運用可掀式固定套降低學齡前兒童靜脈注射之害怕行為

Reducing the Fear of Intravenous Injection in Preschool Children Without the Shackle

王玉琴(Yu-Chin Wang) ； 邱珮華(Pei-Hua Chiu) ； 李佳心(Jia-Xin Li)

《志為護理-慈濟護理雜誌》 20卷3期 (2021/06) Pp. 106-116

摘要

學齡前期兒童住院時面對靜脈注射治療及陌生病房環境，同時護理師執行靜脈注射前衛教技能不足，導致兒童有害怕抗拒行為拉扯管路而脫落。經調查兒童行侵入性靜脈注射之害怕行為高達97.2%；護理師執行靜脈注射衛教流程完整率為58%。分析主因為兒童害怕靜脈注射過程，注射後管路暴露，兒童害怕有拔除舉動，靜脈注射固定板制式無個別性；護理師靜脈注射前衛教流程不完整，未運用治療性遊戲教育。經運用可掀式固定套及卡通壁貼美化病房環境，同時護理師藉由治療性遊戲互動課程，提升護理師於靜注前予兒童衛教之技能，改善後兒童靜脈注射害怕行為降至55%；護理師執行靜脈注射衛教流程完整率達92%，顯示此改善過程降低害怕行為，進而提昇護理照護品質。

關鍵字

靜脈注射 ； 害怕行為 ； 可掀式固定套

並列摘要

Preschool children encounter treatment using an intravenous injection. However, the inadequacy of nursing programs before conducting medical treatment of intravenous injection results in children's fear and resistant behaviors in tube removal. This study demonstrated that up to 97.2% of children are afraid of receiving an intravenous injection. However, the rate of a thorough nursing program, conducted by nurses before executing intravenous injection, was 58%. The analyzed consequence was attributed to children's fear in the process of receiving an intravenous injection and may foster children to remove the tube as a behavioral response to fear. In addition, no individuality on the injection fixed strap was noted. However, the behavioral response of children was reduced to 55% through applying an openable fixed strap and well-decorated wards with cartoon wallpaper, simultaneously operating a therapeutic game-based program, and improving the nursing program before conducting intravenous injection. Consequently, the rate of the thorough nursing program went up to 92% while conducting intravenous injection, showing that such improvements lowered the children's behavioral response to fear and enabled good quality of nursing care.

並列關鍵字

behavioral response of fear ； intravenous injection ； openable fixed strap

參考文獻

李睿軒、張怡貞、胡芳綺、石惠美、陳麗貞、施美娟(2018)．降低學齡前期兒童於急診接受靜脈注射疼痛指數．健康科技期刊，4 (2)，20-34。https://doi.10.6979/TJHS.201803_4(2).0002。

李銘櫻、余佳紋、楊雅鈞、張鈞竹(2014)．降低學齡前期兒童靜脈注射疼痛之方案．護理雜誌，61(2)，68-75。https://doi.10.6224/JN.61.2S.68。

卓燕華、葉麗玲、于凱齡、張鈞竹、陳雪玲(2015)．降低兒科病患靜脈注射後靜脈炎的發生率．護理雜誌，62 (3)，49-57。https://doi.10.6224/JN.62.3S.49。

葉凌鴻、羅方妤、李文婕、郭亭伶、蔡佳玲(2015)．運用治療性遊戲協助一位學齡前期白血病兒童降低Port－A人工血管扎針之恐懼．長庚護理，26(4)，526-538。https://doi.10.3966/102673012015122604014。

溫玉燕、陳郁琪、李翠萍(2013)．降低某兒科病房非預期性靜脈注射重注率．馬偕護理雜誌，7(1)，41-51。https://doi.10.29415/JMKN.201301_7(1).0005。