| Summary: | 碩士 === 國立陽明大學 === 臨床暨社區護理研究所 === 97 === Numerous medical reported that by forming the artery plagues and related complications, hypercholesterolemia serves as the risk factor and contributes to many chronic disease such as cerebral artery disease, cardiovascular (CV) disease, diabetes, hypertension and metabolic disorders and so on. For years, due to improvement in economic status, and changes in diet habit and living styles, the mobility rate of cerebral and CV disease for people in Taiwan has significantly increased. The ineffective control over the tendency of the incidence rate of CV disease in the younger population and the lack of promised caring outcomes for the subjects with family history of hypercholesterolemia (FHHc) has challenged CV health professionals. Therefore, it is urgent for governmental as well as private medical institutes to propagate hygiene education on prevention of FHHc. Nevertheless, until now, there is no reliable instrument for Taiwan’s health professionals to accurately evaluate health needs of FHHc, nor valid comprehensive caring program for them. As such, this nursing research as the first project in Taiwan attempted to systematically investigate this phenomenon by developing a reliable and valid instrument to explore this particular population’s health needs, developing and implementing a “Health Promotion Program for Patients with Familiar Hypercholesterolemia”, and evaluating the effectiveness of this program.
A between-method triangulation research method was employed. Three phases of research process was involved. In the first phase, a critical literature review of CV and FHHc information was practiced. Then, face-to-face interviews by the investigator and the subjects in a leading medical center in the northern Taiwan were conducted in order to collect the data of the subjects’ perceptions of their self-awareness of FHHc, self-care attitudes, self-care competence, and health promotion behaviors. In the second phase, the intervention of this study is titled “The Health Promotion Program for Patients with Familiar Hypercholesterolemia”, which contains four dimensions: dietary treatment, exercise treatment, knowledge of hyperlipidemia, and daily self-care skills, as well as the related appraisal structured-instrument with reliability and validity were developed. In the third phase, a single group pre-and post-test method was applied. In this phase, a purposive sample of 60 subjects was obtained. The one-to-one, face-to-face teaching modes with pamphlet were applied to help coach each of the subjects to learn the contents of health promotion program. Each of the subjects’ questions was clarified, and they were encouraged to learn to take an initiative attitude in managing the health problems. Three months later, subjects were invited to receive post-test by the use of same instrument, and the effectiveness of the intervention by health promotion program was examined.
By the employment of pared t-test, the scores of the outcome variables were significantly higher in the post-test: self-awareness of FHHc, self-care competence, self-care attitudes, and health promotion behaviors, accordingly. Meanwhile, three major constructs of self-care knowledge, attitudes and health promotion behaviors were interrelated: (a) the self-care knowledge and attitudes would directly contribute to health promotion behaviors; (b) self-care attitudes were positively influenced by self-care knowledge; and (c) the self-care attitudes indirectly and positively influence health promotion behaviors. It is also found that the subjects’ self-care attitudes and health promotion behaviors were not significantly improved by the single teaching mode.
It is concluded that the employment of health promotion program was effective for Taiwan’s FHHc. Cardiovascular health professionals were encouraged to continuously apply health promotion program to systematically evaluate FHHc’s health needs and coach them to increase their compliance to caring plans. By learning the accurate medical information and following caring plan, not only the FHHc subject’s disease can early detected and controlled, the complications were also can be more possibly prevented. By doing so, not only their quality of life can be ensured, the limited medical resources can also be better allocated and used
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