先心病介入治疗患儿父母焦虑与需求的调查研究
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摘要
目的探讨先心病介入治疗患儿父母的焦虑水平、需求的现状、影响其焦虑与需求的因素及焦虑与需求的相关性。
方法采用整群抽样的方法,从2008年11月至2009年9月对长沙市5所三级甲等医院的122名准备行先心病介入治疗的患儿父母进行问卷调查。问卷包括一般统计学资料、先心病患儿父母对介入治疗相关知识的调查表、焦虑自评量表(SAS)、先心病介入治疗患儿父母需求量表。选用SPSS 13.0软件进行统计,统计方法包括t检验、方差分析、SNK检验、秩和检验、Spearman秩相关分析、多元逐步回归分析。
结果1.先心病患儿父母的焦虑总分为49.55±11.86,与国内常模(29.78±0.46)比较有统计学意义(t=18.41,p<0.001)；其影响焦虑的因素主要与患儿是否为独生子女、有无医保、患儿父母亲的身份、文化程度及患儿父母对介入知识的了解程度有关。
2.先心病患儿父母需求总得分为98.14±14.06,平均得分为2.89±0.41,从先心病患儿父母需求的五个维度中来看,认为获取信息的需求和被接纳的需求是最重要的,其次是病情保证的需要和获取支持的需求,而最不重要的是舒适的需求。需求排在前十位的依次是：出院前医生护士能向家属详细交待出院后注意事项；希望医护人员告诉我一些关于介入治疗前及介入术后患儿护理需要注意的事情；当患儿的治疗方案将有变化时,希望医护人员能告知我改变方案的目的和意义等。这其中有5条是获取信息的需求,3条是被接纳的需求和2条是获取支持的需求。排在最后的3个需求的条目是：希望能允许家长有时大声哭叫；希望病室能提供单间或包房；希望偶尔能允许家长暂时离开医院片刻；均属舒适的需求。
3.影响先心病患儿父母需求的因素主要与患儿父母的文化程度、对介入知识的了解程度及患儿是否为独生子女有关。
4.先心病患儿父母的焦虑与需求成正相关,从先心病患儿父母焦虑得分与需求的每一个维度的相关性分析,结果为：获取信息的需求与获取支持的需求与焦虑有相关性,成正相关。
结论先心病患儿父母的焦虑评分明显高于正常人群,其影响因素与父母亲的身份、文化程度、患儿有无医保及患儿父母对介入知识的了解程度有关；先心病患儿父母认为获取信息和被接纳的需求是最重要的,其次是病情保证的需要和获取支持的需求,而最不重要的是舒适的需求。建议：临床护理工作者应关注先心病患儿父母的心理状况和需求,做好健康宣教,给予患者家属心理指导,满足其需求,从而减轻其焦虑,促进患儿早日康复。
Objective:To determin the anxiety level among the parents whose children with CHD (congenital heart disease) were retreated by the interventional therapy, and to explore the parents'status of the needs, the impacting factors of the anxiety and needs and the relevance of anxiety and needs.
Methods:Purposive sampling was used to rucruit 122 subjects for this study from 5 tertiary general hospitals in Changsha city. The data collection was done during Nov.2008 to Sept.2009. The instrument used for data collection in this study was the qestionnaire which composed of four parts:demograghic data record form, the related knowledge about the interventional therapy, Self-Rating Anxiety Scale (SAS) and modified the needs scale of the parents. Collecting data were analyzed with software SPSS 13.0 for window, concluding descriptive analysis, SNK test, rank sum test, Spearman rank correlation analysis, multiple stepwise regression analysis.
Results:1. The total sore of anxiety of parents whose children with CHD is 49.55±11.86, is statistically significant (t=18.41, p<0.001), comparing with the domestic norm(29.78±0.46). The main factors impacting the parents'anxiety are the child is the singleton, Children' health insurance, the identity of children'fathers or mothers, the paretents' education level and understanding level of related knowledge about the interventinal therapy of the CHD.
2. The total sore of the needs of parents whose childern were suffered with CHD is 98.14±14.06, the average score is 2.89±0.41. Among the five dimensions of the modified needs scale in this study, the needs of access to information and the needs to be accepted are appraised as most important, followed by the needs of shelter of the illness status and support. The most unimportant is the comfort needs. The top ten needs in the study subsequently are:medical stuff can provide detailed information about children rehabilitation after discharge before discharge; hope that medical personnel to tell the nursing notes pre-precedure and after the precedure; hope medical personnel would tell me the aim and significance if there is any change of the therapy; et al. Among these items, there are 5 items relate to access to information needs subscale,3 items relate to the needs to be accepted; 2 items relate to the support needs subscale. The last 3 rank itmes from the comfort needs subscale, are: hope to allow the parents to crying out sometimes; hope to stay in the sigle room and the parents are able to leave the hospital for a short time occasionally.
3. The main factors affecting needs of parents whose children were suffered CHD included the educational level of parents of children, their involvement in children with knowledge about the extent and whether the child concerned.
4. The correlation of the anxiety and the need of parents whose whose children were suffered CHD is a positive correlation. The correlation analysis shows that access to information needs and access to support the needs and anxiety are related, which is a positive correlation.
Conclusion The anxiety score of parents whose children were suffered CHD is significantly higher than the normal population, their impact factors and parents, sex, education, children with health insurance and parents with knowledge and understanding of the degree of involvement; parents of children with CHD appraised that access to information and accepted needs are the most important needs, followed by the condition to ensure needs and access to support needs and, most unimportant dimensions is the comfort needs. Recommends:Clinical careworkers should be concerned about the psychological needs of parents of the children with CHD, missionary to give families of patients with psychological guidance to meet their needs, so as to reduce their anxiety, to promote children a speedy recovery.
