Hiromoto B M, Dungan J
Straub Clinic and Hospital, Honolulu, Hawaii.
Cancer Nurs. 1991 Jun;14(3):148-54.
Chemotherapy presents a challenge to patients and their families because of altered abilities for self-care. The nurse investigator initiated a protocol study with five patients responding to a query, "What do you need to know?," related to chemotherapy. Evaluation was done during February and March 1989 in a private oncology/hematology clinic in Hawaii. This was an evaluative study designed to measure the effectiveness of a contract learning protocol. A descriptive case study approach was used to analyze findings. Orem's self-care deficit theory of nursing provided the theoretical framework for the protocol. Based on Orem's supportive educative system, the nurse utilized the three types of self-care requisites to develop a learning needs assessment tool. Contract learning reinforced management of self-care deficits with self-care activities. Four of the subjects were able to recognize symptoms, weigh options for actions, initiate self-care behaviors, and evaluate the effectiveness of self-care activities. Findings suggest that the protocol provides a systematic and comprehensive approach to patient's self-care deficits using adult learning principles.
由于自理能力的改变，化疗给患者及其家属带来了挑战。护士研究者发起了一项方案研究，对五名回应“你需要了解什么？”这一问题的患者进行了与化疗相关的研究。1989年2月和3月在夏威夷的一家私立肿瘤/血液诊所进行了评估。这是一项旨在衡量契约学习方案有效性的评估研究。采用描述性案例研究方法分析研究结果。奥瑞姆的护理自理缺陷理论为该方案提供了理论框架。基于奥瑞姆的支持性教育系统，护士利用三种自理需求类型开发了一种学习需求评估工具。契约学习通过自理活动加强了对自理缺陷的管理。四名受试者能够识别症状、权衡行动选择、发起自理行为并评估自理活动的有效性。研究结果表明，该方案运用成人学习原则，为患者的自理缺陷提供了一种系统而全面的方法。
