| 摘要: | 本研究目的探討以護士領導之個案管理對高血脂症介入措施之影響及評估其成效。採實驗性介入研究設計，研究對象以南投縣信義鄉2007~2008年接受成人健檢經臨床確診有「高血脂症」為目標族群之個案。以隨機方式分實驗組與對照組，並以跨理論模式為基礎，藉由衛生所護理師的介入，透過個案管理方式施以增加身體活動量與增強飲食認知、態度、行為改變和生活型態改變等，融入其生活的介入措施探討高血脂症個案管理之成效。研究工具以「高血脂症知識量表」、「行為改變階段」、「生理生化指標」等。利用SPSS15.0套裝軟體分析。結果：實驗組經護士(一)介入措施後三個月「高血脂症知識量表」有明顯高於對照組且達顯著差異(p≦0.001)。(二)介入後六個月，健康行為問題：喝酒、抽煙、運動、烹調及飲食習慣等「行為改變階段」有明顯的改善且達顯著差異(p≦0.001)。(三)「血脂症」：介入後三個月高總膽固醇血脂症之患者減少且達顯著差異(p≦0.001)。(四)生化檢測：介入措施後三個月三酸甘油脂(TG)明顯下降且達顯著差異(p≦0.05)。(五)生理生化檢測：介入措施後六個月總膽固醇(TC)、三酸甘油脂(TG)、體重、腰圍均下降且高密度脂蛋白(HDH)上升達顯著差異(p≦0.01)結論：初步顯示，以護士領導之介入措施方案不僅對研究個案有正面的成效外，亦可提高衛生所護理師獨特的功能與扮演照護提供者的重要角色。
The purpose of this study is to explore nurse’s leader-ship on case management, its interventions on the impact of hyperlipidemia and to assess its effectiveness. It is an experimental intervention study design, the case target groups were people of Hsin Yi Village, Nantou County who diagnosed with "hyperlipidemia" from adult health examination in 2007 and 2008. We used randomly experimental group and control groups method. With the transtheoretical model as a base, from the intervention of clinic nurses by using case management to increase physical activity and increased dietary knowledge, attitudes, behavior change and lifestyle change, etc., and merged into their lives to intervene the effectiveness of hyperlipidemia case management. We used research tools of "Hyperlipidemia Knowledge Scale", "Behavior Change Stage”, "Physiological Biochemical Targets" etc. and use SPSS15.0 package for analysis. Results: (1) Three months after the intervention by nurses, "Hyperlipidemia Knowledge Scale" had increased significantly and reached significant differences (p ≦ 0.001). (2) Six months after the intervention, health behavior problems: drinking, smoking, exercise, cooking and eating habits etc. in "Behavior Change Stage" had improved significantly and significant differences (p ≦ 0.001). (3) "Hyperlipidemia": Three months after the intervention, hyperlipidemia and high total cholesterol patients reduced with significant differences (p ≦ 0.001). (4) Biochemical Tests: Three months after the intervention triglyceride (TG) significantly decreased and reached significant differences (p ≦ 0.05). (5) Biochemical and Physiological Tests: Six months after the intervention the total cholesterol (TC), triglyceride (TG), body weight, waist circumference all decreased and high density lipoprotein (HDH) increased by a significant difference (p ≦ 0.01) Conclusion : Initial signs showed nurse’s leadership intervention programs not only have positive effects on the case study, it can also improve the health clinic care’s unique features and play an important role as care providers. |
