林佩如葉佳雯2025-08-072025-08-072028-07-09U0061-0807202408185600https://www.airitilibrary.com/Publication/alDetailedMesh1?DocID=U0061-0807202408185600https://nutcir-lib.nutc.edu.tw/handle/123456789/438衛生福利部國民健康署提出『健康識能機構實務指引』是有關個人獲得、了解、評判及應用健康資訊的能力。醫療機構有責任提供健康識能的友善服務，不論其健康識能程度高低，皆能有效獲得所需的健康資訊與服務。因此，希望病人或其照顧者都能快速、完整的獲得健康資訊與自我照護知識。 本研究場域為中山醫學大學附設醫院放射腫瘤科，護理同仁在執行放射線治療前會給予病人自我照護的衛教說明，但近年來護理人力不足、業務繁重等因素，護理同仁協助衛教的時間縮減，因而導致衛教的護理指導缺乏完整性。而病人閱讀文字衛教單時對內容的說明敘述理解不夠，導致自我照護的認知缺乏，在執行不夠確實的情形之下，產生對治療過程的焦慮感而加重副作用產生。 因此，本研究的動機與目的希望優化文字衛教單張成為圖像衛教單張，強化病人對放射治療前與治療後自我照護的認知，減輕臨床護理師的工作負擔。並與文字衛教單比較，分析圖像衛教單對頭頸癌病人在自我照護的認知、滿意度是否提升，焦慮程度是否降低。主要收案對象為頭頸癌放射治療病人，研究設計為將病人分為實驗組與對照組，分別給予文字衛教單與圖像衛教單，病人皆有護理同仁提供口頭輔助衛教；在開始治療前先閱讀衛教單，讓受測者填寫放射治療自我照護評核表（前測），而治療開始的第二週再讓受測者填寫放射治療自我照護評核表（後測）衛教滿意度與焦慮程度的問卷調查，以病人對於接受放射治療的自我認知度的前、後測與衛教滿意度差異情形利用SPSS統計軟體進行進行統計與分析。 研究發現，實驗組共30位病人中有26位看完圖像衛教單且願意給予回饋意見，對照組30位病人中僅15位看完文字衛教單，根據資料分析，頭頸癌病人願意完整閱讀完放療手術衛教單張，就能降低害怕的程度，而圖像衛教單在衛教滿意度回饋上有三項平均分數略高於文字衛教單。分析「衛教單張放射治療自我照護認知評核表」結果發現，在自我照護評核表中的14項「瞭解您對放射線相關治療的了解程度」，圖像衛教單後測有11項平均分數高於文字衛教單後測，顯示病人對圖像衛教單有較好的認知。使用漢彌爾頓焦慮量表（HAMA）的6項「放射治療衛教後焦慮程度」，圖像衛教單的6項平均分數低於文字衛教單，顯示病人閱讀圖像衛教單後焦慮程度低於文字衛教單。 總結來說，圖像衛教單加強病人認知，減輕護理師需要重複指導的負擔與縮短衛教時間，因圖像衛教單已將注意事項具像圖像化、輔以文字說明與色彩加強，讓病人與其家人理解並落實自我照護，減輕對治療過程的焦慮與不安，以達到全人醫療的目的，而病人良好的自我照護確實可以降低醫療成本支出，而達到SDGs永續發展目標的『良好健康與福祉』。The National Health Service of the Ministry of Health and Welfare proposed the "Practical Guidelines for Health Literacy Organizations" which are related to individuals' ability to obtain, understand, evaluate and apply health information. Medical institutions have the responsibility to provide health-savvy and friendly services so that everyone, regardless of their level of health literacy, can effectively obtain the health information and services they need. Therefore, we hope that patients or their caregivers can quickly and completely obtain health information and self-care knowledge. The field of this study is the Radiation Oncology Department of the Chung Shan Medical University Hospital. Nursing staff provide patients self-care instructions on health education before performing radiotherapy. However, in recent years, factors such as insufficient nursing manpower and heavy workload have made it challenging for nursing colleagues to assist in health education. The reduced time may lead to a lack of completeness in the nursing guidance of health education. Moreover, the patient's insufficient understanding of the instructions in the traditional text-based health education leaflet leads to a lack of awareness of self-care. This inadequate understanding may contribute to anxiety during the treatment process, as patients may not execute the prescribed care accurately, potentially exacerbating the occurrence of side effects. Therefore, the purpose of this study is to optimize text-base health education leaflets into image-base health education leaflets, which can strengthen patients' self-care awareness before and after radiotherapy to reduce the workload of clinical nurses. And compared with text health education leaflets, we analyze whether image health education leaflets can improve the self-care awareness and satisfaction of head and neck cancer patients, and whether they can reduce anxiety levels. The primary subjects were patients undergoing radiation therapy for head and neck cancer. The research design divides the patients into an experimental group and a control group, providing written health education sheets and image health education sheets respectively. All patients have nursing colleagues to provide oral auxiliary health education; At the beginning of treatment, the health education sheet is read and the subjects are asked to fill in the radiotherapy self-care assessment form (prediction). During the second week after treatment begins, subjects are asked to complete a Radiation Therapy Self-Care Assessment Form (post-test). For the questionnaire survey on satisfaction and anxiety, SPSS statistical software was used to conduct statistical analysis based on the differences in self-perception of patients before and after receiving radiotherapy and the satisfaction with health education. The study found that 26 of the 30 patients in the experimental group read the image-base health education leaflets and were willing to provide feedback, while only 15 of the 30 patients in the control group read the text health education leaflets. Data analysis shows that adequate reading of health education leaflets about radiotherapy and surgery can reduce fear levels. The average scores of the three health education satisfaction feedback items in the health education leaflets were slightly higher for the image health education leaflets than for the text health education leaflets. The analysis results of the "Health Education Leaflet Radiation Therapy Self-Care Awareness Assessment Form" found that among the 14 items in the self-care assessment form "Understanding one's own understanding of radiotherapy-related treatments", 11 items were "Understanding radiotherapy treatment". The average posttest score of the imaging health education leaflets was higher than the posttest score of the text health education leaflets, indicating that patients' understanding of the imaging health education leaflets improved after using the 6 items of "radiotherapy" in our hospital. Hama). Regarding the "Anxiety level after health education", the average score of the four items on the image health education leaflet was lower than the written health education leaflet, indicating that the patient's anxiety level after reading the image health education leaflet was lower than the written health education leaflet. In summary, the image-base health education sheet enhances patients' cognition, reduces the burden of repeated instructions on nurses and shortens the time of health education, because the image health education sheet has made the precautions concrete and graphic, supplemented by textual explanations and color enhancements, so that Patients and their families understand and implement self-care to reduce anxiety and uneasiness about the treatment process in order to achieve the purpose of whole-person care. Effective self-care by patients can indeed reduce medical costs and achieve the "good health" of the SDGs sustainable development goals. and well-being'.zh衛教單張健康識能資訊圖像焦慮衛教滿意度Health education leafletsHealth literacyInformation graphicsAnxietyEducation satisfactionmaster thesis