有系統與無系統心臟導管術術前指導效果之比較研究

A Comparative Study of the Effects of Structured and Unstructured Pre-Cardiac Catheterization Instructions on Children and Their Parents

陳月枝(Yueh-Chih Chen)

《Acta Paediatrica Sinica》 21卷1期 (1980/03) Pp. 40-47

摘要

臺大醫院心肺功能室自民國49年開始施行心臟導管術，使得先天性心臟病的診斷更趨正確、藥物治療更有效，使病童的手衍更為安全。目前每年平均有3百位病童接受檢查。如何做好術前指導，使得檢查過程順利些，一直是醫護人員所關心的問題。本研究是調查60位3~15歲住院接受心臟導管術的先天性心臟病病童的父母對心臟導管術的認識情形，及探求有系統的術前指導及無系統術前指導兩者的效果比較。
結果顯示，父母對心臟導管術的認識是有限的。有系統的術前指導方法與無系統的術前指導方法相比，不但可以增進父母對心臟導管術的認識，較能改善父母的認識和態度，增加兒童在檢查過程中的合作程度，而且可以節省護理人員的時間，增加兒童及其父母自我控制的能力，增加兒童及其父母對護理人員的信心，使得兒童及其父母皆能在醫師的優良技術及護理人員的細心準備和護理之下，順利地度過這項可能引起高度焦慮不安的心臟導管檢查。

並列摘要

This study is an investigation of sixty 3 to 15 year-old patients with congenital heart disease who were hospitalized at the National Taiwan University Hospital for cardiac catheterization. The purpose is to compare the effects of structured and unstructured pre-catheterization instructions on the children and their parents.
In the structured instructions given to these patients, slides, tape-recordings, objects, and field trips were adopted to explain the following to the subjects and their parents: the procedures of pre-catheterization preparation and the process of catheterization, why catheterization should be done, how parents could assist, the possible complications which might occur after the catheterization and how to handle them. The roles played by the nursing personnel throughout the entire process were emphasized.
The finding in this study shows that the parens' understanding of cardiac catheterization was very limited-20% of them had never heard of it before.
The advantages of the structured instructions over the unstructured instructions as found in this study are:
1) Parents gained more understanding of cardiac catheterization.
2) More parents showed positive change in their attitude toward catheterization.
3) Children cooperated more during the examination, especially the age group of 3-7 years old.
4) The improvement in parents' understanding enhanced their children's cooperativeness in the procedure.
In summary, the structured instruction given to pre-cardiac catheterization patients saved the time of the nursing personnel and alleviated the anxiety and apprehension of the children and their parents which resulted in more constructive cooperation and better self-control on their part. It is, therefore, concluded that structured instruction is a much better means than the unstructured instruction in preparing the children and parents for cardiac catheterization.

並列關鍵字

cardiac catheterization ； effects of structured instruction ； independent nursing function