運用分散注意力策略於地區醫院急診學齡前兒童接受靜脈注射之成效

Effectiveness of Distraction Strategies in Preschool Children Undergoing Intravenous Line Placement at the Emergency Department in Regional Hospitals

10.6142/VGHN.201712_34(4).0002

黃芳梅(Fang-Mei Huang)；鄭夙芬(Su-Fen Cheng)；李雅玲(Ya-Ling Lee)；陳紀雯(Chi-Wen Chen)

急診室 ； 學齡前兒童 ； 分散注意力 ； 靜脈注射 ； 疼痛 ； 害怕 ； emergency department ； preschool children ； distraction ； intravenous line placement ； pain ； fear

榮總護理

34卷4期（2017 / 12 / 01）

342 - 355

繁體中文

背景：建立靜脈注射管路是兒科急診最常見的處置之一，兒童在緊急且陌生的情境中接受靜脈注射易造成疼痛與害怕，臨床上實有必要發展有效之護理策略。目的：旨在探討運用分散注意力策略介入於急診學齡前兒童接受靜脈注射時，其主觀疼痛與害怕感受之成效。方法：採隨機分派實驗性研究，對象為滿三歲到未滿七足歲學齡前病童，收案樣本數共90人，靜脈注射的過程中分為三組，一組為對照組，二組為實驗組，分別為觀看卡通影片，及觀看卡通影片加手握壓力球之介入策略。研究工具以黑色籌碼片(Poker Chip Tool)來測量害怕程度；中文籌碼片(Chinese Poker Chip Tool)，紅色來測量疼痛程度。結果：分散注意力介入結果顯示觀看卡通影片顯著減輕學齡前病童之疼痛與害怕(p＜ .01)；卡通影片加手握壓力球僅顯著減輕其害怕(p＜ .01)，對其疼痛則無顯著差異。結論與建議: 分散注意力策略介入於急診學齡前兒童接受靜脈注射過程中，觀看卡通影片能有效減輕兒童靜脈注射過程的疼痛與害怕，減少病童抗拒行為，使病童順利完成治療，藉由此研究可降低護理人員與學齡前病童間之衝突，亦可減輕護理人員照護初期之焦慮感，提升護病之間的關係及醫療照護成效。

Background: Intravenous line placement is an invasive procedure that can result in pain and feelings of panic. It often induces an uncomfortable experience and anxiety, especially in the emergency setting for children and their parents. The aim of this study was to determine whether distraction strategies could reduce pain and fear during intravenous line placement for preschool children in the emergency department. Method: Ninety 3-7-year-old participants in the emergency department were randomly divided into three groups: the control group, the cartoon watching group, and the cartoon watching with soft ball pressing group. In the pretest-posttest design, acute pain and fear were evaluated using the Chinese Poker Chip Tool with four red chips that represented ＂pieces of hurt＂ and four black chips that represented ＂pieces of fear.＂ Results: Of the two distraction strategies, watching cartoons was associated with significantly less pain and fear (both p ＜ .01) during intravenous line placement in the emergency department. However, cartoon watching combined with soft ball pressing reduced children's fear (p ＜ .01) but not pain. Conclusion: This study demonstrated the efficacy of using cartoon watching as a distraction strategy during intravenous line placement in the emergency department for preschool children. This strategy successfully reduced pain and fear during intravenous line placement and improved the medical treatment experience and the effectiveness of healthcare.

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