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Physical activities and correlates of clinical nurses in Taipei municipal hospitals. 台北市立医院临床护士身体活动状况及相关因素分析。
Pub Date : 2005-12-01 DOI: 10.1097/01.JNR.0000387551.50458.F5
Yuh-Shwu Lee, Yi-ching Huang, Y. Kao
The purpose of this study was to investigate the physical activity profiles of clinical nurses in Taipei municipal hospitals. This study also explored the factors that influence physical activity, including personal background and social psychological factors. A total of 400 Taipei municipal hospital clinical nurses were selected using a randomized procedure to participate in a 3-day physical activity record assignment and fill in a structured questionnaire. Study results indicate that energy expenditure for clinical nurses on working days are higher than that on non-working days. Non-working days of clinical nurses are characterized by a lack of physical activity. Nurses who were required to take turns working in three shift rotation cycles, those with education at the junior college level or below, and those who were married tended to spend more energy on physical activity. Social psychological factors affecting the physical activities of clinical nurses include mainly exercise self-efficacy. Heavy work loading, poor health conditions, laziness, and lack of time tended to lower exercise self-efficacy. On non-working days, perceived barriers to exercise are the main issue area affecting moderate-to-vigorous physical activity. Nurses with greater perceived barriers to exercise spend less energy on physical activity. The main influencing factors for perceived barriers to exercise include laziness and lack of time.
摘要本研究旨在探讨台北市市立医院临床护士之身体活动状况。本研究还探讨了影响体育锻炼的因素,包括个人背景和社会心理因素。本研究采用随机方法,选取400名台北市立医院临床护士参与为期3天的身体活动记录分配,并填写结构化问卷。研究结果表明,临床护士在工作日的能量消耗高于非工作日。临床护士的非工作日的特点是缺乏体力活动。被要求三班轮流工作的护士、受过大专或以下教育的护士以及已婚的护士倾向于在体育锻炼上花费更多的精力。影响临床护士身体活动的社会心理因素主要包括运动自我效能感。繁重的工作负荷、糟糕的健康状况、懒惰和缺乏时间往往会降低锻炼的自我效能。在非工作日,运动障碍是影响中高强度体育活动的主要问题。认为运动障碍较大的护士在体育活动上花费的精力较少。人们认为阻碍锻炼的主要因素包括懒惰和缺乏时间。
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引用次数: 21
Physical and social predictors for pre-term births and low birth weight infants in Taiwan. 台湾早产儿与低出生体重儿之生理与社会预测因子。
Pub Date : 2002-06-01 DOI: 10.1097/01.JNR.0000347586.08328.D6
Yili Ko, Yi-Cheng Wu, P. Chang
The purpose of this study was to examine the risk factors associated with pre-term labor (PTL) (< 37 gestational weeks) and low birth weight (LBW) (< 2500 gm) infants in a healthy Taiwanese population. From December 1998 through June 1999, a total of 633 healthy pregnant women were recruited at three teaching hospitals in Taipei. Using a prospective study design, the pregnancy outcome information was followed up by telephone or from medical records during the first month postpartum. Data were statistically analyzed by multiple logistic regression. The prevalence of premature births was 5.4%, and the prevalence of LBW infants was 5.1%. Pre-term births were significantly associated with high self-reported fatigue scores (OR = 3.45); extreme maternal age (< 20 and >/= 35 years, OR = 2.38); history of abortion (>/= 2, OR = 3.11); maternal height (
摘要本研究旨在探讨台湾健康人群中早产(PTL)(< 37孕周)及低出生体重(LBW) (< 2500 gm)婴儿的相关危险因素。从1998年12月至1999年6月,台北三所教学医院共招募了633名健康孕妇。采用前瞻性研究设计,通过电话或产后第一个月的医疗记录跟踪妊娠结局信息。数据采用多元逻辑回归进行统计学分析。早产儿患病率为5.4%,低体重儿患病率为5.1%。早产儿与自我报告的高疲劳评分显著相关(OR = 3.45);极端产妇年龄(< 20岁和>/= 35岁,OR = 2.38);流产史(>/= 2,OR = 3.11);母体身高(
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引用次数: 20
A randomized controlled trial of early kangaroo care for preterm infants: effects on temperature, weight, behavior, and acuity. 一项早产儿早期袋鼠式护理的随机对照试验:对体温、体重、行为和视力的影响。
Pub Date : 2002-06-01 DOI: 10.1097/01.JNR.0000347592.43768.46
M. Chwo, G. Anderson, M. Good, D. Dowling, S. H. Shiau, Der‐Ming Chu
