探討衛教機器人介入對發炎性腸道疾病病患在疾病認知與焦慮憂鬱的成效

Abstract

背景與目的： 發炎性腸道疾病（IBD）為一種慢性且具複雜性的腸道疾病，病患常因對疾病知識的缺乏及病況的不確定性，面臨高度的焦慮與憂鬱風險。隨著數位醫療發展，衛教機器人已成為提供即時衛教與心理支持的新型態工具。本研究主要探討運用LINE官方帳號建置之規則型（Rule-based）衛教機器人，對於提升IBD病患疾病認知及改善焦慮、憂鬱之成效。 方法： 本研究採單組前後測之類實驗設計，以方便取樣招募 39 位 IBD 病患為研究對象。介入措施為期四週的數位衛教機器人互動，內容涵蓋疾病知識、飲食指導、藥物衛教及心理支持資源。研究工具包括「基本屬性與臨床特徵資料」、「疾病知識評估問卷」、「醫院焦慮與憂鬱量表（HADS）」及「衛教機器人滿意度調查」。資料以描述性統計及無母數檢定進行分析。 結果： 研究結果發現，受試者在介入後之「疾病認知」總分由前測 9.00 分提升至 9.31 分，達統計顯著差異（p < .05），特別在飲食原則與檢查目的之認知提升最為顯著；惟涉及複雜藥理之類固醇知識則無顯著改變。在心理層面，焦慮與憂鬱總分雖呈改善趨勢但未達統計顯著，然進一步分析發現，介入前「不知道臨床試驗」或「焦慮較高」之病患群體，在介入後改善幅度較佳，表示衛教機器人具備賦能（Empowerment）與資訊支持之效益。此外，受試者對衛教機器人之整體滿意度高達37.641分（滿分 50 分），尤以「圖文淺顯易懂」獲得最高評價。 結論： 本研究證實規則型衛教機器人能有效提升 IBD 病患的疾病認知，並具備高接受度與便利性。雖短期介入對降低整體焦慮憂鬱分數之效果有限，但對於資訊需求較高之初診斷或高焦慮病患，仍具顯著的心理支持潛力。建議未來臨床實務可將此衛教機器人納入常規照護，作為門診衛教之延伸輔助，以強化病患的自我照護能力。

Background and Objectives: Inflammatory Bowel Disease (IBD) is a chronic and complex intestinal condition. Patients often face high risks of anxiety and depression due to a lack of disease knowledge and uncertainty regarding the disease course. With the advancement of digital health, chatbots have emerged as novel tools for providing immediate health education and psychological support. This study aimed to evaluate the effectiveness of a rule-based health education chatbot, built on the official LINE account platform, in enhancing disease knowledge and alleviating anxiety and depression among IBD patients. Methods: A single-group pretest-posttest quasi-experimental design was employed. Thirty-nine patients with IBD were recruited via purposive sampling. The intervention involved a four-week interaction with the digital health education chatbot, covering disease knowledge, dietary guidelines, medication education, and psychological support resources. Research instruments included a Demographic and Clinical Characteristic Questionnaire, an IBD Disease Knowledge Scale, the Hospital Anxiety and Depression Scale (HADS), and a Chatbot Satisfaction Survey. Data were analyzed using descriptive statistics and non-parametric tests. Results: The results indicated a significant improvement in overall disease knowledge scores, increasing from 9.00 to 9.31 post-intervention (p < .05). Improvements were most notable in the understanding of dietary principles and examination purposes; however, knowledge regarding complex medications (e.g., steroids) showed no significant change. Regarding psychological outcomes, while total scores for anxiety and depression showed improving trends, they did not reach statistical significance. However, subgroup analysis revealed that patients who initially lacked knowledge of clinical trials or had higher baseline anxiety demonstrated greater improvement, suggesting the empowerment and informational support benefits of the digital tool. Furthermore, the overall satisfaction score was high (Mean =37.641/50), with "easy-to-understand graphics and text" receiving the highest rating. Conclusion: This study confirms that a rule-based health education chatbot effectively enhances disease knowledge among IBD patients and demonstrates high user acceptance and convenience. Although the short-term intervention showed limited effects on reducing overall anxiety and depression scores, it holds significant potential for providing psychological support to newly diagnosed or highly anxious patients with high information needs. It is recommended that future clinical practice incorporate this chatbot into routine care as an extension of outpatient health education to strengthen patients' self-care capabilities.