Edwards Helen, Walsh Anne, Courtney Mary, Monaghan Sarah, Wilson Jenny, Young Jeanine
School of Nursing, Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia.
J Adv Nurs. 2007 Feb;57(3):257-69. doi: 10.1111/j.1365-2648.2006.04077.x.
This paper reports an evaluation of the effectiveness of a peer education programme in developing paediatric nurses' evidence-based knowledge and attitudes towards fever management and the sustainability of these changes.
In general, paediatric nurses' fever management knowledge seems to be mediocre. They believe fever to be harmful, causing febrile convulsions and brain damage. Antipyretics are administered to prevent febrile convulsions and alternate antipyretics are given when temperatures are not reduced.
A quasi-experiment was conducted from August 2002 to March 2003. An experimental group of Registered Nurses received the peer education programme and peer support and education were promoted for those unable to attend the sessions. A control group continued its normal practices. Seventy-seven nurses were eligible to attend the programme; 74.0% attended at least one session, 52% two or more. Questionnaire data were collected 1 month before and 1 and 4 months after the peer education programme from 56.3% to 77.8% of eligible experimental and 40.9% to 51.6% of eligible control group nurses.
Interaction effects between group and time were found in overall knowledge (P = 0.01), specifically knowledge of the physiology of fever (P = 0.001), and attitudes towards evidence-based fever management (P = 0.05). In addition, experimental group nurses demonstrated statistically significantly more knowledge of general fever management principles at 4 months after the intervention than control group nurses (P = 0.01), and compared with their own knowledge at baseline (P < 0.001).
Educational programmes targeting practice change must be theoretically based and target knowledge, attitudes and barriers to change. The programme tested here, which incorporated peer education and support and facilitated group change, is adaptable to other practices, groups and settings.
本文报告了一项关于同伴教育计划在培养儿科护士基于证据的发热管理知识及态度以及这些变化的可持续性方面有效性的评估。
总体而言，儿科护士的发热管理知识似乎一般。他们认为发热有害，会导致热性惊厥和脑损伤。使用退烧药来预防热性惊厥，当体温未降低时更换退烧药。
于2002年8月至2003年3月进行了一项准实验。一组注册护士组成的实验组接受了同伴教育计划，并为那些无法参加课程的护士提供同伴支持和教育。对照组继续其常规做法。77名护士有资格参加该计划；74.0%的人至少参加了一次课程，52%的人参加了两次或更多次。在同伴教育计划开始前1个月以及计划开始后1个月和4个月，从56.3%至77.8%符合条件的实验组护士和40.9%至51.6%符合条件的对照组护士中收集问卷数据。
在总体知识（P = 0.01）、特别是发热生理学知识（P = 0.001）以及对基于证据的发热管理的态度（P = 0.05）方面，发现了组间和时间的交互作用。此外，干预后4个月，实验组护士在一般发热管理原则方面的知识在统计学上显著多于对照组护士（P = 0.01），并且与她们自己基线时的知识相比也有显著增加（P < 0.001）。
针对实践变革的教育计划必须有理论依据，并针对知识、态度和变革障碍。这里测试的计划纳入了同伴教育和支持并促进了群体变革，适用于其他实践、群体和环境。
