甲型血友病兒童家庭治療和護(hù)理行為的干預(yù)模式研究.pdf

1、Objectives:The study exploredanapplicable nursing intervention modeandcomprehensive nursing intervention measures on family treatmentand nursing for childrenwith hemophiliaAand their parents,and examined the effect of co

2、mprehensive nursingintervention.
　　Methods:Aself-control,quasi-experimental study was conducted withaconvenientsample of52children with hemophiliaAand their parents discussedand summarized theproblems in family treatm

3、entand nursing for children with hemophiliaso to developcomprehensive nursing intervention measures including individualized coagulation factorsinjection training course,hemophiliahealth education programs,children hemop

4、hiliafamilies sodalityand follow-up visiting of the family treatmentand nursing behaviorsthrough literature reviewand expert consultation.Datawere collected using structuredquestionnairesand MPOC-56scale from January,201

5、2to March,2013.Chi-Square testand Paired-Samples T test were utilized for dataanalyses.
　　Results:
　　1.After intervention,among22items of family treatmentand nursing behaviors,19itemswere significantly improved com

6、pared with that before intervention(X2=59,88,36,47,96,30,13,57,34,67,55.06,55.06,55.06,21.85,22.69,45.69,39.33,68.25,11.99,35.39,35.39,17.24,81.51,85.75,13.57,respectively;P<0.01).The incidence of"correctlyrecord every b

7、leedingand treatment"among the patient was2cases(3.85％)beforeintervention,while that was48cases(92.31％)after intervention.The incidence of"monthly report the bleedingand therapy nursing information to nurses"was raised f

8、rom5cases(20％)before intervention to52cases(100％)after intervention,and the differencewas statistically significant(X2=81.51,85.75,respectively;P　　2.The participation rate of preventionand treatment for hemoph

9、iliaincreased dramaticallyfrom13.46％before intervention to94.63％after intervention.
　　3.Theaccuracy rate of emergency treatment was greatly enhanced from34.62％beforeintervention t080.77％after intervention.
　　4.The

10、totalaverage score of the MPOC scale increased from4.19±0.11before interventionto5.48±0.11after intervention.Theaverage score of each dimension raised from3.18±0.12(EP),3.12±0.17(PGI),4.11±0.18(PSI),4.96±0.29(CCC),5.64±0

11、.39(RSC)beforeintervention to5.21±O.11(EP),6.09±0.18(PGI),5.42±0.29(PSI),5.18±0.26(CCC),6.23±0.33(RSC)after intervention,respectively.
　　5.Compared with that before intervention,the parents of children with hemophilia

12、Ahadsignificantly higher satisfaction with processes of care in EP(t=-176.294,P<0.001),PGI(t=-179.571,P<0.001),PSl(t=-34.350,P<0.001),CCC(t=-9.083,P<0.001),RSC(t=-21.007,P<0.001)and the total scale(t=-129.311,P<0.001)aft

13、er intervention.Suggestions for improvement of the study program:
　　1.Make24hours consultationaccessible to the patients in case of bleeding,or familymembers'havingany queries.
　　2.Assess the feasibility of usingas

14、hort message service(SMS)to monitor the incidence ofbleeding episodes in children with hemophilia.
　　3.Development ofaHemophiliaLink Nurse trainingand education pack.(Link nursesarepracticing nurses withan expressed i

15、nterest inagiven specialty,with formal links toclinical nurse specialistsand other specialist staffs.The role involvesattending meetings todiscuss ideasand new developments,and relaying findings to other ward nurses to i

16、mprovetheir practice).
　　4.Arrangement of home visiting group for maintaining health careand family treatment forpatients with hemophiliaA.
　　5.Developamore complete understanding of the impact of hemophiliaon pare

17、nt's lives.Parentsare deeplyaffected by their child's condition.And their livesare transformed by theexperiences of living withachild with hemophilia.Parents'responsesare influenced byhow well their child manages the dis

18、orderand the difficulties he experiences.Furtherstudiesare required in order to developamore complete understanding of the impact ofhemophiliaon parent's lives.
　　Conclusions:
　　1.The findings reveal that the compr

19、ehensive nursing intervention contribute to improvingthe parents'abilities of performing family treatmentand nursing behaviorsaccuratelyandthe parents'satisfaction with the process of care,which indicates that the nursin

20、gintervention modeland measuresare effectiveandapplicable to children with hemophiliaAand their parents.
　　2.This study suggests that some intervention measures focusing on the behaviors suchasunderstandingand partici

21、pating in preventionand treatment,family rehabilitation trainingand clotting factor injection,should beadopted in further study.
　　3.Alarge sample,multi-central study should be carried out in future study in order toc