灣新移民婦女週產期照護之影響因素。北市醫學雜誌，10(3)，288-294。
15. 李以文, Y. W.,顧潔修, C. H.,江衍良, Y. L.,黃璉華, L. W.(2013)。臺灣2000~2012醫護研究以新移民女性為對象的趨勢分析。長庚科技學刊，19，115-126。
16. 林晶晶, C. C.,陳淑賢, S. H.(2007)。護理指導對外籍配偶的哺乳型態、哺餵母乳知識及態度之成效探討。實證護理，3(2)，161-169。
17. 邵上智, S. C.,蔡明翰, M. H.,蔡培癸, P. K.,劉雪娥, H. E.(2015)。多媒體衛教光碟合併護理指導對於初次冠心病患者在疾病知識、態度及自我照顧行為之成效探討。護理暨健康照護研究，11(3)，175-186。
18. 徐獻洲, H. C.,陳思蓉, S. J.,黃美智, M. C.(2012)。文化適切性衛教改變越籍母親發燒處理訊息動機與行為技能之成效。護理雜誌，59(6)，55-64。
19. 翁敏雪, M. H.,李從業, T. Y.,李文宗, W. C.(2003)。產前錄影帶衛教介入措施對產婦分娩自我控制成效之探討。新臺北護理期刊，5(2)，49-58。
20. 許碧純, P. C.(2014)。婚姻移民從事家庭照顧工作之動態：以在台灣之越南與印尼女性配偶為例。通識教育與多元文化學報，4，25-63。
21. 郭淑芬, S. F.,陳月枝, Y. C.,毛新春, H. C.,鄒國英, K. I.(2000)。個別性護理指導對初產婦照顧新生兒相關因素之成效探討。護理研究，8(2)，152-164。
22. 陳昭惠, C. H.(2008)。國內母乳哺育諮詢網絡之推展。醫療品質雜誌，2(4)，30-34。
23. 陳瑩倢, Y. C.,李淑桂, S. K.,曾淑梅, S. M.,黃淑媛, S. Y.,曾英珍, Y. C.(2009)。提升某醫學中心婦產科產婦對產後衛教之滿意度。中山醫學雜誌，20(1)，1-14。
24. 葉娜娸, N. H.(2005)。台北=Taipei City, Taiwan, ROC，國防醫學大學護理學研究所=National Defense Medical Center。
25. 詹紹華, S. H.,王凱欣, K. H.,王靜枝, J. J.,林為森, W. S.,張嘉蘋, J. P.(2014)。多媒體影音光碟於筆型胰島素注射護理指導之效益－以南部某醫學中心為例。護理暨健康照護研究，10(2)，123-133。
26. 劉美芳, M. F.,李慈音, T. Y.(2009)。新生兒臍帶護理的迷思。護理雜誌，56(5)，80-86。
27. 蔡佳憓, C. H.(2005)。台北=Taipei City, Taiwan, ROC，國立陽明大學護理學研究所=National Yang-Ming University。
28. 衛生福利部國民健康署（2017b）‧寶貝來了真歡喜-認識產兆和新生兒照護‧引自http://mediafile.hpa.gov.tw/www/health99/media/public/zip/50271.zip [Health Promotion Administration, Ministry of Health and Welfare. Taiwan, ROC. (2008). Preparing for the birth: Signs of labor and newborn care. Retrieved from http://mediafile.hpa.gov.tw/www/health99/media/public/zip/50271.zip]
29. 衛生福利部國民健康署（2017a）‧哺餵寶寶真趣味-認識哺乳和嬰兒副食品‧引用http://mediafile.hpa.gov.tw/www/health99/media/public/zip/50272.zip [Health Promotion Administration, Ministry of Health and Welfare. Taiwan, ROC. (2008). Breastfeeding and principles of introducing supplemental food. Retrieved from http://mediafile.hpa.gov.tw/www/health99/media/public/zip/50272.zip]

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