Kangaroo care (KC) has been the intervention for preterm infants in numerous published studies. However, most well designed studies to date have used a one-group repeated measure design. This methodology is not as definitive as an experimental design. Because of the absence of a comparable control group, change between pretest and posttest may be due to any other environmental variables or normal variation of subjects (Kirk, 1995). This randomized controlled trial (RCT) was done to test the hypotheses that KC infants would have higher mean tympanic temperatures, less weight loss, more optimal behavioral states, and lower acuity (length of stay). Thirty-four eligible mother-infant dyads were randomly assigned to the KC or the control group by computerized minimization on the day following birth. Stratification variables included infant gender, birth weight, delivery method, and parity. KC infants compared to control infants had higher mean tympanic temperature (37.3 degrees C vs. 37.0 degrees C), more quiet sleep (62% vs. 22%), and less crying (2% vs. 6%) all at p=.000. No significant difference was found for weight loss and acuity (length of stay). These findings can be used for evidence-based nursing practice in Taiwan. With the knowledge attained from this RCT, nurses can educate and motivate mothers to keep their stable preterm infants warm by skin-to- skin contact inside their clothing, thereby encouraging self-regulatory feeding.
在许多已发表的研究中,袋鼠式护理(KC)一直是早产儿的干预措施。然而,迄今为止,大多数设计良好的研究都使用了单组重复测量设计。这种方法不像实验设计那样确定。由于没有可比较的对照组,测试前和测试后的变化可能是由于任何其他环境变量或受试者的正常变化(Kirk, 1995)。本随机对照试验(RCT)旨在验证KC婴儿平均鼓室温度较高、体重减轻较少、行为状态更优、视力(住院时间)较低的假设。34名符合条件的母婴在出生后一天通过计算机最小化随机分配到KC组或对照组。分层变量包括婴儿性别、出生体重、分娩方式和胎次。与对照组婴儿相比,KC婴儿的平均鼓室温度更高(37.3摄氏度对37.0摄氏度),睡眠更安静(62%对22%),哭泣更少(2%对6%),p= 0.000。体重减轻和视力(住院时间)无显著差异。本研究结果可为台湾循证护理实务提供参考。有了从这项随机对照试验中获得的知识,护士可以教育和激励母亲通过衣服内皮肤对皮肤的接触来保持稳定的早产儿温暖,从而鼓励自我调节喂养。
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引用次数: 97
Cost and care quality between licensed nursing homes under different types of ownership. 不同所有制下持牌护理院的成本及护理质素。
Pub Date : 2002-06-01 DOI: 10.1097/01.JNR.0000347594.28520.61
Chun-Lan Lee, Tao Liu, Ling Wu, U. Chung, Liz Lee
In Taiwan, there is some uncertainty and concern regarding the quality and safety of unlicensed nursing homes, as they are typically crowded and poorly equipped. There are data insufficient regarding the quality of care in licensed nursing homes for the government to reliably assist unlicensed facilities to become licensed. The purpose of this study was to examine the relationship between the different nursing home ownership types and the following dependent variables: (1) operating cost per resident day, (2) RN to resident ratio, (3) facility size, (4) occupancy rate, and (5) quality of care amongst licensed nursing homes nationwide. The descriptive study used a survey design. Data were obtained from 28 licensed nursing homes using self-administered questionnaires, on-site interviews and record reviews. Data were analyzed by Kruskal-Wallis test, Mann-Whitney U test and Spearman s correlation. A positive and significant relationship existed between nursing home quality and the RN ratio per resident day. Chain/For-profit and Chain/Non- profit nursing homes tended to have higher operating costs and a better quality of service. Secondary research is still needed to examine the results by detailed cost analysis or by research oriented toward outcomes of residents care. These findings provide basic reference for the government for planning the operation of nursing home facilities and also to assist the many unlicensed nursing homes to ultimately become licensed. The results also present important data for developing reimbursement policies.
