Proczkowska-Björklund Marie, Runeson Ingrid, Gustafsson Per A, Svedin Carl Göran
Division of Child and Adolescent Psychiatry, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
Acta Paediatr. 2008 Sep;97(9):1238-42. doi: 10.1111/j.1651-2227.2008.00896.x. Epub 2008 Jun 6.
To see how dominance in adult communication and child behaviour during premedication affects the child's unwillingness to take premedication.
Ninety-five children scheduled for ENT surgery were video-filmed during premedication. All communication was translated verbatim and the communication was grouped according to; if the parent or nurse directed their communication towards the child or not, or; if they talked about nonprocedural matters or procedural matters.
Unwillingness to take premedication was associated with more parent communication and less anaesthetic nurse communication compared to willingness to take premedication. There was a heighten risk that the child took their premedication unwillingly if their parent talked more directly to the child (OR = 4.9, p < or = 0.01), the child gave hesitant eye contact with the anaesthetic nurse (OR = 4.5, p < or = 0.05), the child had experienced an earlier traumatic medical procedure (OR = 4.1. p < or = 0.001) or if the child placed her/himself nearby their parent (OR = 4.0, p < or = 0.001).
Together with behaviour that could be signs of shyness and earlier medical traumatic experience, parents that are actively communicating with their child before premedication may heighten the risk that the child will take the premedication unwillingly.
观察术前用药期间成人沟通方式及儿童行为中的主导性如何影响儿童对术前用药的抵触情绪。
对95名计划接受耳鼻喉科手术的儿童在术前用药期间进行录像。所有沟通内容逐字翻译,并根据以下标准进行分类:家长或护士的沟通是否针对孩子,或者;他们谈论的是非手术相关事宜还是手术相关事宜。
与愿意接受术前用药相比,不愿接受术前用药与家长更多的沟通及麻醉护士较少的沟通有关。如果家长与孩子直接交流更多(比值比=4.9,p≤0.01)、孩子与麻醉护士眼神交流犹豫(比值比=4.5,p≤0.05)、孩子曾经历过更早的创伤性医疗程序(比值比=4.1,p≤0.001)或者孩子靠近家长(比值比=4.0,p≤0.001),那么孩子更有可能不情愿地接受术前用药。
除了可能表现出害羞和早期医疗创伤经历的行为外,在术前用药前积极与孩子沟通的家长可能会增加孩子不情愿接受术前用药的风险。