發燒多媒體護理指導方案對發燒兒童主要照顧者之健康識能、發燒恐懼及處理之成效

背景:本研究旨在測試發燒多媒體護理指導方案，於兒科門診對改變主要照顧者健康識能及發燒恐懼之成效分析。方法: 採類實驗研究，於台灣中部某區域教學醫院之兒科門診針對六歲以下兒童因主訴發燒而至門診求診之主要照顧者進行收案，為避免個案相互干擾，先收集對照組完成後再收集實驗組。以英國國家衛生和臨床技術優化研究所(NICE)之發燒指引為基礎，發展發燒多媒體衛教介入方案，文獻內容依實證方法並採專家建議發展一段影片，藉由智慧型手機掃描QR碼連結信息，做為主要介入措施。符合條件之個案完成前測之後，對照組給予常規書面衛教單張，而實驗組則接受發燒多媒體護理指導方案，之後接完成後測。研究工具含「患童及主要照顧者基本資料表」、「發燒處置之訊息、動機、行為技能評量表」、「情境焦慮量表 」及簡式「健康識能量表」等量表。使用SPSS 22.0版，以描述性及推論性統計進行資料分析。共選取184人，實驗組93人及對照組91人。結果: 研究結果顯示；實驗組在接受發燒多媒體護理指導方案之後，在處理發燒訊息、態度及技能比對照組有顯著改善(p<.05)，在社會規範、自我效能、情境焦慮及健康識能等部分，二組則無顯著差異(p>0.5)。結論:以NICE為基礎的發燒多媒體護理指導，能改善主要照顧者對發燒的訊息、態度及技能，亦能增加照顧者對發燒處理的信心及降低焦慮程度。研究結果能提供主要照顧者對兒童發燒照護之實務參考。

Objective: This study evaluated the effects of a multimedia nursing instruction program about fevers for a pediatric outpatient clinic to improve the health literacy of primary caregivers and fever phobia in children with pyrexia. Methods: The study was conducted in a pediatric outpatient clinic in a regional teaching hospital in Taichung. The participants were primary caregivers of children younger than 6 years old who visited the pediatric clinic due to their children having fevers. The experimental group was recruited after the control group in order to avoid mutual interference between the groups. The multimedia program was developed based on the guidelines of the National Institute for Health and Care Excellence (NICE) for the development of fever, which is based on empirical methods and expert advice. The program was developed to scan QR code links to information via smartphones as the main intervention measure. A pretest-posttest experimental study was designed. The control group received a brochure, and the intervention group received the multimedia nursing guidance program on fever. The measurement tools used were the “Parental knowledge, attitudes, and concerns” scale, the “State anxiety inventory” (STAI-S), and the “Short-form health literacy” scale. The data were analyzed using SPSS 22.0 with statistical and descriptive statistics. The parents were randomly assigned to the experimental group (n = 93) and the control group (n = 91). Results: The results of the study showed that the experimental group had a significant improvement in the treatment of fever signs, attitudes, and skills after completing the multimedia program (p<0.05). However, there were no significant differences between the two groups in terms of social norms, self-efficacy, situational anxiety, and health knowledge (p>0.05.) Conclusion: The developed multimedia program can improve the knowledge, attitudes, and skills of primary caregivers in regard to fever. It can also increase confidence and reduce anxiety towards fever. The study provides a practical reference for primary caregivers to care for children with fevers.