學齡前期兒童看診害怕行為之改善方案

Reducing Fear in Preschool Children During Clinical Examinations

本專案旨在改善學齡前期兒童門診看診時害怕行為的比率。本院學齡前期兒童有73%於門診看診時出現害怕行為，造成患孩害怕不安的心理衝擊，環境次序的混亂、醫病關係的緊張，間接影響門診看診品質。分析看診害怕行為之主要原因為：門診環境單調、護理人員白制服及動作粗魯、缺乏吸引孩童的輔助工具及對檢查工具感到害怕所致。故成立專案小組，針對原因，收集相關文獻與探討找出解決方法後，以改善兒科門診環境、改變護理人員制服、增加輔助玩具、為檢查工具換裝、舉辦在職教育等方法，來改善患孩看診時害怕行為的問題，而將73%的害怕行為比率降低至37%，使患孩能安心看診，同時亦能提升護理品質。

In the author’s hospital, pre-intervention observations showed that almost three-quarters (73%) of all pre-school aged children visiting a clinic showed signs of fear, which affected the attitudes of other children, disturbed the general environment, created tense relationships between doctors and patients, and affected the quality of medical treatment. Primary reasons for fear among these young patients include lack of child-friendly settings, the attitudes of nursing personnel, nurses’ appearance, a lack of tools and techniques especially designed to attract children and hold their attention, and the frightening appearance of examining tools. An action team was formed to respond to the perceived needs identified during these observations. Changes that were recommended and accepted were redecorating all pediatric clinics, changing the uniforms of pediatric nurses, purchasing special toys for use during examinations, changing the external appearance of examining tools, and offering inservice classes on reducing fear among visiting children. As a result of these changes, the percentage of pre-school aged patients exhibiting signs of fear in the hospital’s outpatient clinics fell to 37%.