- 期刊
學齡期兒童在接受骨髓移植治療過程中的行為反應
The Behavioral Responses of School-aged Children Receiving Bone Marrow Transplantation
摘要
本研究目的乃探討學齡兒童接受骨髓移植治療過程中，於無菌室保護隔離期間，其所經歷的治療過程和行為反應。本研究是按田野研究法，以觀察者即參與者的方式，每日參與護理活動3~4小時，觀察記錄個案的行為反應，事後書寫成行為過程記錄。研究結果計收三名個案，收集114篇行為過程記錄，資料加以分析、整理後，分三個階段來探討患童的治療計劃、身體變化及行為反應。第一階段：骨髓移植前6~9天一一加強治療引發身體副作用的衝擊期：此期間患童會有較多確認行為以認識治療方法和身體副作用，以及認識無菌室之治療環境。第二階段：骨髓移植後二至三週一一免疫系統抑制期：此期是血球之低谷期，患童較多以處理問題的行為應付、處理自己的經驗，以減輕治療及身體之不適。第三階段：骨髓移植後三至六週一一骨髓功能恢復期：進展至此期，患童之身體恢復，情緒反應隨血球檢驗值起起伏伏，焦急地期待能早日轉出無菌室！研究個案年齡自六至十二歲，分析比較其行為反應，發現年齡較小之患童，較多運用確認行為來認識治療經驗和身體之變化，情緒反應較多，依賴醫護人員之支持、陪伴。年齡較大的患童在以確認行為辨認自己之經驗後，較多以處理問題之行為來與醫護人員共同處理自己的治療及身體變化等經驗。本研究期呈現學齡患童於骨髓移植過程中的治療經驗與行為反應，提供照護人員之參考，以合適的照護活動，協助患童渡過整個移植治療之過程。
關鍵字
無資料並列摘要
The purpose of the study is to observe the school-aged children receiving bone marrow transplantation isolated in the aseptic units and to present their behavioral responses. The field study is used to conduct the procedure of the study, that is, the ovserver acts as the participant. The observer takes part in the nursing activities for a period of three or four hours each day. Mean whiIe, the researcher ovserves and records the behavioral responses of the cases, later, she writes down the process recording. The resuIt of the study consists of three cases and collects 114 pieces of process recording. When all the deta are in, they are analyzed, evaluated and then divided into three stages which deal with the therapy plans, the body changes and the behavioral responses of the patients. The first stage-the impact of conditioning therapy on the side effects of the body: In the period of condition therapy if the patients show much oriented behavior, they wiII knwo the purpose of the therapy and side effects of their bodies and are curious about the isolation setting. The second stage-the immunization systems of the patients are inhibited; their bodies are so weak that they are easily contract diseases. In this period, an adequate nutrition can support the patients. The blood cells of the patients are situated at the low valley period. The patients are inclined to take problem-solving behaviors to deal withtheir own problems and ease their discomfort which they go through the therapy. The third stage-the function of bone marrow is increasingly restored and their complications are improved. while the patients come into this stage, their psirits are increasingly recovered. Also, their emotional responses follow the ups and downs of inspection deta. They are anxious to transfer out of aseptic isolation units. The cases of the study range from six years old to twelve years old. Analyzing and comparing the behavioral responses of the cases, the researches finds that the younger patients are inclined to take oriented behavior to recognize their therapy experiences and body changes; as a result, the have more emotional responses than the older patients do and they depend on nursing staff for support and care. The older patients are Iiable to take problem-solving behavior after they recognize their behavior and identify their own experiences. They tent to calloborate with nursing staff to handle with their therapy and body changes. The study shows the therapy experiences and the behavior responses of the school-aged children during the period of bone marrow-transplantation. The researcher would like to present the study to the nursing staff for reference and sincerely hope that they will help these kinds of patients through the bone marrow transplantation with their adequate nursing activities.