气管切开术后慢性呼吸衰竭患儿家庭护理负担的相关因素

Hirunya Jeennamsai, Nantaga Sawasdipanich, J. Deerojanawong
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引用次数: 0

摘要

引言 儿童慢性呼吸衰竭是一个严重的健康问题,导致出院后在家中进行气管造口术。当儿童需要复杂的医疗治疗时,在家中为其提供长期护理就变得具有挑战性,这给护理人员带来了负担。 目标 1) 描述在家接受气管造口术的慢性呼吸衰竭患儿的护理负担;2) 研究在家接受气管造口术的慢性呼吸衰竭患儿的护理自我效能、社会支持、应对和护理负担之间的关系。 设计 采用描述性相关设计,以 Chou 的照顾者负担为概念框架 方法 通过有目的性的抽样调查,以纳入标准为依据,样本包括 85 名照顾 3 个月至 15 岁在家接受气管造口术儿童的照顾者,他们于 2022 年 5 月至 2023 年 1 月期间在曼谷市区的一家超级三级医院和泰国北部省份的一家三级医院接受护理。数据收集工具包括:护理者和儿童个人信息问卷、护理者负担问卷、护理自我效能问卷、社会支持问卷和应对问卷。这些问卷的内容效度指数分别为 0.86、0.97、0.92 和 0.97,内部一致性信度(Cronbach's alpha coefficient)分别为 0.90、0.95、0.95 和 0.92。数据分析采用描述性统计和皮尔逊积矩相关。 结果 护理人员的总体负担得分平均处于中等水平(M = 2.57,SD = 0.10)。此外,照顾者在所有分量表中的负担感知均处于中等水平,包括身体负担、情感负担、社会负担和经济负担(中值分别为 2.51、2.42、3.00 和 3.00,标差分别为 0.98、1.01、1.15 和 1.15)。社会支持处于较高水平(中值=2.83,标差=0.07),与照顾者负担呈显著负相关(r=-.292,p=.007)。护理自我效能感较高,而应对能力处于中等水平;然而,这些因素与护理者负担之间并无显著相关性(r = -.182, p = .097 和 r = -.139, p = .203)。 建议 本研究的结果突显了需要在家中进行气管造口术护理的慢性呼吸衰竭患儿的护理人员所承受的负担,以及与这种负担相关的因素。医护人员有必要提供有针对性的培训计划,以提高护理人员在家庭儿童护理方面的知识和技能。此外,还应考虑提供信息和情感支持,以及提供必要的医疗设备,以减轻护理人员的负担。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Factors Related to Caregiver Burden of Children with Chronic Respiratory Failure with Tracheostomy at Home
Introduction Chronic respiratory failure in children is a significant health problem leading to tracheostomy at home following hospital discharge. Providing long-term care for children at home becomes challenging when they require complex medical treatments, placing a burden on caregivers.  Objectives 1) To describe caregiver burden of children with chronic respiratory failure with tracheostomy at home, and 2) To examine the relationships between caregiving self-efficacy, social support, coping, and caregiver burden of children with chronic respiratory failure with tracheostomy at home.  Design A descriptive correlational design employing Chou’s caregiver burden as the conceptual framework Methodology Through purposive sampling with inclusion criteria, the sample included 85 caregivers of children aged three months to 15 years old with tracheostomy at home, who were receiving care at a super tertiary hospital in Bangkok metropolitan area and a tertiary hospital in a northern province of Thailand from May 2022 to January 2023. The instruments used for data collection comprised the following: the personal information of caregiver and children questionnaire, the caregiver burden questionnaire, the caregiving self-efficacy questionnaire, the social support questionnaire, and the coping questionnaire. These instruments revealed content validity indices of .86, .97, .92 and .97, respectively and internal consistency reliability, with Cronbach’s alpha coefficients of .90, .95, .95 and .92, respectively. Data were analyzed using descriptive statistics and Pearson’s product-moment correlation.  Results The overall caregiver burden score averaged at a moderate level (M = 2.57, SD = 0.10). Furthermore, caregivers perceived a moderate level of burden across all subscales, including physical, emotional, social, and financial burdens (M = 2.51, 2.42, 3.00 and 3.00, with SD = 0.98, 1.01, 1.15 and 1.15, respectively). Social support was at a high level (M =2.83, SD = 0.07) and revealed a significant negative correlation with caregiver burden (r = -.292, p = .007). Caregiving self-efficacy was high, while coping was at a moderate level; however, there was no significant correlation between these factors and caregiver burden (r = -.182, p = .097, and r = -.139, p = .203, respectively).  Recommendation The results from this study highlighted the burden experienced by caregivers of children with chronic respiratory failure requiring tracheostomy care at home, as well as the factor related to this burden. It is necessary for healthcare providers to provide targeted training programs aimed at enhancing caregivers’ knowledge and skills in home-based child care. Additionally, offering informational and emotional support, along with providing necessary medical equipment, should be considered to alleviate caregiver burden.
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