The Communicative Behaviors of the Preschooler with Congenital Heart Disease during the Post Operative Period.

Abstract

本研究目的是在探討先天性心臟病學齡前兒童手術後，停留加護病房期間的溝通行為 特點，藉以提供護理人員參考，促進護理人員對病童溝通行為的重視，進而提供病人 良好的照顧。研究方法是利用田野研究法，觀察七位5至7歲學齡前先天性心臟病兒童 手術後，拔除氣管內管後四小時之溝通行為，從實際觀察病人的過程中獲得資料，事 後將行為過程與以詳細紀錄，並以內容分析法將溝通行為及內容與以分析。在分析43 頁行為過程紀錄中，共得溝通行為1235個單元，其中表達行為佔59.3%，反應指示佔 19%，行為指示10.5%，自我協助佔5.7%，收集資料佔5.5%。就溝通型態而言，非語言 型態佔77.5%，語言型態佔22.5%，就溝通內容而言，有關於自己的佔78.4%，有關於 事物佔12 .7%，有關於他人僅佔8.9%。同時，病人最關心身體的疼痛以及飲食、休息 、活動、呼吸方面的需要。從結果中顯示，護理人員在照顧手術後先天性心臟病的學 齡前兒童時應(1)加強及重視非語言溝通型態的觀察技巧(2)加強了解溝通行為之意義 及目的(3)主動滿足病人的基本需要。 The purpose of this study was to investigate the communicative behavior of preschoolers with congenital heart disease during the post-operative period. Data was collected by the field method and content analysis was used to analyze behavioral characteristic. Seven children were observed when they were in the ICU. The observation period was restricted to the first four hours after endotracheal tube was removed from them. The total behavioral units were 1235. They were divided into three categories : (1) function , (2) pattern , and (3) content. The function of communicative behavior included expression 59.3% ; instruction response 19% ; ability to direct 10.5% ; self- help 5.7% and data-collection 5.5%. The pattern of communication behavior included nonverbal 77.5% and verbal 22.5%. The content of communicative behavior included information concerning self 78.4% general events 12.7%, and other persons 8.9%. The children’s biggest concerns were the basic needs of relieving pain ; rest ; activities and respiration . In conclusion, the findings suggested that when nurses care for children with CHD they are supposed to be sensitive to nonverbal cues during the post-operative period . They should improve their observation skill to actively meet the patient’s basic needs.