兒童住院壓力狀況調查報告

A Study of the Conditions of Stress in Hospitalized Children

陳季員(Jih-Yuan Chen)

《The Kaohsiung Journal of Medical Sciences》 2卷10期 (1986/10) Pp. 616-634

https://doi.org/10.6452/KJMS.198610.0616

摘要

本研究分析發現住院兒童 (412歲)101人之壓力因素歸納成四個主要因素：因素一：害怕面對醫護人員引發疼痛和威脅的壓力感。因素二：因害怕預期的分離和身體不完整而引發的壓力感。因素三：因害怕被剝奪、限制而引發的壓力感。因素四：因念舊、害怕有所失落而引發的壓力感。其中住院兒童的性別、年齡、診斷、住院準備，對此四個因素整體而言，具有顯著差異。女孩因害怕預期的分離和身體不完整而引發的壓力感較高；男孩因念舊、害怕有所失落而引發的壓力感較高；外科病童因害怕面對醫護人員引發疼痛和威脅的壓力較高。同時發現抽血、X光照射、導管插入及手術穿刺等變項對兒童壓力感因素的影響有關。
另觀察發現病童感受到害怕面對醫護人員引發疼痛和威脅的壓力感時，則易顯現夜尿、白天尿濕；對因害怕預期的分離和身體的不完整而引發的壓力感時，則易表現話太多、過度活動不安；對因念舊，害怕有所失落而引發的壓力感時，則易顯現便秘、下痢、大小便習慣改變、白天尿濕等反應。由此可協助護理人員於觀察兒童行為時可同時注意兒童壓力來源，以幫助解除兒童壓力導致的危機。

並列摘要

This study revealed that the perceptions of stress in 101 hospitalized children (age:4－12 y/o) could be classified into four main groups based on the varying factors that can produce stress in these children:
Factor I: Child's stress caused by the fear of physical pain & mental threat induced by physicians and nurses in the hospital.
Factor Ⅱ: Child's stress caused by the fear of expected separation & disintergration.
Factor Ⅲ: Child's stress caused by the fear of deprivation & limitation.
Factor Ⅳ: Child's stress caused by nostalgia & the fear of the loss of spirits.
There are significant correlations between the characteristics of age, sex, diagnosis and preparation for hospitalization of the hospitalized children and mentioned factors of stress. These correlations provide useful information for nursing staffs in relating to hospitalized children. The following is a brief summary of the findings: 1.Girls feel much more stress in the factor No.Ⅱ in which the child's stress caused by the fear of expected separation & disintergration. 2.Boys feel much more stress in the factor No.Ⅳ where the child's stress is caused by nostalgia & the fear of the loss of spirits; 3.Preschool children and children in pediatric surgery feel much more stress due to factor No.I child's stress caused by the fear of physical pain & mental threat induced by physician and nurses in hospital. Additional stress factors are invasive procedures such as blood withdrawal, radiological examination, catheter insertion and operation.
It was also obsered that when hospitalized children felt stress from the factor No.I (child's stress caused by the fear of physicial pain & mental threat induced by physicians and nurses in hospital) that very often nocturia and daytime wetting were observed. Children in the study also evidenced hyperactivity, were hypertalkative and restless if the stress was related to factor No.Ⅱchild's stress caused by the fear of expected separation & disintergration. Constipation, diarrhea, changes in bowel habits and daytime wetting occurred in children who displayed evidenced of factor No.Ⅳchild's stress caused by nostalgia & the fear of the loss of spirits.
Utilizing the above information nursing personnel are encouraged to pay more attention to the reaction of stress in the hospitallized child. With a greater awareness and improved observation of the hospitalized child's behavior the mursing staff will be better able to utilize resources to prevent stress and render solutions to the problems related the child's stress.

並列關鍵字

hospitalized children ； perception of stress ； behavior reaction