探討氣喘兒童主要照顧者對氣喘症狀及控制程度之判讀

Caregiver perception of children's asthma symptoms and control.

彭佳怡(Jia-Yi Peng)

指導教授 ： 李淑杏

中山醫學大學/醫學院/護理學系碩士班/碩士(2017年)

摘要

氣喘病童因年齡因素，在治療過程中需要主要照顧者的協助。氣喘發作時，主要照顧者能否正確評估症狀及控制程度，會影響就醫的決定及疾病預後。研究目的在探討氣喘病童主要照顧者在評估氣喘症狀及控制程度的正確率及其影響因素。以橫斷式研究設計，於中部某區域教學醫院兒科門診，立意取樣，對82位氣喘病童之主要照顧者進行資料收集。研究工具包括氣喘症狀評估表、世界氣喘防治小組 (GINA)氣喘控制程度評估表、兒童氣喘控制測驗中文版、及氣喘知識來源與氣喘知能問卷。資料以「t檢定」、「卡方檢定」、及「Kappa統計量」分析。結果發現主要照顧者對氣喘症狀及控制評估的正確度與醫師相比，僅達中等吻合。主要照顧者之人口學特質、氣喘知識來源、及氣喘相關知能，皆與評估正確率未達統計上相關。但氣喘控制程度評估的正確率與病童的氣喘發作 (p= .00)及控制程度(p= .00)有顯著相關；另外，氣喘症狀評估的正確率也與病童的氣喘控制程度也息息相關(p = .01)。建議重新審視臨床衛教方法的適當性及成效，尤其是症狀過於抽象較難辨認，應加強衛教技巧。另外應將氣喘控制程度評估列為常規衛教項目，每次的回診中加強評估的回覆示教，以提升照顧者的評估技巧。

關鍵字

氣喘 ； 學齡兒童 ； 主要照顧者 ； 氣喘控制評估 ； 氣喘症狀評估

並列摘要

Background and purpose: Therapeutic regimen of asthma during childhood needs considerable assistance by caregivers. Caregiver’s perception of child’s asthma symptoms and level of control have a major impact on children’s prognosis when asthma with acute exacerbation. Therefore, the purpose of this study is to evaluate the ability of caregivers’ assessment on both symptoms and level of control of asthma.
Methods: Cross-sectional survey on a purposive sample of 82 asthma children’s caregivers was conducted in a teaching hospital in central Taiwan. The measurements included asthma symptom evaluation, asthma control test of Global initiative for asthma (GINA), Chinese childhood asthma control test (C-CACT), and asthma knowledge test. Data were analyzed by t-test, chi-square test, and kappa statistics.
Results: The caregiver’s perception of children’s asthma symptoms and level of control both showed moderate agreement with physician’s assessment. No significant relations were found on caregiver assessments with demographics, and knowledge. However, the caregiver’s evaluation of asthma control was statistically significant with children’s exacerbation (p= .00) and level of control (p= .00). Furthermore, children’s level of asthma control was significantly related to caregiver’s assessment of symptoms (p= .01).
Suggestions: The obscurity of asthma symptoms may worsen caregivers’ assessment skills, Therefore, enhancements of health education modality should be critically prioritized. Level of asthma control is suggested evaluating routinely, meanwhile, caregiver’s assessment skills are needed be checked during clinical visits.

並列關鍵字

asthma ； school-age children ； caregiver ； asthma assessment ； asthma symptom assessment.

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