| 摘要: | 本研究以在老人健檢中被檢驗出為高血脂且有意願接受衛教之病患，分配至控制組及不同的實驗組中，針對其個人健康知覺、疾病知識、態度及行為，衛教介入前後的問卷調查，進行各衛教媒介及指導方式的成本效益比較，並配合老人特質與不同的衛教媒介與指導方式，找出各種衛教最適合何種特質之老人。 研究結果顯示，不同衛教方式介入後，在認知、態度及行為上的改變，以認知的改進最多，其次為行為，最後為態度。就各構面之改進情形，顯示利用錄影帶，針對65歲以上高血脂老人之衛教方式是可行的。在認知改進的病患特質方面，在衛教第一組(控制組)中，有喝酒習慣者，可使用本方法；在衛教第二組中(實驗組一)，則建議非獨居且有喝酒習慣者可採用此種衛教方式。在衛教第三組中(實驗組二)，建議老化程度小於9分者採用此種衛教方式。在衛教第四組中(實驗組三)，建議一般自覺健康狀況在50分以下者(包含50分)且有喝酒習慣者，可採用此組，增進認知改進程度。而在施行衛生教育介入時認知、態度及行為三構面中，彼此間的關係：態度會直接影響行為，而認知除直接影響行為外亦透過態度的改變，間接影響行為，因此在實行衛生教育或制定相關衛生教育教材時，應以改變病患之認知為首要條件。 未來在衛生教育及教材之選擇上，應配合被衛教者之個人特質，而使用錄影帶的衛教方式是值得推廣的。; Objective: To access the effects of four different mediums utilized to educate elderly with high cholesterol. Patient-treatment matching technique was also used to identify the characteristics of patients having the best results for each medium. Data sources: Total 667 samples were collected from middle Taiwan including one academic medical center, two metropolitan hospitals and two local community hospitals. Knowledge, attitude and practice regarding high cholesterol were evaluated pre and post intervention. Principal finding: Our study revealed that different health education mediums show different performances in improving knowledge. Videotape has the best improvement in knowledge regarding high cholesterol while other independent variables were controlled including age, education, marriage status, family history, alcohol utilization, knowledge before intervention, sex, smoking, body mass index, self-perceived audition, eyesight, and health perception. In addition, we found that alcoholic elderly had the best result in using individual education with pamphlet. Among elderly assigned group education with pamphlet, elderly who not living alone, smoker had better performance than others. Measured by MSQ (Mental Status Questionnaire), elderly with score under 9 had the best performance among patients who teaches by using audiotape. Finally, alcoholic elderly with lower general health score under 50 had the best performance among patients teaches by videotape. Conclusion: Although our study found that for elderly with age 65 and above, videotape generally are suitable health education medium, appropriated health education medium should be selected based on patient’s characteristics. |
