系統性護理指導對改變熱性痙攣患童主要照顧者疾病態度、認知、關注及處理行為成效

熱性痙攣是兒童時期最常見的抽搐疾病，痙攣時的臨床表現常造成主要照顧者心理的衝擊，故需要給予照顧者明確的資訊，來處理抽搐以減輕焦慮。本研究主要目的在了解系統性護理指導對改變熱性痙攣患童主要照顧者態度、認知、關注及處理行為的成效。本研究方法採實驗設計法之前、後測量設計，以立意取樣選取中部某醫學中心小兒科病房熱性痙攣患童主要照顧者為對象，按週別分爲控制組22位進行病房常規衛教處置及實驗組24位接受系統性護理指導，並於護理指導前後及出院後兩星期郵寄問卷進行測量。利用「熱痙攣患童父母之相關認知、態度、關注與行為問卷」評估主要照顧者接受系統性護理指導對相關態度、認知、關注與處理行為的成效。所得資料以SPSS/PC18.0版進行描述性、卡方及獨立t檢定等統計分析。結果顯示：控制組及實驗組在接受不同的衛教指導方式後對熱性痙攣患童的相關態度、認知、關注及處理行為都具有成效，但實驗組在接受系統性的護理指導之後，四個量表的得分成效明顯高於控制組（P＜.001）。而且在出院後兩個星期對衛教指導的記憶延長效果，實驗組明顯優於控制組(P＜.01)。故熱性痙攣照護手冊及系統性護理指導，應可作為未來臨床護理人員提供照護之參考。

Febrile convulsion is the most common seizure disorder in children. The appearance of seizure attacks made a great psychologic impact on primary caregivers, so their initial reaction is often inappropriate and maybe actually lead to harm. Primary caregivers of such children need specific information to manage seizures and decrease their anxiety. This study was to understand the effects of systematic nursing intervention on knowledge, attitudes, concerns and practices of primary caregiver. A pretest-posttest experimental study was designed, enrolling a purposive sample of caregiver who had febrile convulsion children and admitted to medical center pediatric ward in middle Taiwan. The intervention group (n=24) received systematic nursing interventions from the researcher and the control group (n=22) received regular nursing care from staff nurses.The differences of the two groups were measured via before and after nursing inerventions. The effects of systematic nursing intervetnion were evaluated using the「Questionnaire on parental knowledge, attitudes,concerns and practices」for primary caregiver. Data were analyzed via descriptive, χ2, pair t-test, and independent t-test using SPSS/PC 18.0. The results showed that control and intervention group receiving different interventions had been effective in attitudes, knowledge, concerns and practices. But the intervention group had significantly higher scores than control group（P＜.001）. After two weeks discharged from hospital, the intervention group were still significantly higher score than control group(P＜.01).The systematic nursing interventions by "febrile convulsion care pamphlet" could be supplied in clinics in the future.