| Summary: | 碩士 === 中山醫學大學 === 公共衛生學系碩士班 === 96 === Subject I: The needs assessment program of the secondary stroke prevention education for stroke patients in Taiwan
Research Objective: This study attempted to understand the knowledge, attitude, brief of social environment and self efficacy of stroke patients for development of the stroke education material for patients.
Background: Stroke or Cerebrovascular accident (CVA) has been the second cause of death in Taiwan. As the age increases, both the mortality rate and incidence rate of cerebrovascular accidents in Taiwan increases. The occurrence of cerebrovascular accidents related to knowledge about stroke, lifestyle and risk factors of stroke. It is very important for stroke patient to know how to avoid secondary stroke and rehabilitation after strokes, which requires systematic education in order to make them available to stroke patients.
Research Methods: The study was conducted from August to November 2007. It performed a needs assessment of stroke education for 127 stroke patients in a college medical center and its surrounding 7 municipal communities in Central Taiwan. The study was structured based on social cognitive theories, with which the questionnaires were designed, and the relationships between characteristics of patients and their stroke related knowledge, personal attitude, brief of social environment and self-efficacy were analyzed. The study also statistically analyzed conditions of stroke patients on items regarding to knowledge, attitude, brief of social environment and self-efficacy by measures of calculating frequency and means.
Results: We did a regression analysis according to the participants’ characteristics, knowledge, attitude, brief of social environment and self-efficacy. This research found that lack of knowledge in the patients was related to aging (P=0.01), diagnosis with three types of chronic diseases (including hypertension, diabetes mellitus, and hyperlipidemia) (P<0.01) and occurrence of cerebrovascular accident at least twice and above (P=0.01). Negative attitude was related to low education level and delay of stroke attack treatment for more than three hours (P<0.01). Besides, a negative perspective towards social environment was related to male (P=0.03), patients who were not diagnosed with three types of chronic diseases (including hypertension, diabetes mellitus and hyperlipidemia) (P=0.04) and occurrence of stroke at least twice and above (P<0.05). However, negative self-efficacy was related to stroke of twice and above (P<0.01). For the knowledge related to the stroke warning signs and hospital admission, the stroke patients had a lower correct response rate for some of the items such as “Difficulty to swallow and drooling are the warning signs for stroke” and “The golden three hours to receive medical treatment is within the first three hours after the onset of stroke”. The answers with a lower correct response rate in the section related to risk factors knowledge include “Stroke patients have a higher chance of secondary stroke than the regular person”, “Alcohol drinking is bad for health”, “The high blood glucose in diabetes patients is related to stroke”, “Stroke patients should have adequate exercise”, “Patients with hyperlipidemia have a higher chance of stroke”, and “Smoking is related to the onset of stroke”. In the part of attitude items, the personal attitude score was low in "Regular visit to the medical institutions if rehabilitation is needed",“Drink alcohol moderately”, “Weight controlling”, “Participation in the social activities” and “Actively engaging in a conversation with the others”. The three items with lower scores in the section on brief of the social environment included the improvement of living environment was helpful with ambulation, social care resources were beneficial for stroke patients and the public had understanding towards stroke information. For the section on self-efficacy of the stroke patients, there were three items with lower score included stress adjustment, physical activities and continuous rehabilitation.
Conclusion: This study evaluated the knowledge, attitude, brief of social environment and self-efficacy of the stroke patients in Taiwan. The information gathered by this study will provide an understanding of the needs for stroke patients in several aspects. In addition, it can be used as a reference for the public teaching materials of the stroke education.
Subject II:The stroke education program on community based for mild and moderate stroke patients
Research Objective: This study explores the impact of intervention of stroke education on knowledge, attitude, brief of social environment and self-efficacy of mild and moderate stroke patients before and after intervention in a community.
Background: Cerebrovascular disease is a persistent threat to the health of the general public in Taiwan. Symptoms of stroke were more severe than the first stroke. Hence, it is important that the stroke patient is essential for stroke education.
Method: From August to November 2007, mild and moderate stroke patients resident in 7 communities of Central Taiwan were recruited and intervention of stroke education was implemented. The content of the intervention combines stroke prevention education sessions, rehabilitation after stroke, psychological consultation and physiological function examination. Pretest (T0) was measured before the health education intervention while the posttest (T1) was immediately measured after the eight weeks intervention. Two months after the education intervention, telephone interview was used to measure the follow-up test (T2). The assessment was focused on the stroke prevention knowledge, attitude, brief of social environment, self-efficacy, and impact on activities of daily living. Besides, the effect of health education for stroke was examined.
Results: There 45 stroke patients who participated in the intervention of stroke education for the whole course. After education intervention, warning signs and attitude in hospital admission knowledge (T0: 3.09 vs. T2: 3.56, p<0.01), risk factors knowledge (T0: 6.33 vs. T1: 7.38, p=0.02; T0: 6.33 vs. T2: 7.60, p<0.01) and dietary knowledge (T0: 3.58 vs. T2: 3.87, p<0.03) of the stroke patients had improved significant. The patients’ social participation attitude (T0: 4.51 vs. T1: 5.11; T0: 4.51 vs. T2: 5.24, p<0.02) and their ADL scores (T0: 78.89 vs. T1: 85.91, p<0.001) had been significantly elevated.
Conclusion: It was found that intervention of stroke education has a significantly positive effect on stroke related knowledge of the stroke patients in the community. It also enabled the patients to hold a positive social participation, and improved patient’s activities of daily living (ADL).
|
|---|