方法采用整群抽样的方法,从2008年11月至2009年9月对长沙市5所三级甲等医院的122名准备行先心病介入治疗的患儿父母进行问卷调查。问卷包括一般统计学资料、先心病患儿父母对介入治疗相关知识的调查表、焦虑自评量表(SAS)、先心病介入治疗患儿父母需求量表。选用SPSS 13.0软件进行统计,统计方法包括t检验、方差分析、SNK检验、秩和检验、Spearman秩相关分析、多元逐步回归分析。
结果1.先心病患儿父母的焦虑总分为49.55±11.86,与国内常模(29.78±0.46)比较有统计学意义(t=18.41,p<0.001)；其影响焦虑的因素主要与患儿是否为独生子女、有无医保、患儿父母亲的身份、文化程度及患儿父母对介入知识的了解程度有关。
2.先心病患儿父母需求总得分为98.14±14.06,平均得分为2.89±0.41,从先心病患儿父母需求的五个维度中来看,认为获取信息的需求和被接纳的需求是最重要的,其次是病情保证的需要和获取支持的需求,而最不重要的是舒适的需求。需求排在前十位的依次是：出院前医生护士能向家属详细交待出院后注意事项；希望医护人员告诉我一些关于介入治疗前及介入术后患儿护理需要注意的事情；当患儿的治疗方案将有变化时,希望医护人员能告知我改变方案的目的和意义等。这其中有5条是获取信息的需求,3条是被接纳的需求和2条是获取支持的需求。排在最后的3个需求的条目是：希望能允许家长有时大声哭叫；希望病室能提供单间或包房；希望偶尔能允许家长暂时离开医院片刻；均属舒适的需求。
3.影响先心病患儿父母需求的因素主要与患儿父母的文化程度、对介入知识的了解程度及患儿是否为独生子女有关。
4.先心病患儿父母的焦虑与需求成正相关,从先心病患儿父母焦虑得分与需求的每一个维度的相关性分析,结果为：获取信息的需求与获取支持的需求与焦虑有相关性,成正相关。
结论先心病患儿父母的焦虑评分明显高于正常人群,其影响因素与父母亲的身份、文化程度、患儿有无医保及患儿父母对介入知识的了解程度有关；先心病患儿父母认为获取信息和被接纳的需求是最重要的,其次是病情保证的需要和获取支持的需求,而最不重要的是舒适的需求。建议：临床护理工作者应关注先心病患儿父母的心理状况和需求,做好健康宣教,给予患者家属心理指导,满足其需求,从而减轻其焦虑,促进患儿早日康复。
Objective:To determin the anxiety level among the parents whose children with CHD (congenital heart disease) were retreated by the interventional therapy, and to explore the parents'status of the needs, the impacting factors of the anxiety and needs and the relevance of anxiety and needs.
Methods:Purposive sampling was used to rucruit 122 subjects for this study from 5 tertiary general hospitals in Changsha city. The data collection was done during Nov.2008 to Sept.2009. The instrument used for data collection in this study was the qestionnaire which composed of four parts:demograghic data record form, the related knowledge about the interventional therapy, Self-Rating Anxiety Scale (SAS) and modified the needs scale of the parents. Collecting data were analyzed with software SPSS 13.0 for window, concluding descriptive analysis, SNK test, rank sum test, Spearman rank correlation analysis, multiple stepwise regression analysis.
Results:1. The total sore of anxiety of parents whose children with CHD is 49.55±11.86, is statistically significant (t=18.41, p<0.001), comparing with the domestic norm(29.78±0.46). The main factors impacting the parents'anxiety are the child is the singleton, Children' health insurance, the identity of children'fathers or mothers, the paretents' education level and understanding level of related knowledge about the interventinal therapy of the CHD.
2. The total sore of the needs of parents whose childern were suffered with CHD is 98.14±14.06, the average score is 2.89±0.41. Among the five dimensions of the modified needs scale in this study, the needs of access to information and the needs to be accepted are appraised as most important, followed by the needs of shelter of the illness status and support. The most unimportant is the comfort needs. The top ten needs in the study subsequently are:medical stuff can provide detailed information about children rehabilitation after discharge before discharge; hope that medical personnel to tell the nursing notes pre-precedure and after the precedure; hope medical personnel would tell me the aim and significance if there is any change of the therapy; et al. Among these items, there are 5 items relate to access to information needs subscale,3 items relate to the needs to be accepted; 2 items relate to the support needs subscale. The last 3 rank itmes from the comfort needs subscale, are: hope to allow the parents to crying out sometimes; hope to stay in the sigle room and the parents are able to leave the hospital for a short time occasionally.
3. The main factors affecting needs of parents whose children were suffered CHD included the educational level of parents of children, their involvement in children with knowledge about the extent and whether the child concerned.
4. The correlation of the anxiety and the need of parents whose whose children were suffered CHD is a positive correlation. The correlation analysis shows that access to information needs and access to support the needs and anxiety are related, which is a positive correlation.
Conclusion The anxiety score of parents whose children were suffered CHD is significantly higher than the normal population, their impact factors and parents, sex, education, children with health insurance and parents with knowledge and understanding of the degree of involvement; parents of children with CHD appraised that access to information and accepted needs are the most important needs, followed by the condition to ensure needs and access to support needs and, most unimportant dimensions is the comfort needs. Recommends:Clinical careworkers should be concerned about the psychological needs of parents of the children with CHD, missionary to give families of patients with psychological guidance to meet their needs, so as to reduce their anxiety, to promote children a speedy recovery.
引文
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