提升漿液性中耳炎病童執行居家照護正確率

Improving the Accuracy of Caring for Children with Serous Otitis Media at Home

洪惠琪(Huey-Chyi Horng) ； 王錦文(Jiu-Wen Wang) ； 潘愛蘭(Ai-Lan Pan) ； 賴倫瑩(Lun-Ying Lai) ； 張思儀(Szu-I Chang) ； 李美玉(Mei‐Yu Lee)

《馬偕護理雜誌》 14卷2期 (2020/07) Pp. 11-20

https://doi.org/10.29415/JMKN.202007_14(2).0002

摘要

漿液性中耳炎為兒童常見及復發率高的疾病，以藥物及中耳壓力平衡運動治療為主，長期未治癒易有聽語發展障礙及嚴重合併症與面臨手術等問題，故落實漿液性中耳炎照護為重要課題。專案旨在提升家屬對漿液性中耳炎疾病認知及居家照護能力，漿液性中耳炎病童能確實執行中耳壓力平衡運動，以正確落實漿液性中耳炎照護的目標。2017年12月3日至2018年1月5日於門診調查50位漿液性中耳炎病童及家屬，發現居家照護正確率僅59.8%，經問卷、訪談分析原因：照顧者輪流照顧及不清楚漿液性中耳炎居家照護重要性、病童無法正確執行中耳壓力平衡運動、政策規範內容不完整、門診護理人員未確實執行衛教。解決方案：經由專案小組透過實證及文獻查證後，修訂漿液性中耳炎照護規範與護理指導內容、舉辦護理人員在職教育、設計中耳通氣治療球；運用多元護理指導工具以提升家屬對病童居家照護認知與能力，對病童運用遊戲式治療方法進行中耳壓力平衡運動等策略。結果：門診漿液性中耳炎病童居家照護執行正確率由59.8%提升至88.3%。此專案有效提升家屬對病童執行居家照護的能力及病童確實執行中耳壓力平衡運動，期望能將專案持續推廣，以正確落實漿液性中耳炎病童的居家照護。

關鍵字

漿液性中耳炎 ； 病童 ； 居家照護 ； 自動充氣

並列摘要

Serous otitis media is a common disease in children. If it is left untreated, it may lead to severe comorbidities and obstacles in the development of speech, and as the result surgery may be necessary. From the period of December 3, 2017 to January 5, 2017, fifty children with serous otitis media were investigated in the outpatient department, and questionnaires regarding home care regarding serous otitis media in children. The result showed a low rate of accuracy, 59.8% only, in the items of home caregiving to children with serous otitis media. The major reasons of inaccuracy after analysis included family caregivers were unclear with the importance of care due to frequent changes in caregivers, the child-patient was unable to perform the exercise of middle-ear equalization correctly, incompletion of health care plan and information leaflet, and a lack of in-service education in outpatient department. Solution: Through the evidence and literature, ad hoc groups were assigned to revise the care specification and health education content, carrying out in-service education, innovative design of the middle ear ventilation treatment ball, and the use of multi-teaching tools in improving the knowledge and skills of caregivers in caring for children with serous otitis media at home. Moreover, we adopted play therapy in helping children learn about the exercise of middle-ear equalization. Results: The accurate rate of home caregiving to children with serous otitis media increased from 59.8% to 88.3% after implementation of the project. Conclusion: The project has enhanced the ability of family members to effectively perform home caregiving correctly for their sick children. We hope to continue the project in helping with the home care of pediatric patients with serous otitis media.

並列關鍵字

serous otitis media ； children ； home care ； auto-inflation