護理諮詢支持照護對改善父母照顧初診斷先天性心臟病童不確定感之成效探討

背景: 初診斷先天性心臟病童父母面對病情、照護不了解產生不確定感，藉由專業護理師提供面對面的衛教諮詢與支持，協助父母採取妥善的適應策略，能減輕不確定感。目的：本研究欲探討護理諮詢支持照護對改善父母照顧初診斷先天性心臟病童不確定感之成效。方法：本研究採類實驗性單組前後測設計，採立意取樣，於台中市某區域醫院小兒科病房、小兒加護病房、嬰兒室、病嬰室、門診由護理師進行第一次收案，提供衛教資料、臉書衛教資訊網站、聯繫窗口，並於一個月、第三個月進行追蹤收案，共 17位初診斷先天性心臟病童父母完成問卷填寫。資料採GEE 分析檢視護理諮詢支持照護對改善父母照顧初診斷先天性心臟病童不確定感之成效，護理諮詢照護所收集的照顧者需求資料則採質性內容分析。結果：護理諮詢支持照護對於改善父母照顧初診斷先天性心臟病童不確定感具有顯著成效，在介入的第一個月並無顯著改變，但在第三個月後父母不確定感明確下降。護理諮詢照護所收集的照顧者需求包括：情緒反應、治療訊息的不明確性、依賴醫護人員的照護。結論: 本研究驗證Mishel不確定感理論，提供護理諮詢支持照護可降低先天性心臟病童父母不確定感，研究結果可作為日後相關研究之參考。

Background: The parents whose children are newly diagnosed as congenital heart disease (CHD) experience a sense of uncertainty due to unclear treatment information. Provision of professional face-to-face health education and consultation support care could assist parents adapt and reduce the sense of uncertainty.Purpose: The purpose of this study was to explore the effect of nursing consultation support care on improving the parents’ uncertainty of children with a newly diagnosed congenital heart disease.Methods: This was a single group with pre-post test quasi-experimental study design. Purposive sampling was conducted. Participants were recruited from the pediatric ward, pediatric intensive care unit, baby room, sick baby room, and outpatient department of a metroharbor hospital in Taichung City. Data were collected on the date of recruitment, first and third month after recruitment. Total 17 participants were recruited. Data were analyzed by GEE to examine the effect of improvement on the sense of uncertainty for the parents.Result: Data was not significantly different from the base line until third month. The parents’ uncertainty level was significantly lower than the baseline in the third month. The result indicated that nursing consultation support care significantly improve the level of parents’ uncertainty. Parents’ concerns were divided into three domains, including emotional response, unclear treatment options, and medical staff dependence.Conclusion: The study results confirmed Mishel’s uncertainty theory that nursing consultation support care could improve the parents’ uncertainty.