急性兒科病人家屬住院壓力之改善專案

A Project to Reduce the Stress for Sick Children and Fami1y Members at General Pediatric Care Unit

住院對兒童或父母而言都是一件極具壓力的經驗感受，不僅影響病人家屬情緒、身體功能及照護病童的能力，甚至影響護病關係。本專案旨在找出住院病童家屬的壓力源，以提出適切的解決方案，協助其降低住院壓力。本專案單位為急性兒科病房，以病人家屬壓力源及壓力指數調查表調查其壓力程度，結果顯示平均壓力指數高達2.8分，且由現況分析發現導致其住院壓力源包括：（1）不了解病童疾病、（2）靜脈注射時病童哭鬧反應、（3）病房佈置不具兒科特色、（4）不認識及找不到主護護士及（5）對環境不熟悉。專案小組於2004年8月，針對導因推出各項解決方案，包括：設計寶寶日誌傳遞疾病相關訊息協助了解病情、推行無痛靜脈注射、重新佈置病室、重新設計認識全責護士之方法、設立護理人員位置指示動態燈及做病房環境清楚標示圖等。於介入措施執行後，2005年4月再度調查病人家屬壓力指數，結果其平均壓力指數降至1.3分，達專案目的。本專案不但發揮降低病人家屬住院壓力之功效，也增進護病互動與溝通，讓其能更安心參與病童的照護過程。Hospitalization is a stressful experience for children and family members because it is not only affects the emotions, physical function, and care ability of family members during hospitalization, but also influences the nurse patient relationship. The aim of this project was to identify stressors of family members in order to provide appropriate solutions to diminish the stress of hospitalization. This project was conducted at an acute pediatric unit using a stressor questionnaire to survey the stress scores of family members. The results revealed that the average stress score was about 2.8 points, and five major stressors were identified, including (1) family members’ lack of understanding of children’s illness, (2) children crying during intravenous injection, (3) the pediatric ward design was not matched to pediatric characteristics, and (4) families' inability to find primary care nurses and (5) lack of familiarity familiar with the environment. During August 2004, the project team proposed strategies, including use of daily notes to help family members to understand children's status, implementing EMLA before intravenous injection, redecoration of the pediatric unit, redesign of primary care nurses name card, redesign of lighting to point out position of nurses, and setting up ward orientation signs. After intervention the mean stress score of families during hospitalization was decreased to 1.3 points and the aims of this project were achieved. This project not only reduced the stress of family members, but also improved the nurse patient relationship and made them feel more secure during care processes.