在台湾,无照养老院的质量和安全存在一些不确定性和担忧,因为它们通常很拥挤,设备也很差。关于有执照的养老院的护理质量的数据不足,政府无法可靠地帮助无执照的机构获得执照。本研究旨在探讨不同疗养院所有权类型与以下因变量之间的关系:(1)每住客日营运成本,(2)注册护士与住客比率,(3)设施规模,(4)入住率,以及(5)全国持牌疗养院的护理质量。描述性研究采用调查设计。数据来自28家持证养老院,采用自填问卷、现场访谈和记录回顾。数据分析采用Kruskal-Wallis检验、Mann-Whitney U检验和Spearman相关检验。养老院质量与每住客日护士护理比率之间存在显著正相关。连锁/营利性和连锁/非营利性养老院往往具有较高的运营成本和较好的服务质量。还需要通过详细的成本分析或以居民护理结果为导向的研究来检验结果。这些研究结果为政府规划养老院设施的运营提供了基本参考,也为许多无牌养老院最终获得牌照提供了帮助。研究结果也为制定报销政策提供了重要数据。
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引用次数: 6
The efficacy of problem solving strategies utilized in professional nursing concepts course to improve problem solving abilities in students enrolled in a two-year baccalaureate nursing program. 在专业护理概念课程中运用问题解决策略提高两年制护理学士学位学生解决问题能力的效果。
Pub Date : 2002-06-01 DOI: 10.1097/01.JNR.0000347590.36144.BD
Jing-Jy Wang, Chi-Hui Kao Lo, Kuei‐Min Chen, Jane Lee Hsieh, Y. Ku
Using problem solving strategies in professional nursing concepts course (PS-PNC) was a newly developed core course in a two-year baccalaureate nursing program in an institute of technology. The purpose of this study was to evaluate the efficacy of problem solving strategies used in this new course to improve students clinical problem solving abilities. Prior to the PS-PNC, 12 faculty who participated in the teaching received complete training, and then continued to receive supervision and to conduct group discussions during the whole period of the PS-PNC implementation. A one- group posttest design with repeated measures was used. In total 49 nursing students from one class agreed to be recruited as the study subjects. The PS-PNC was performed separately in three semesters. After each class learning, students would start their clinical practice, were advised by the same faculty group who participated in the PS-PNC, and were asked to submit three written nursing process recordings during each clinic. Assignments from the three practices were named post-test I, II, and III sequentially, and provided the data for this study. A coding strategy was developed by the investigators. Then, data were collected and analyzed by four selected faculty who had been involved in the PS- PNC. The overall score of problem solving indicated that the three post-tests significantly increased, meaning those students clinical problem solving ability improved. However, data on the sub-concepts of problem solving on nursing assessment, nursing diagnosis, nursing intervention, and nursing evaluation showed no constant improvement. It is inferred that teaching of professional nursing concepts utilizing problem-solving strategies may be useful for future nursing students but dignified control should be strengthened.
在专业护理概念课程中运用问题解决策略(PS-PNC)是一门新开设的理工学院两年制护理学士课程的核心课程。本研究的目的是评估问题解决策略在新课程中对提高学生临床问题解决能力的效果。在PS-PNC实施之前,12名参与教学的教师接受了完整的培训,然后在PS-PNC实施的整个过程中继续接受监督和小组讨论。采用重复测量的单组后测设计。一个班级共49名护生同意被招募为研究对象。PS-PNC分三个学期分别进行。每堂课学习结束后,学生将开始临床实践,由参与PS-PNC的同一教师小组提供建议,并要求在每次临床期间提交三份书面护理过程记录。这三个实践的作业被依次命名为后测试I、II和III,并为本研究提供了数据。研究人员开发了一种编码策略。在此基础上,选取4位参与PS- PNC的教师进行数据收集和分析。问题解决总分显示三次后测均显著提高,说明学生临床问题解决能力有所提高。然而,在护理评估、护理诊断、护理干预和护理评价的问题解决子概念方面的数据没有持续的改善。由此推断,运用问题解决策略的专业护理概念教学可能对未来的护理学生有用,但应加强尊严控制。
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引用次数: 5
Health promotion and partnerships: collaboration of a community health management center, county health bureau, and university nursing program. 健康促进和伙伴关系:社区健康管理中心、县卫生局和大学护理计划的合作。
Pub Date : 2002-06-01 DOI: 10.1097/01.JNR.0000347588.90402.38
Chih-Ling Huang
