Tsai Shian-Ting, Chou Fan-Hao
Department of Nursing, National Cheng Kung University Hospital, ROC.
Hu Li Za Zhi. 2012 Aug;59(4):43-53. doi: 10.6224/JN.59.3.43.
Properly educating myocardial infarction (MI) patients in the extremely busy cardiac care unit (CCU) work environment is difficult for CCU nurses.
This study examined the effectiveness of multimedia nursing education in reducing illness-related anxiety and uncertainty in MI patients following percutaneous coronary intervention (PCI).
A quasi-experimental study with judgment sampling was designed and performed at a medical center in South Taiwan. The control group (n = 36) received written nursing education material and the experimental group (n = 40) received multimedia nursing education. Participant illness-related anxiety and uncertainty was measured at four specific periods, namely (1) at admission to the CCU, (2) immediately after completing the nursing education interventions, (3) upon transfer to the general ward, and 4) at discharge. Measurement tools included Mishel's uncertainty in illness scale (MUIS), the state-trait anxiety inventory (STAI), and noninvasive physiological monitoring instruments.
Results showed that both interventions lowered anxiety ÷ uncertainty in participants with moderate to severe levels (experimental group - anxiety: t₃₉ = -6.615, p < .001 and uncertainty: t₃₉ = -8.317, p < .001; control group - anxiety: t₃₅ = -4.767, p < .001 and uncertainty: t₃₅ = -9.739, p < .001). The experimental group achieved significantly greater reductions than the control group in terms of anxiety and uncertainty in each of the four measurement periods.
CONCLUSIONS / IMPLICATIONS FOR PRACTICE: Based on the evidence, both nursing education formats are valid for patient education and may be chosen based on CCU clinical conditions.
在极度繁忙的心导管加护病房(CCU)工作环境中,对心肌梗死(MI)患者进行恰当的教育,对CCU护士而言颇具难度。
本研究探讨多媒体护理教育在降低经皮冠状动脉介入治疗(PCI)后MI患者疾病相关焦虑及不确定性方面的效果。
在台湾南部的一家医学中心设计并进行了一项采用判断抽样的准实验研究。对照组(n = 36)接受书面护理教育材料,实验组(n = 40)接受多媒体护理教育。在四个特定时段测量参与者的疾病相关焦虑及不确定性,即(1)入住CCU时,(2)完成护理教育干预后即刻,(3)转至普通病房时,以及(4)出院时。测量工具包括米舍尔疾病不确定感量表(MUIS)、状态-特质焦虑问卷(STAI)以及无创生理监测仪器。
结果显示,两种干预措施均降低了中重度参与者的焦虑及不确定性(实验组 - 焦虑:t₃₉ = -6.615,p <.001;不确定性:t₃₉ = -8.317,p <.001;对照组 - 焦虑:t₃₅ = -4.767,p <.001;不确定性:t₃₅ = -9.739,p <.001)。在四个测量时段中的每一个时段,实验组在焦虑及不确定性降低方面均显著大于对照组。
结论/对实践的启示:基于这些证据,两种护理教育形式对患者教育均有效,可根据CCU临床情况选择。