血液透析患者護理指導認知程度之探討

Cognition of Nursing Care Instruction for Hemodialysis Patients

10.6299/JHA.2016.3.3.R4.43

李秀珠(Shiow-Ju Lee)；方梅珍(Mei-Chen Fang)；蔡曉薇(Shiau-Wei Tsai)；徐南麗(Nan-Ly Hsu)

血液透析 ； 護理指導 ； 認知 ； hemodialysis ； nursing care instruction ； cognition

健康與建築雜誌

3卷3期（2016 / 10 / 01）

43 - 51

繁體中文

背景：在台灣血液透析病患之盛行率極高，護理人員給予之護理指導對於病患的健康扮演重要角色。目的：探討血液透析患者對護理指導認知程度及影響因素。方法：研究時間自民國104年9月起至105年6月止，研究對象為北部某醫院行血液透析六個月以上的患者100位。研究工具為血液透析護理指導認知量表，此為量性研究。問卷採用Likertscale五分計分法，軟體以SPSS 21進行資料處理，信度內容採內在一致性，效度採專家及內容效度。結果：影響血液透析患者對護理指導認知整體認知平均分數為4.30分，其中以動靜脈瘻管照護的認知最高為4.72分，其次為日常生活保健4.67分；血液透析治療4.64分；飲食控制4.40分；尿毒症併發症4.13分；尿毒症病因3.91分；性問題3.90分。血液透析患者的性別、年齡、教育程度、職業、經濟狀況、婚姻狀況、宗教信仰、疾病史、每週透析次數、透析年資及家族史在護理指導認知程度上有顯著差異。迴歸分析結果顯示：教育程度、每週透析次數、宗教信仰、性別及職業共可解釋96.6%變異量。結論／實務運用：本研究結果有助於執行護理指導時應考量個別差異，予個別性的教導，進而提升血液透析患者護理指導品質。

Background: The prevalence of hemodialysis in Taiwan is remarkably high. The instruction given by nurses plays an important role to hemodialysis patients. Purposes: To investigate the cognition scores and impact factors that may affect the hemodialysis patients on the health education given by nurses. Methods: This research started from September 2015 and ended to June 2016. Subjects 100 who had received hemodialysis for more than 6 months from a regional hospital located in northern Taiwan were recruited. Likert scale 5-point and SPSS 21 were used to analyze the data. Internal consistency reliability, expert's opinion and content validity were conducted. Results: The average score for 7 dimension of cognition on nursing instruction as a whole was 4.30. The highest cognition dimension score 4.72 was on the education regarding the care of vascular access. The second highest score 4.67 was on the daily health maintenance. The third one was 4.64 on the hemodialysis treatment, the following 4 dimension were 4.40 on diet control, 4.13 on uremic complications, 3.91 on the causes of uremia, and 3.90 on sexual problems. Their gender, age, education, occupation, economic status, marital status, religion, medical history, frequency to receive hemodialysis in one week, dialysis year and family history showed significant differences with the degree of cognition. Further regression analysis found that education, frequency to receive hemodialysis in one week, religion, gender and occupation could explain 96.6% of the variance. Conclusions/Implications for Practice: It is important to consider the unique characteristic of individual difference for patients, and apply it to improve the nursing instruction and elevate the quality of nursing care.

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