氣喘兒童之症 狀評估與處置

氣喘是全球性盛行率與花費最高的兒童慢性健康問題，其不定期發作與惡化的疾病壓 力影響到氣喘兒童生命的安危及全家人的生活品質。兒童之自我照護能力常因其發展 特性而受限，因此其健康照護常賴於其他照顧者來達成。本文將介紹兒童氣喘所造成 之衝擊與影響、氣喘兒童之診療指引與照護模式、氣喘兒童之症狀評估與症狀自我處 置，以期協助醫療團隊成員以及病童、家屬藉由簡易之自我監測系統及時進行評估疾 病之嚴重度，並藉由適當自我處置以避免氣喘惡化，以改善病童與家人之生活品質。 Asthma is the most prevalent and costly chronic childhood disease worldwide, unexpected flare -ups and exacerbation of which threaten the safety and quality of life of children and their families. As the capacity for self-management among children is limited by their developmental level, much of the weight of asthma management falls on the shoulders of caregivers. This article outlines the impact of asthma, and guidelines for diagnosis and management of asthma, and symptom self- monitoring and management in children. It is aimed at facilitating self-monitoring to improve assessments of the severity of the condition in order to prevent deterioration and improve the quality of life of children and their families

癌症兒童父母親面臨病童就學狀況之考慮及相關因素之初步探討

本研究旨在探討癌症兒童父母親，在面臨病童就學時會有的考慮及相關因素.研究採 橫斷式調查法，選取「中華民國兒童癌症基金會」106 位病童之家長，進行問卷及電 話追蹤訪談.調查資料採因素分析、描 述性統計、皮爾森基差相關與變異數分析進行 分析解釋.重要結果發 現：(1)父母對癌症病童就學有四項考慮因素，包括：「學校 可運用的 資源」、「孩子可獲得的關照」、「孩子的體力恢復情況」、及「孩 子的 就近性照顧」，其中以「孩子的體力恢復情況」是最重要的考慮；(2)患孩的年齡和 父母的考慮因素成負相關，其中小於6歲的患童父母顯著地較13歲以上的患童父母有 較多考慮情形；(3)患孩的患病期間和父母的考慮情形成負相關；其中患病期間少於1 年者的父母較10年以上的父母顯著地有較多考慮情形；(4)父母親的年齡顯著地和所 考慮的「學校可運用資源」成負相關，母親年齡及職業，和父母考慮孩子的就近性照 護有顯著差異.期待本研究初步結果能增強醫院、家庭及學校間的轉介聯絡網、推動 弱病學童教育體制之建立及增強學校護理人員有關癌症兒童照護訓練等三方面提出參 考建議.；This study aimed to understand parents’ considerations for schooling of children with cancer and relevant factors. The research design employed a cross-sectional survey approach. The parents of 106 children recruited from the registry of the Childhood Cancer Foundation of the Republic of China, were investigated by questionnaire and telephone follow-up. Data was processed by factor analysis, descriptive statistics, product-moment correlation, and one- way ANOVA. Results showed that: (1) Four dimensions of parents’ consideration were: available resources at school, acquirable attention to child, physical recovery status of child, and accessible caring of child, Physical recovery status was the first leading factor of consideration. (2) Negative correlation between child’s age and parents consideration; parents, with children aged less than 6 significantly had more consideration than those with children aged more than 13. (3) Negative correlation between duration of illness and considerations; parents whose child’s duration of illness was less than I year, significantly had more consideration than where if was mare than 10 years. (4) Negative correlation between parents’ age and available resources at school; Mother’s age and occupation revealed significantly different in accessible caring of child. It is hoped that such preliminary study findings will be valuable references to promote the hospital-family - school referral system, special education programs for vulnerable schoolers, and in-service education programs for school nurses

