先天性心臟病患童父母於開心手術前後需求之探討

Parents' Needs of Children With Congenital Heart Disease During Pre-and-Post Open Heart Surgery

先天性心臟病是兒童常見的先天性疾病之一，其種類繁多，除了少數可能會自行關閉或癒合外，多數的先天性心臟病需藉由手術方式修補、矯正後，患童方才得以存活；當父母從決定先天性心臟病患童手術開始，歷經手術過程至住進加護病房，期間有喪子的可能，促使父母的需求及壓力也急遽變化。故本研究目的在探討病童父母於開心手術前後的需求及影響需求之相關因素。參與本研究之個案共有98位病童父母，包括術前47位及術後51位0-6歲先天性心臟病患童之父母，利用結構性問卷，將父母需求的內容分成:減輕焦慮、得到病童的消息、能幫助病童、與病童相處、得到支持及安慰、環境設備的需求等六類。以Likert五分量表將需求程度分成非常需要到非常不需要五個程度，得分滿分五分；結果顯示其父母的需求平均得分於手術前為4.169分，手術後為4.026分皆介於非常需要到很需要之間，但在減輕焦慮、得到病童消息及能幫助病童三方面，在統計上顯示手術前需求程度高於手術後之需求。本研究結果期待護理人員在了解父母開心手術前後需求，運用其專業的知識及技巧，於不同階段提供適當的協助，以提高照護品質及時效，藉以降低父母的壓力。Congenital heart disease is a common congenital disease for children. Majority children with congenital heart disease require operative process to repair or correct impair areas to secure survival. Parents of children with congenital heart disease were more stressful and concern about their needs when their children were undergoing open heart surgery, followed by operation and admitted into intensive care unit. Loss of children may happen during this medical process. The purpose of this study was to explore the views of their parents about the needs and associated factors during pre- and-post-open heart surgery. 98 subjects were recruited by convenience sampling of 47 pre-surgery and 51 post-surgery from 0 to 6 years old children's parents. Six different need components were included in the structured questionnaire based on parents' needs: need to decrease anxiety, need to seek children's information, need to interact with children, need to help children, need to call for support and consultation, and need to be satisfied with facilities and equipments and was a 0 to 5 Likert's type scale with 0 mean 'very much need' 4 meaning 'very much don't need'. The result showed average scores of parents' needs during pre-open heart surgery was 4.169, which was between 'very much need' and 'very need' as the same as post-open heart surgery was 4.026. The result revealed that the need to decrease anxiety, need to seek children's information, and need to help for children were significantly increased, especially for post-open heart surgery. The results of this study may provide health professionals with the knowledge and skills to care for parents of children with congenital heart disease who are undergoing open heart surgery. Understanding parents' needs and providing necessary care, will ultimately improve the quality of care and decrease the stress reaction.