自然照護技術於臥床病人主照顧者知識、技能、態度成效探討

The Effects of Natural body movement and patient handling Technique in Primary Caregivers of Patients with Bedridden on Knowledge, Skills, Attitude

背景：「自然照護技術」是一種不拖移、不拖拉的擺移位技術，運用身體自然的姿勢與力量，輕鬆完成翻身及移位的動作，國內尚未有針對此照護衛教之介入研究。目的：探討「自然照護技術」於臥床病人其主照顧者擺移位知識、技能及態度之成效。方法：採類實驗設計，以方便取樣，選取某醫院附設居家護理所其符合收案條件之臥床病人及其主照顧者，分為實驗組（自然照護技術教學）及對照組（衛教單張教學），每組各30位，以自擬的問卷量表收集前測資料，介入後立即第一次後測，再隔4週後，進行第二次後測。以描述性、推論性統計及重複測量單因子相依變異數分析進行統計分析。結果：研究結果發現，「自然照護技術」於臥床病人主照顧者，其執行病人擺位移位知識、技能、態度進步程度，優於對照組只接受衛教單張口頭說明教學擺位移位，達顯著差異（p<0.05）。分析主要原因實驗組「接受自然照護技術多媒體學習光碟-含示範演練及回覆示教」，可以強化主照顧者視覺的注意力，配合示範演練及回覆示教，有助於記憶及學習成效。結論：自然照護技術介入對主照顧者擺移位知識、技能及態度有顯著成效，未來能務實推廣自然照護技術之教導，提升照顧者照顧知能，達到更優質的健康照護服務。

Background: '' Natural body movement and Patient Handling Technique'' is a non-dragging and non-shifting technique that uses body natural posture and strength to easily complete the tasks of moving or turning over a patient. There is not yet an interventional study on this care and health education in the nation. Aim: Discussion on the positioning knowledge, skills, and attitude of the primary caregiver with the“Natural body movement and Patient Handling technique”, to helping caring for bedridden patients. Methods: Adopting the quasi-experimental design to facilitate sampling, and selecting the bedfast patients and their primary caregivers who meet the conditions in a home care unit, and divide them into an experimental group（Natural body movement and Patient Handling technique used multimedia learning with CD-Containing that help demonstration drills and teach back）, and a control group（health education leaflet）, 30 persons in each group, collected pre-test data with a self-developed questionnaire, the first post-test is done immediately after the intervention, and the second post-test is done after another 4 weeks. Statistical analysis is carried out by descriptive and inferential statistics and repeated measures single-factor dependent variance analysis. Results: The study comes to a significant difference（p<0.05）that the '' Natural body movement and Patient Handling technique used multimedia learning with CD-Containing that help demonstration drills and teach back '' by the main caregiver of bedfast patients had better knowledge, skills, and attitudes in performing patient positioning than the control group who only received oral instructions from the health education leaflet. The main reason that the experimental group is better the learner. Because this can strengthen the main caregiver’s visual attention. It also help caregiver to cooperate with the demonstration drills and teach-back lesson. It thus helps in memorizing and learning this skill. Conclusion: The intervention of natural care technique has a significant effect on the knowledge, skills, and attitudes of primary caregivers. In the future, we can pragmatically promote the teaching of Natural body movement and Patient Handling Technique, improve the caring knowledge and skills of caregivers, and achieve better health care services.