Laine L, Shulman R J, Bartholomew K, Gardner P, Reed T, Cole S
Office of Educational Resources, Texas Children's Hospital, Houston.
Am J Dis Child. 1989 Mar;143(3):374-7. doi: 10.1001/archpedi.1989.02150150136033.
A major cause of anxiety in parents of hospitalized children is insufficient information about hospital procedures. In an effort to determine the extent to which parental anxiety could be diminished and knowledge and satisfaction enhanced in regard to total parenteral nutrition (TPN), we developed a booklet that describes the mechanics of TPN administration and related procedures. When informal discussions were held between parents and members of the nutritional support team during four alternating periods (every five to six months), parents of first-time recipients of TPN either did not receive the booklet (period 1, n = 20; period 3, n = 30) or received it (period 2, n = 23; period 4, n = 27). Within one week of TPN initiation, parents in both groups completed the Spielberger State-Trait anxiety scale, an attitude questionnaire, and a quiz on TPN. No differences between groups were found in ethnic background, socioeconomic status, severity of illness, age of children, or route of TPN administration. Predisposition to anxiety was also similar between the groups. In contrast, acute situational anxiety was significantly greater in the group with no booklet than in the booklet group. Parents in the no-booklet group demonstrated less comfort in the care of their children and less knowledge about TPN than did the booklet group. Written information provided to parents decreased their anxiety and increased satisfaction with patient care more successfully than did verbal communication. Such a booklet may reduce parentally induced anxiety in the child and facilitate parent-hospital staff interactions.
住院儿童家长焦虑的一个主要原因是对医院程序的信息了解不足。为了确定在全胃肠外营养(TPN)方面,家长的焦虑能在多大程度上得到缓解,以及知识和满意度能得到多大提升,我们编写了一本描述TPN管理机制及相关程序的手册。在四个交替时间段(每五到六个月)里,当家长与营养支持团队成员进行非正式讨论时,首次接受TPN治疗的患儿家长中,有些没有收到手册(第1阶段,n = 20;第3阶段,n = 30),有些收到了手册(第2阶段,n = 23;第4阶段,n = 27)。在开始TPN治疗的一周内,两组家长都完成了斯皮尔伯格状态 - 特质焦虑量表、一份态度问卷以及一份关于TPN的测验。两组在种族背景、社会经济地位、疾病严重程度、儿童年龄或TPN给药途径方面均未发现差异。两组的焦虑倾向也相似。相比之下,未收到手册组的急性情境性焦虑明显高于收到手册组。未收到手册组的家长在照顾孩子时表现出的舒适度较低,对TPN的了解也比收到手册组少。与口头交流相比,向家长提供书面信息能更成功地减轻他们的焦虑并提高对患者护理的满意度。这样一本手册可能会减少家长引发的患儿焦虑,并促进家长与医院工作人员之间的互动。