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The Characteristics of Hospitalized Children's Pain Experience

住院兒童疼痛經驗的特性

摘要


兒童理解力、語言、字彙的限制,缺乏流利或豐富的敘述,致使對疼痛經驗的評估有困難,因此國內應發展出兒童對疼痛的描述字言,以為疼痛的評估依據。研究目的為了瞭解住院兒童的疼痛經驗、感受、及其處理方法,請6歲以上的住院兒童57名畫一張圖表達他們“疼痛的情形、疼痛的感覺或疼痛所想到的”、和“疼痛時所想要做的事是?”,並請兒童談談所畫的內容,繪圖之前讓兒童回憶過去疼痛的經驗,先將記得的疼痛部位,任其挑選脂筆的顏色,在人體外型的圖上,表示出疼痛的部位及範圍,並述說其疼痛時的感覺、內心的感受及想法,並界定其疼痛的程度,及疼痛的處理方式。住院兒童發生不適的經驗則以頭痛、腹痛、發燒為主。兒童發生疼痛時的處理策略歸為:自我選擇治療、情緒集中措施、健康照顧人員協助、打針、姿勢、運動、活動。住院兒童常合併多種的不適經驗,多數會主訴三種不適的現象,且使用描述疼痛的字言多達57種,但常被使用的是痛、針刺感、酸痛、及脹痛。唯頭痛的感覺以痛、針刺感、酸痛、眩暈為主。腹痛則以脹痛、難過、嘔心為主。而疼痛發生時,多數是採取自我選擇治療,或情緒集中措施,但就每一措施則仍常須藉打針而止痛,住院中兒童疼痛發生時較會向醫師求助,再配合臥床休息,仍有部分病童被餵服藥物,少數會向護士求助,年齡較小者尋求母親的支持是必要的。住院中兒童因疼痛發生限制其活動、能力降低、或憂鬱則選擇紅色、黑色、綠色、或單一缺乏色彩表達其疼痛的感覺。

關鍵字

住院兒童 疼痛 繪畫

並列摘要


This study was designed to further understanding of children's pain experiences and sensations, and to develop strategies to care for hospitalized children who suffering from pain. Fifty-seven hospitalized children over the age of six were given crayons and asked to point out the location of their pain, current or past, on a figure of the human body in order to discover the location of the pain and its intensity. Then they were asked to draw a picture expressing the condition, feeling, and sensation of their pain, and what they wanted to have done about it, The most frequent complaints were of headaches, abdominal pain and fever. The most common management strategies for coping with children's pain include: self-selected treatments, emotionally focused strategies, health care provider assistance, injection analgesics, and the strategy of altering position, increasing activity or motion. Thirty-two (56.1%) of the 57 words used by the children as descriptors of pain were used by at least three children. Words like hurts, stinging, soreness, suicide, dizziness, crying, throw out, uncomfortable, bloatedness were consistently used by children who rated their pain intensity as 4 or higher on the pain scale. There was significant related to ”age” and ”pain feelings were described by the children”. Younger children were more likely to respond with words related to the physical aspects of their pain while older children added a psychological connotation in their response, e.g., suicide, panic, sad, hate, and uncomfortable. N=35.1% of the children used three words in this study. These subjects, as a result of their pain, showed signs of depression, were less active and suffered a decrease in their normal abilities, As a result, their paintings were simpler and less colorful; and were characterized by darker colors, especially reds, blacks and greens.

並列關鍵字

Hospitalized child Pain Painting

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