多媒體輔助教學於糖尿病病人初次胰島素治療臨床效益之探討

The Clinical Efficacy of Multimedia-Assisted Instruction for Diabetic Patients in Initiating Insulin Therapy

詹紹華(Shao-Hua Chan)；蔡明燕(Ming-Yan Tsai)；邱智鈴(Ge-Lin Chiu)；王靜枝(Jing-Jy Wang)；林為森(Weirsen Lin)

影音光碟教學 ； 胰島素注射 ； 滿意度 ； multimedia Audio ； insulin injection ； satisfaction

若瑟醫護雜誌

14卷1期（2020 / 07 / 01）

6 - 19

繁體中文

目的：糖尿病病人儘早接受胰島素治療，能增進日後血糖控制。考量傳統教學的時間與護理工作的負荷，故本研究目的為探討多媒體影音光碟的輔助教學方式，對初次實施胰島素注射治療的病人之胰島素注射認知、護理人員指導時間、血糖控制及滿意度之成效。方法：本研究為類實驗設計，採立意取樣，於南部某醫學中心新陳代謝科門診收集樣本，樣本分為實驗組與對照組，每組收案各51人。提供實驗組「胰島素治療衛教影片」於衛教室讓個案觀看學習後再請患者實際於輔具操作，對照組則使用傳統式衛教。使用胰島素認知量表、胰島素注射技能量表、與多媒體學習滿意度調查問卷進行個案前後測。獨立樣本t檢定、配對樣本t檢定、卡方檢定等統計分析法呈現研究結果。結果：研究結果發現多媒體影音光碟的輔助教學與傳統護理指導在病人胰島素注射技巧認知及血糖控制雖無顯著差異，但多媒體影音光碟的輔助教學能顯著減少臨床護理人員護理指導的時間及有較高的護理指導滿意度。結論：在護理人力匱乏與工作負荷繁重之狀況下，多媒體影音光碟教學方式在有效時間內能增進病人對於胰島素注射技巧的認知、有效降低護理指導時間且能提升學習者的滿意度。本研究之介入方案具有確實的效益與可行性，可以作為各醫療院所護理人員進行糖尿病病人胰島素注射相關護理指導活動規劃與設計之參考。

Purposes: Patients with diabetes receive insulin treatment earlier may facilitate blood sugar control in the future. In considering time and work load of traditional teaching by nurses, This study examined the effects of a combined multimedia-audio assisted and regular instruction on personal insulin knowledge, teaching time , blood sugar control and satisfaction among patients with primary insulin injection. Methods: A quasi‐experimental with purposive sampling design was conducted. Subjects were drawn from the metabolic clinic of a medical center in southern taiwan and divided into the experimental group (multimedia-audio assisted) and the control group (regular instruction), with 51 subjects in each group. Data were collected used a structured demographic questionnaire, insulin knowledge scale,insulin injection skills Scale, and the multimedia learning satisfaction questionnaire before and after the intervention . Statistical analysis methods such as independent sample t-test, paired sample t-test, and chi-square test are presented. Results: Finding of this study show no significant difference between the two groups in terms of injection competency, blood glucose control, yet higher satisfaction and less time spent (p＜.001) on health education by nurses were found in the experimental group . Conclusions: In light of the current nursing shortage and the heavy workloads of nurses, using multimedia-audio for patient education is not only cost - effective but also may improve patient satisfaction. Healthcare institutions may implement the findings of this study to plan patient education related to insulin-pen injections.

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