Effective partnerships were established between a community health management center, a county health bureau and a university nursing program. A health fair was undertaken to heighten public health awareness through the collaboration of these various agencies. In this research, formative, process, and summative evaluations were conducted to determine the benefits of partnerships. Elements evaluated included the planning process, health fair relevancy, integration of community resources, participants satisfaction and knowledge acquisition, and partnership satisfaction. The samples of this study included (1) 529 adult participants who completed the on-site evaluation questionnaires; (2) 1,090 child participants who returned gift-reward cards; (3) 114 partners who gave written feedback on their satisfaction; and (4) 57 third-year and 16 fourth-year undergraduate nursing student participants. Data was collected from the evidence report of the Department of Health, the project proposal, activity protocols, meeting records, the project final report, students term papers, and questionnaires. The chief administrator of the County Health Bureau was very impressed with the creative exhibits in the fair and, therefore, invited a coalition to continue further workshops. Seventeen educational exhibits, two dance programs and two drama programs related to health issues were demonstrated in the fair. Resources from community organizations were successfully integrated and allocated. Community participants expressed satisfaction with the fair and anticipated similar activities in the future. Participants revealed more than 80% accuracy in health knowledge quizzes. The senior nursing students highlighted their interaction with the community, community health nurses, and health volunteers. Community-based health promotion and nursing education can be successfully connected when various disciplines and sectors form effective partnerships.
社区卫生管理中心、县卫生局和大学护理项目之间建立了有效的伙伴关系。通过这些不同机构的合作,举办了一次卫生博览会,以提高公众对卫生的认识。在本研究中,进行了形成性、过程性和总结性评估,以确定伙伴关系的好处。评估的要素包括规划过程、卫生公平相关性、社区资源整合、参与者满意度和知识获取以及伙伴关系满意度。本研究样本包括:(1)529名完成现场评估问卷的成人;(2) 1090名返还礼品奖励卡的儿童参与者;(3)书面反馈满意度的114名合伙人;(4) 57名大三护生和16名大四护生。数据收集自卫生部证据报告、项目提案、活动协议、会议记录、项目最终报告、学生学期论文和问卷。县卫生局局长对博览会上富有创意的展品印象深刻,因此邀请一个联盟继续举办讲习班。17个教育展览、两个舞蹈节目和两个与健康问题有关的戏剧节目在博览会上展出。成功地整合和分配了社区组织的资源。社区参与者对博览会表示满意,并期望将来举办类似的活动。参与者在健康知识测试中的准确率超过80%。高年级护生强调了他们与社区、社区卫生护士和卫生志愿者的互动。当各个学科和部门形成有效的伙伴关系时,以社区为基础的健康促进和护理教育可以成功地联系起来。
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引用次数: 8
Change in quality of life in patients with permanent cardiac pacemakers: a six-month follow-up study. 永久性心脏起搏器患者生活质量的改变:为期六个月的随访研究。
Pub Date : 2002-06-01 DOI: 10.1097/01.JNR.0000347593.20897.2E
Hsing-Mei Chen, Y. Chao
The purpose of this study was to investigate the quality of life (QOL) in patients before and after permanent pacemaker implantation. A follow-up study design was adopted and purposive sampling was applied to recruit subjects from two medical centers in Taipei City. Subjects were interviewed before pacemaker implantation. Follow-up interviews were conducted at second, fourth, and sixth month after pacemaker implantation. There were 42 subjects enrolled in this study. These subjects had moderate QOL (62.4 +/- 15.9 on a scale of 97) before pacemaker implantation and the QOL improved significantly after pacemaker implantation(p <.05). The QOL improvement reached a peak at the end of the fourth month and the scores decreased at the end of the sixth month vs. the fourth month (p <.05). They had significant improvement in general well-being, sleeping, appetite, physical activity, and physical symptoms (p <.05), but not in cognitive function, social participation, work capability and sexual function (p >.05). Subjects with spouses as their main caregivers had significantly better improvement in QOL after pacemaker implantation. Subjects perceptions of distress from arrhythmia were the most significant determinant in their QOL pre and post pacemaker implantation. The findings suggest that aggressively resolving arrhythmia distress is important for improving QOL.
