中重度持續型氣喘兒童自我管理計畫之成效

The Effectiveness of a Self-Management Program in Children with Moderate to Severe Persistent Asthma

鄭淑貞(Shu-Chen Cheng) ； 李欣慈(Hsin-Tzu Lee) ； 李威德(Wei-Te Lee)

《台灣醫學》 19卷3期 (2015/05) Pp. 233-245

https://doi.org/10.6320/FJM.2015.19(3).03

摘要

中重度持續型的氣喘兒童，每天都發生症狀，夜間症狀每週大於一次， 惡化可能影響其活動、睡眠及生活品質。以Vygotsky社會文化理論（1978）當作架構，建構一有效的護理措施，培養氣喘兒童的自我管理能力，並探討其成效。研究方法採縱貫式、單盲、實驗設計的研究方式，進行1－2次個別指導，並評估其介入後立即、一個月、兩個月及三個月的成效。研究結果以廣義線性模式進行分析，顯示實驗組在第一個月、第二個月及第三個月之氣喘知識平均分數的改變量，與前測相比，皆多於控制組的改變量4分以上，均達統計上的顯著差異（p ＜ .01）。本研究成果可有效提升氣喘兒童疾病自我管理的知識， 且可改善其肺功能。

關鍵字

Vygotsky理論 ； 學齡兒童 ； 中重度持續型氣喘 ； 自我管理計畫

並列摘要

Children with moderate to severe persistent asthma include asthma attacks occurring more than once daily, asthma symptoms occurring at night more than once a week, or asthma attacks that affect their activities, sleep and quality of life. The aim of this study is to establish an effective intervention by using Vygotsky socio-cultural theory (1978) as a framework to help children with moderate to severe persistent asthma to develop self-management skills, and to further explore the effectiveness of this intervention. Research method used in this study is a longitudinal, single-blind, experimental design. The asthma self-management program was applied to the intervention group once to twice individually. Outcomes of applying this program would be evaluated immediately and at 1, 2, 3 months after completing this program. The Generalized Linear Model was used as a tool to analyze the results of this study. The results in this study showed that at the first, second and third month follow-up, children in the intervention group had more gain of asthma knowledge compared with the control group (varied score ＞4) (p＜.01 ). The results in this study have presented that, after completing this program, children with asthma in the eastern of Taiwan did have improved lung function and also have better knowledge related to self-management about their disease.

並列關鍵字

Vygotsky's theory ； school-age children ； moderate to severe persistent asthma ； self-management program

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