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手術後兒童對疼痛的因應策略

Coping Strategies of Children in Post Operation Pain

摘要


本研究在瞭解手術後兒童面臨疼痛時所採取的因應方式。研究對象爲80位5-14歲手術後第一天的兒童。資料的收集是運用一張卡通人物史奴比,經歷手術的漫畫,以看圖說故事的方式與兒童會談,引導兒童說出自己經歷手術後的疼痛感受及處理疼痛的經驗。研究結果得知:96.25%的兒童知道引起手術手疼痛的導因,大多數認爲:「身體移動」是造成疼痛的主因。在處理疼痛的方法上,陪伴者多以「維持病童生理舒適及給予安撫、支持」居多;而護理人員則以「給止痛劑」爲主。兒童認爲止痛劑最能止痛,其次爲親人陪伴、安慰與扶持,自己忍耐、身體固定不動、放鬆、分散注意力、觸摸、吃東西/喝開水及求神均能有效減輕疼痛。手術後兒童對疼痛的因應:首先是「忍耐」(55%)且不分年齡與性別,其次是「自己設法減輕疼痛」年齡愈長愈明顯,5-10歲的兒童較「不知道該怎麽辦」,常以「抒發情緒」來因應。手術後疼痛時大多數兒童(76.25%)會「求助他人」,主要求助的對象爲陪伴的家人,會找護士幫忙者僅佔2.5%。兒童對疼痛的呈現乃以非語言的行爲爲主。大部份兒童(71.5%)認爲疼痛影響睡眼,飲食、活動也受到限制且失去控制感爲負面的經驗感受;但部分學童(20%)則認爲經歷此次疼痛,學會忍耐、感覺被愛、得到關心、且恢復了健康,已能體認到承受疼痛的正面意義。同時發現「忍耐」、「抒發情緒」、「身體固定不動」及「求神」,爲我國兒童對手術後疼痛獨具的本土化的因應策略。本研究的結果,可幫助護理人員認識手術後兒童因應疼痛的方法,且瞭解在照顧兒童的過程中,需配合年齡發展特性,以及細心觀察與評估兒童忍痛的表情與行爲重要的重要性,除給藥止痛外,宜多應用非藥物減痛措施給予安慰、觸摸與陪伴,以有效的幫助兒童減輕手術後的疼痛問題。

並列摘要


The purpose of this study is to understand interaction strategies used by post-operative children. The pain feeling and management of the 80 children at the age of 5-14 years old interviewed revealed that their interactions were much influenced by traditional culture As a result they counteracted the pain mostly by endurance and self-created pain relieving methods. Unless the pain was beyond their endurance and ability to manage, they would ask the family members accompanying them for consolation and encouragement. The family members in turn would encourage them by saying “Be brave !” and “Do endure!” in addition to some words of consolation. It was further found that 5-10 years old children would make every relaxant effort to relieve the pain, but there was still a small number of children knowing nothing about what to do with the pain. Only 2.5% of children with pain would ask nurses for help. The nurses primarily administrated analgesics, but such practice still leaves much to be evaluated.

被引用紀錄


卓麗鳳(2000)。家屬對手術後病人使用止痛劑的擔心與病人疼痛控制的相關性〔碩士論文,臺北醫學大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0007-1704200714450641

延伸閱讀


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  • 趙師萱(2021)。兒童術後疼痛控制彰化護理28(2),10-16。https://doi.org/10.6647%2fCN.202106_28(2).0004
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