本研究的目的是探讨永久性起搏器植入前后患者的生活质量(QOL)。本研究采随访研究设计,并以有目的的抽样方法,从台北市两间医疗中心招募受试者。在起搏器植入前对受试者进行访谈。在心脏起搏器植入后的第2、4、6个月进行随访。共有42名受试者参加了这项研究。这些患者在植入起搏器前的生活质量为中等(62.4 +/- 15.9(97分制)),植入起搏器后生活质量显著改善(p . 0.05)。以配偶为主要照顾者的受试者在心脏起搏器植入后的生活质量有明显改善。受试者对心律失常痛苦的感知是其起搏器植入前后生活质量的最重要决定因素。研究结果表明,积极解决心律失常窘迫对改善生活质量很重要。
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引用次数: 16
Concerns of hospitalized care from patients perspectives. 从患者角度对住院护理的关注。
Pub Date : 2002-06-01 DOI: 10.1097/01.JNR.0000347591.43768.9D
M. Yen, Ching-Huey Chen, Shieu-Ming Chou
Nurses constantly face the need to provide patient care, both physical and psychological, within the health care arena. Nursing staff must have an understanding of the concerns and experiences of hospitalization, and the sensitivity to elicit the patient s own private language of health care needs. The purpose of the study was to examine the concerns of health care needs from patients point of view. The specific objective was to understand the experiences of hospitalized patients. The grounded theory method was applied for this purpose with major assumptions from the symbolic interaction perspective. Twelve subjects were recruited from medical and surgical units at a teaching hospital using purposive sampling, and were interviewed. Data were in the form of transcripts from tapes, field notes, and analytic and process memos. The constant comparative technique was utilized to discover the core themes that would explain most of the variation and integrate the data, codes and memos. Three coding processes, open coding, axial coding, and selective coding, were employed. Six aspects were generated from the results of the study to describe patients concerns. The hospitalized experience was depicted as searching for certain aspects of health care needs including focus on the physical condition, promptness and effectiveness of nursing services, health professionals caring attitudes when giving service and their responsibility, food preparation, environment, and medical expenses.
在卫生保健领域,护士不断面临着为病人提供身体和心理护理的需要。护理人员必须了解住院的问题和经历,并敏感地引出病人自己的私人语言的卫生保健需求。本研究的目的是从患者的角度探讨对医疗保健需求的关注。具体目标是了解住院病人的经历。为此,本文采用扎根理论方法,并从符号交互的角度进行主要假设。采用有目的抽样的方法,从某教学医院内科和外科部门招募12名受试者进行访谈。数据以磁带抄本、现场笔记、分析和过程备忘录的形式存在。不断的比较技术被用来发现核心主题,这将解释大部分的变化,并整合数据,代码和备忘录。采用开放编码、轴向编码和选择性编码三种编码过程。从研究结果中产生了六个方面来描述患者的关注点。住院经历被描述为寻找医疗保健需求的某些方面,包括关注身体状况、护理服务的及时性和有效性、卫生专业人员提供服务时的关怀态度及其责任、食物准备、环境和医疗费用。
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引用次数: 8
The effectiveness of teaching strategies for creativity in a nursing concepts teaching protocol on the creative thinking of two-year RN-BSN students. 护理概念教学方案中创新教学策略对两年制RN-BSN学生创新思维的影响。
Pub Date : 2002-06-01 DOI: 10.1097/01.JNR.0000347589.98025.63
Y. Ku, Chi-Hui Kao Lo, Jing-Jy Wang, Jane Lee Hsieh, Kuei‐Min Chen
Because of changes in the medical environment, nurses must maintain the ability of divergent thinking to solve the health problems of patients. However, many nurses whose work in clinical practice has become routine have lost the ability of creativity. To cultivate nurses creativity should be a goal of nursing education. The purpose of this study is to evaluate a nursing concepts teaching protocol by utilizing teaching strategies directed toward creativity to promote creativity in two-year RN-BSN students. This study design is a time series and one group experiment utilizing multiple instances of treatment. Teaching strategies for creativity were applied to a teaching unit and 52 two-year RN-BSN students were tested for creativity before the end of each semester. This study was conducted from March, 1999 to May, 2000, but only 30 students completed all tests and reached a 58% return rate. Torrance s (1974) definitions of creativity includ fluency, flexibility, and uniqueness were followed and the instrument, a questionnaire on Creativity in the application of the Nursing Process Tool (CNPT), was designed based on Emerson (1988). The content validity of Chinese-version CNPT was.79. The inter-coder reliability between two researchers was.84 following a coding guide that ten nursing education experts had established. The results indicated that 30 two-year RN-BSN students had improved fluency and flexibility. The improvements reached a significant level after the third semester. Only uniqueness declined. It is suggested that nursing faculty apply teaching strategies uniqueness more often in a teaching protocol of nursing concepts. By utilizing teaching strategies of creativity in a teaching protocol of nursing concepts, it is expected that two-year RN-BSN students can acquire characteristics of creativity for problem-solving skills in clinical settings.
