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[母亲的情绪状态与儿童在小手术期间的行为]

[Emotional states of mothers and behavior of the child during minor surgery].

作者信息

Tourigny J

出版信息

Can J Nurs Res. 1992 Spring;24(1):65-80.

PMID:1464058
Abstract

The objectives of this descriptive correlational study were to measure the degree of fear-anxiety in mothers and in their children who were having minor surgery, and then to verify if there was a relationship between these two variables. Other variables examined were: child's age, rooming-in, premedication and child's experience with surgery. Fifty (50) mothers described their emotional states both on the day before and during the surgery. Fifty (50) children between the ages of two (2) and ten (10) years old were observed at five different times (one hour preoperatively, leaving for the OR, pre-induction, coming back to the room and one hour post-operatively). Their behaviours were noted on a new scale, the ECEO: Echelle des comportement de l'enfant opéré. This scale was developed to describe the behaviour of children experiencing fear, anxiety and pain. Results show that the mother's fear-anxiety score was significantly higher during the surgery than before it (t df.49 = 3.77, p < 0.001). Rooming-in significantly affected mothers' emotional states (F = 4.07, p < 0.05). Younger children were more affected than older ones; they also showed more distress when the mother was present (t df.49 = 5.31, p < 0.001). Rooming-in contributed significantly to the child's stress score; children whose mother roomed-in at least one night showed more distress behaviours than children whose mothers did not room-in (t df.48 = 2.03, p < 0.05). A correlation was found between the degree of mothers' fear-anxiety and the children's fear-anxiety-pain score or distress behaviours (r = .28, p < 0.05). A strong relationship was established between the total distress score of the child and his or her score when the mother was present (r = .81, p < 0.01). These results support the theory of social referencing: the child is influenced greatly by the mother's emotional state and he refers to her for the interpretation of events provoking anxiety. Therefore, nurses should inform and support mothers, especially those who are rooming-in; they should also make more use of parents in the preparation and the management of the child for surgery. The development and validation of an instrument measuring fear-anxiety-pain in younger children will facilitate evaluation of the effect of surgery or other procedures on the child, and the planning adequate interventions.

摘要

这项描述性相关性研究的目的是测量接受小手术的母亲及其子女的恐惧焦虑程度,然后验证这两个变量之间是否存在关联。研究考察的其他变量包括:孩子的年龄、母婴同室、术前用药以及孩子的手术经历。50位母亲描述了她们在手术前一天及手术期间的情绪状态。对50名年龄在2岁至10岁之间的儿童在五个不同时间点进行了观察(术前一小时、前往手术室途中、诱导前、回到病房以及术后一小时)。根据一种新的量表——ECEO:接受手术儿童行为量表,记录他们的行为。该量表旨在描述经历恐惧、焦虑和疼痛的儿童的行为。结果显示,母亲的恐惧焦虑得分在手术期间显著高于手术前(t值,自由度为49,t = 3.77,p < 0.001)。母婴同室对母亲的情绪状态有显著影响(F = 4.07,p < 0.05)。年龄较小的孩子比年龄较大的孩子受影响更大;当母亲在场时,他们也表现出更多的痛苦(t值,自由度为49,t = 5.31,p < 0.001)。母婴同室对孩子的压力得分有显著影响;母亲至少陪住一晚的孩子比母亲没有陪住的孩子表现出更多的痛苦行为(t值,自由度为48,t = 2.03,p < 0.05)。母亲的恐惧焦虑程度与孩子的恐惧焦虑疼痛得分或痛苦行为之间存在相关性(r = 0.28,p < 0.05)。孩子的总痛苦得分与母亲在场时的得分之间建立了很强的相关性(r = 0.81,p < 0.01)。这些结果支持了社会参照理论:孩子受母亲情绪状态的影响很大,他会参照母亲来解读引发焦虑的事件。因此,护士应该为母亲提供信息并给予支持,尤其是那些母婴同室的母亲;她们还应该在孩子手术的准备和管理过程中更多地利用家长。开发并验证一种测量年幼儿童恐惧焦虑疼痛的工具将有助于评估手术或其他程序对孩子的影响,并规划适当的干预措施。

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