自學式手冊介入策略對醫師診斷罕見疾病急性紫質症之成效研究

Abstract

本研究目的旨在探討以自學式手冊介入策略，對醫師診斷罕見疾病急性紫質症的知識、態度、自我效能之成效。 本研究採用實驗組控制組前後測設計，並採立意取樣方式選取國內特定科別的臨床醫師為研究對象。本研究工具為自行設計的自填式結構性問卷，問卷內容經信效度檢定及進行預試分析而完成。而自學式手冊內容為參考國內外相關文獻、訪談醫師和急性紫質症病患後，自行編製發展而成，最後經專家學者審閱後定稿。本研究招募方式採陌生拜訪，兩組前後測間隔時間相等，最終收得40位實驗組醫師及48位對照組醫師。其介入成效以單因子共變數分析方式檢定其成果。 研究結果顯示，自學式手冊內容符合醫師需求，且經介入後醫師在診斷急性紫質症的知識、態度、自我效能等三方面，均達統計上顯著差異。 本研究為國內首次以衛生教育觀點對醫師進行罕見疾病衛生教育之介入研究，其自學式手冊可供醫師參考使用，而研究成果可供未來罕病防治之參考。

The objectives of this study is to probe the intervention effect of a self-instructional manual for physician diagnosing a rare disease-Acute Porphyria. This study bases on “Pretest-Posttest Control Group Design” and selects specific field physicians as target audience. This self-administered structure questionnaire was developed through the process of reliability and validity of test and pre-test analysis. The content of self-instructional manual is built up from relevant literatures’ references, interviews with physicians and patients, and is finalized with experts’ reviews. Finally, we collected results from 40 physicians in experimental group and 48 physicians in control group (never met before, randomely picked up and willing to answer to our questionnaire), by giving them the same duration between pre-test and post-test. The intervention effects were evaluated by using one way analysis of covariance. The result of this study demonstrates the self-instructional manual can fit in the physician’s interests and needs, and can increase their knowledge, attitude, and self-efficiency when diagnosing Acute Porphyria, and all of above have statistically proven significant differences. This is the first time in the country that we do a study on rare diseases issue from health education’s perspective for physicians. The self-instructional manual can provide references for physiciansand the results of this research can serve as future preventive references for rare diseases.