由于医疗环境的变化,护士必须保持发散思维的能力来解决患者的健康问题。然而,许多护士在临床实践中工作变得程式化,失去了创新能力。培养护士的创新能力应成为护理教育的目标。本研究的目的是评估护理概念教学方案,并运用创新导向的教学策略来促进两年制RN-BSN学生的创新能力。本研究设计是一个时间序列和一组实验,利用多个治疗实例。本研究将创造性教学策略应用于一个教学单元,并在每学期结束前对52名两年制RN-BSN学生进行创造性测试。本研究于1999年3月至2000年5月进行,但只有30名学生完成了所有测试,回报率达到58%。遵循Torrance(1974)对创造力的定义,包括流畅性、灵活性和独特性,并在Emerson(1988)的基础上设计了“护理过程工具(CNPT)应用中的创造力”问卷。中文版CNPT的内容效度为0.79。两个研究者之间的编码间信度为。84,遵循10位护理教育专家制定的编码指南。结果表明,30名两年制RN-BSN学生的流利性和灵活性均有提高。在第三学期之后,这种改善达到了显著的水平。只有独特性下降了。建议护理教师在护理概念教学方案中更多地运用教学策略的独特性。通过在护理概念教学方案中运用创造性教学策略,期望两年制RN-BSN学生在临床环境中获得解决问题的创造性特征。
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引用次数: 15
Parenting stress and parents' willingness to accept treatment in relation to behavioral problems of children with attention-deficit hyperactive disorder. 父母压力和父母接受治疗意愿与注意缺陷多动障碍儿童行为问题的关系。
Pub Date : 2002-03-01 DOI: 10.1097/01.JNR.0000347582.54962.04
Yu-fang Lin, Hsin-Hsin Chung
The purpose of this research was to explore parenting stress and parents' willingness to accept treatment in relation to the behavioral problems of children with Attention-Deficit Hyperactive Disorder (ADHD). A total of 100 subjects, either fathers or mothers of children with ADHD, were recruited by convenience sampling from southern Taiwan. The results of this research were: (1) the standardized score for parents' perception of the behavioral problems of their ADHD children was 67.09. (2) The standardized score for parents perception of parenting stress was 62.00. (3) The parents who were most willing to accept treatment were those in the parent training group. (4) The behavioral problems of ADHD children were significantly related to parenting stress (p .001). (5) ADHD children's behavioral problems and parental self-awareness of psychological and emotional problems were the two variables most influential on parenting stress, and recognition of the pathological cause was the most influential factor in willingness to accept treatment. Through this research we also found that the parents hoped that a parent training group would be established. Therefore, nursing personnel can try to develop parent training groups in order to relieve parents' parenting stress.
本研究的目的是探讨父母压力和父母接受治疗意愿与注意缺陷多动障碍(ADHD)儿童行为问题的关系。本研究采用方便抽样的方法,从台湾南部地区招募了100名ADHD儿童的父亲或母亲。研究结果表明:(1)父母对ADHD儿童行为问题认知的标准化得分为67.09分。(2)父母教养压力感知标准化得分为62.00分。(3)最愿意接受治疗的家长为家长训练组。(4) ADHD儿童的行为问题与父母压力有显著相关(p .001)。(5) ADHD儿童的行为问题和父母对心理和情绪问题的自我意识是影响父母教养压力的两个变量,对病理原因的认识是影响接受治疗意愿的最重要因素。通过本次调查,我们还发现家长希望建立家长培训小组。因此,护理人员可以尝试发展家长培训小组,以缓解家长的育儿压力。
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引用次数: 33
期刊
The journal of nursing research : JNR
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