Asthma Management Efficacy of School Nurses in Taiwan

As the key health care providers in school settings, the school nurses' asthma management efficacy is crucial to children's health and their continued participation in school learning activities. This article describes the psychometric testing of the asthma management efficacy scale (AMES) for use with school nurses. A cross-sectional survey design was used to assess the asthma management efficacy of 60 school nurses in Taipei. Taiwan. Factor analysis resulted in four factor domains including asthma medication administration, asthma pattern identification. school management behaviour. and monitoring peak expiratory flow rate which explained 76.4% of the variance in school nurses' asthma management efficacy. The school nurses experience in performing school asthma management activities was positively correlated to their asthma management efficacy (r = 0.33, p <0.05). School nurses who had experience with the inhaled asthma medicines had significantly higher efficacy scores on the medication administration subscale (t = -2.89, p<0.01) than did the school nurses who lacked this experience. School nurses who had experience in using peak expiratory flow meters had significantly higher efficacy scores on the total AMES (t = -1.90, p <0.05) and on the monitoring peak expiratory flow rate subscale (t = -5.37,p < 0.001) than the school nurses who lacked this experience. Given the need to have nurses who are well prepared to provide asthma care in school settings. implications for nursing education, practice. and further research are discussed. (C) 2002 Elsevier Science Ltd. All rights reserved

學校護理人員對氣喘兒童照護之再教育需求

氣喘是校園中最常見之兒童慢性疾病，氣喘學童在校園中的日常症狀監測與用藥，乃 至於緊急症狀處置，實有賴於學校護理人員有效地提供日常及緊急照護。本研究旨在 瞭解學校護理人員對兒童氣喘的知識、照顧經驗及其影響因素，以瞭解學校護士對氣 喘照護之再教育需求。資料蒐集乃以隨機取樣選取台北地區60名服務於中小學及大專 學校的護理人員，以不記名方式評估分析其20題三方面之氣喘知識：氣喘特性與症狀 、氣喘藥物與治療、氣喘監測與處置。結果顯示學校護理人員對氣喘特性與症狀之知 識程度最佳，但對氣喘監測與處置之知識程度最差。氣喘知識和校護之學校服務年資 呈負相關，其中年資和整體氣喘知識（r=-0.38,p<0.05）及氣喘特性與症狀（r=-0. 36,p<0.05）達顯著負相關。校護於不同階段年資間的氣喘知識（F=3.70,P<0. 05） ，與服務於不同層級學校間的氣喘知識（F=3.38,P<0.05）呈顯著差異。迴歸分析顯 示，學校護理人員的年資越淺、過敏史越長，氣喘知識越好，此二變項可以解釋整體 氣喘知識全部變異量的49.2%。本研究結果建議增強學校護理人員有關氣喘兒童照護 之職前與繼續教育，俾使學校護理人員有充分的氣喘知識背景與獨立判斷的緊急應變 能力，以提升氣喘兒童於學校中的照護品質。 Asthma is the most common chronic disease of children in schools. Symptom monitoring, medication use and urgent symptom management mostly rely on school health care nurses to provide both daily and urgent care approaches. This study aims at measuring the asthma knowledge, asthma care experiences, and the contributing factors with respect to asthma knowledge to explore the re- education need of the school health care nurse. Data was randomly and anonymously collected from 60 school nurses who worked in elementary, middle, high schools and colleges. 20-item &quot;Asthma Knowledge Scale&quot; consisted of three subscales:characteristics of asthma, medication administration and symptom assessment/urgent treatment. The findings showed a good knowledge level of the characteristics of asthma but poor knowledge of symptom assessment/urgent treatment. Asthma knowledge was negatively correlated with the school nurses' length of service(r=-.38 ,p< .05). There were significant differences in asthma knowledge according to years of services(F=3.70,p<.05)and the type of school(F=3.38,p<.05). The regression analysis showed that the shorter the years of school service and the longer the experience of allergy that the school nurses had, the better asthma knowledge they attained. These variables explained 49.2% of the total variance. Improvements to the quality of care of children with asthma and the management capability of school nurses as well as the pre- service and in-service education program related to children with asthma are discussed