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, Kelvin Grove, Qld, Australia.
J Clin Nurs. 2007 Oct;16(10):1966-79. doi: 10.1111/j.1365-2702.2007.01767.x.
This study examined effectiveness of a theoretically based education programme in reducing inappropriate antipyretic use in fever management.
Paediatric nurses' inconsistent, ritualistic antipyretic use in fever management is influenced by many factors including inconsistent beliefs and parental requests. Determinants of antipyretic administration, identified by the theory of planned behaviour, were belief-based attitudes and subjective norms.
A quasi-experiment explored group effects of a peer education programme, based on the theory of planned behaviour, on factors influencing paediatric nurses' antipyretic administration. Surveys and chart audits collected data from medical wards at experimental and control hospitals one month pre and one and four months postpeer education programme.
All nurses employed in targeted wards were eligible to participate in surveys and all eligible charts were audited. The peer education programme consisted of four one-hour sessions targeting evidence-based knowledge, myths and misconceptions, normative, attitudinal and control influences over and rehearsal of evidence-based fever management. All nurses in experimental hospital targeted wards were eligible to attend. Peer education and support facilitated session information reaching those unable to attend sessions.
Two-way univariate anovas explored between subject, experimental and control group and within subject factors, pre, post and latency data. Significant interactions in normative influence (p = 0.01) and intentions (p = 0.01), a significant main group effect in control influence (p = 0.01) and a significant main effect between audit data across time points (p = 0.03) highlight peer education programme effectiveness in behaviour change. Normative, control and intention changes postpeer education programme were maintained in latency data; mean temperature was not.
The peer education programme, based on a behaviour change theory, initiated and maintained evidence-based intentions for antipyretics use in fever management.
The promotion of evidence-based change in organizational unit intentions and behaviour highlights the crucial role peer support and education can play in continuing educational programmes.
本研究检验了一项基于理论的教育项目在减少发热管理中不当使用退烧药方面的效果。
儿科护士在发热管理中对退烧药的使用不一致且墨守成规，这受到多种因素影响，包括观念不一致和家长的要求。计划行为理论确定的退烧药给药决定因素是基于信念的态度和主观规范。
一项准实验探究了基于计划行为理论的同伴教育项目对影响儿科护士退烧药给药因素的组间效应。调查和病历审核在同伴教育项目前1个月以及项目后1个月和4个月收集了实验医院和对照医院内科病房的数据。
目标病房的所有护士都有资格参与调查，所有符合条件的病历都接受审核。同伴教育项目包括四个一小时的课程，内容涉及循证知识、误区和误解、规范、态度及控制影响以及循证发热管理的演练。实验医院目标病房的所有护士都有资格参加。同伴教育和支持促使课程信息传达给那些无法参加课程的人。
双向单变量方差分析探讨了组间、实验组与对照组以及组内因素，即前测、后测和延迟数据。规范影响（p = 0.01）和意图（p = 0.01）存在显著交互作用，控制影响存在显著的组间主效应（p = 0.01），不同时间点的审核数据之间存在显著主效应（p = 0.03），这突出了同伴教育项目在行为改变方面的有效性。同伴教育项目后规范、控制和意图的变化在延迟数据中得以维持；平均体温则没有。
基于行为改变理论的同伴教育项目启动并维持了发热管理中使用退烧药的循证意图。
促进组织单位意图和行为的循证改变凸显了同伴支持和教育在继续教育项目中可发挥的关键作用。
