提升學齡前呼吸道感染兒童噴霧治療之認知和技能

Enhancing Cognition and Skill in Aerosol Therapy in Preschool Children with Respiratory Infections

蔡宜蓁(Yi- Tseng Tsai)；陳怡伶(Yi-Lin Chen)；胡彩華(Tsai-Hua Hu)；江素維(Su-Wei Chiang)；邱苡瑄(Yi-Hsuen Chiu)；朱奕蓉(Yi-Rong Jhu)；梁蕙芳(Hwey-Fang Liang)

呼吸道感染 ； 學齡前兒童 ； 治療性遊戲 ； 噴霧治療 ； aerosol therapy ； play therapy ； preschool children ； respiratory infectionsa

志為護理-慈濟護理雜誌

16卷4期（2017 / 08 / 01）

63 - 74

繁體中文

學齡前兒童住院以呼吸道感染居冠，噴霧治療為主要緩解方式，兒童的認知發展、呼吸型態及醫療配合度，皆會影響噴霧治療藥物吸收成效。調查護理師噴霧治療衛教完整率53.3%、學齡前兒童對噴霧治療認知和技能正確率僅36.7%，導因來自1.護理師未善用治療性遊戲衛教溝通模式；2.兒童對部分衛教內容難以理解；3.缺乏標準衛教流程及易觀測噴霧治療成效輔助工具。依據護理品質監測管理(management by objectives, MBO)標準，護理師衛教完整率需達95%；病人認知層面達85%以上，故解決之道為規劃治療性遊戲溝通教育訓練課程、培訓護理師衛教溝通技能、訂定標準衛教流程及創新輔助工具。改善後護理師噴霧治療衛教完整率提升至97.3%、兒童噴霧治療認知技能正確率達90.5%，顯示經遊戲互動確實可強化孩童對醫療處置之適應，進而提升兒童對噴霧治療的認知技能及治療成效。

Aerosol treatment is the primary relief method of respiratory infections, the leading cause of hospitalization among preschool children. The effectiveness of drug absorption during aerosol treatment is determined by children's cognitive development, breathing patterns, and treatment compliance. A survey revealed that the completion rate of nurses on health education regarding aerosol treatment was 53.3%, and the prevalence of aerosol treatment-related cognition and skills among preschool children was 36.7%. According to analysis, the causes of the ineffectiveness were identified: 1) the nurses did not utilize play therapy effectively; 2) the children had difficulty understanding certain material; and 3) the absence of health education standard and auxiliary tools for observing aerosol treatment effectiveness. According to the management-by-objective (MBO) system, the completion rate of RNs on health education and patient comprehension of treatment should be 95% and 85% respectively. By planning play therapy communication courses, enhancing nurses' communication skills, establishing standard health education processes, and developing innovative auxiliary tools, the nurses' aerosol treatment-related health education completion rate increased to 97.3% and the prevalence of the children's aerosol treatment-related cognitive skills increased to 90.5%. This demonstrated that enhancement of interactive games in children's adaptation to medical treatment, aerosol treatment-related cognitive skills, and the treatment effectiveness.

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