背　景血液透析病人大多缺乏血液透析自我照顧知識、不遵從血液透析自我照顧行為、以及存在著無力感。目　的本研究目的在瞭解接受血液透析一年內患者的自我照顧知識、自我照顧行為及無力感現況，以及多媒體互動式光碟介入後之成效。方　法採類實驗法雙組前後測之研究設計，收案地點為高雄縣市願意參與此研究的透析中心，包括地區醫院及區域醫院共六家醫院。經研究者說明研究目的及過程，同意者即開始接受問卷資料收集，研究工具包括：血液透析自我照顧知識、血液透析自我照顧行為及無力感三個問卷，以及多媒體互動式光碟。之後實驗組接受每週一次，連續四週的血液透析自我照顧衛教光碟指導，並於四次衛教後進行立即後測，間隔四週後再
進行第二次後測。控制組則只接受常規性護理指導，並且於徵求個案同意後進行前測，第四週及第八週進行後測及第二次後測。結　果結果顯示，個案存有知識不足、無法完全達成透析日常自我照顧並存有中等程度的無力感，而多媒體互動式光碟不但具有可以有效提升自我照顧知識（p < .000）、自我照顧行為（p < .000）、改善無力感（p < .000）之成效，且效果是持續性的。結　論／實務應用本研究發現，實驗組個案在接受光碟衛教後，較控制組於自我照顧知識、行為及無力感皆有顯著之成效，顯示光碟衛教具有良好成效。而且根據結果顯示此光碟可適用於
大多仍為中老年人為主的血液透析患者，本研究的研究結果及工具亦可作為日後相關研究的參考依據和護理教材。

Background: Hemodialysis (HD) patients have low self-care knowledge, poor self-care behavior, and powerlessness.Purpose: The authors designed this study to, first, understand the current state of first-year HD patients’ self-care knowledge,self-care behavior, and powerlessness and, second, assess the effectiveness of an interactive multimedia CD educational
intervention.Method: A quasi-experimental, repeated measures design,with intervention and comparison groups, was used. All subjects for this study were recruited fromsix dialysis centers in southern Taiwan. The three points for outcome testing included baseline,4 weeks, and 8 weeks.
Research tools included an HD self-care knowledge questionnaire, an HD self-care behavioral questionnaire,a powerlessness questionnaire, and an interactive multimedia CD.Results: Results found that participants possessed insufficient knowledge, were incapable of completely achieving or comprehending routine self-care, and were affected by powerlessness.
The interactive multimedia CD intervention effectively enhanced self-care knowledge (p G .000) and self-care behavior (p G .000) and improved powerlessness (p G .000). Positive results persisted well after the conclusion of the intervention.Conclusions/Implications for Practice: Participants in the intervention group had better self-care knowledge and behaviors and feeling of control over their lives than those in the control group. This illustrates the positive effects of the interactive multimedia CD. Results demonstrate the potential benefits of using
the interactive multimedia CD with elderly patients in HD and nursing practice education.