父母親因應兒童感染H1N1新型流感之照顧經驗

Abstract

背景：2009年3、4月間起於美墨爆發之H1N1新流感疫情，迅速蔓延全球，造成流感大流行。在流感爆發的高峰期曾造成全台近2000所停課的班級數，當這些感染的兒童返回家庭，進行自主居家健康管理，究竟家庭照顧者的父母，需要哪些協助？站在公共衛生立場需要更多關懷與瞭解。 目的：探討父母親參與疾病照顧過程中的因應經驗與照顧需求。 方法：本研究採質研究，透過半結構式的訪談指引進行深度訪談收集資料，採立意取樣方式以2009年至2010年2月期間家有感染H1N1兒童，需進行自主居家健康管理的父母親為對象，共訪問20個家庭的母親(18位)或父親(2位)。 結果：一、照顧者的疾病處理經驗可分為四部分：(一)疾病照顧的需要與策略：對兒童不適表現及父母自我照顧能力的擔憂，其處置為醫療藥物使用、監控兒童的健康狀態、執行輔助性照護措施、尋求諮詢；(二)預防他人感染H1N1：特別擔心傳染給其他家庭成員，採取當局建議的隔離、消毒與良好衛生習慣等措施；(三)對兒童健康居家管理的生活因應：包括三餐準備、學童的課業問題、休閒娛樂活動，及照顧期間父母請假與薪資收入；(四)照顧者人際關係的改變：採取隱藏保密、矇混過去及暫離壓力源等。 二、兒童急性感染期間照顧者的需求與期待：包括家庭生活、資訊、健康照護、職場支持、校園疫情告知與落實等五方面需求。 結論與建議：父母親在兒童感染H1N1的照顧上扮演多重角色，衍伸多樣需求應被瞭解；本研究提供未來再度爆發新興流感盛行或相似的疾病處置上，政府可以對兒童疾病照顧者提供哪些適切服務的參考。

Background：The H1N1 influenza virus first appeared in Mexico and the United States in March and April 2009. The outbreak of H1N1 rapidly spread worldwide and become a pandemic. At the peak of H1N1 in Taiwan, it caused resulted of the temporally shutting down of almost two thousands classes. During these infected children was in voluntary home quarantine protocol, what support did parents need as as family caregiver? As a public health professional, these are the areas that we have to concern and to understand. Objectives: The purpose of this study was to explore the coping experience and caring needs of parents having to take care of there children with H1N1. Methods: This is a qualitative research, using semi-structural interview guide and in-depth interview method to collect data. Purposive sampling was used to recruit twenty parents in the study. The criteria of the participants were the parents who took care of their children with H1N1 that were in voluntary home quarantine protocol during 2009 to February 2010. Results: The experiences of the disease management include four parts: (1) the strategy and need for the care of the disease: including self worries to take care of children’s physical discomfort. The coping strategies included the usage of the medication, monitoring the children’s health, practicing supportive caring strategies, and seeking consults from others. (2) Prevent others from contracting H1N1: especially the spreading of H1N1 to other family members. The coping strategies included quarantine, sanitary, and good personal hygiene. (3) The life coping of children in the voluntary home quarantine protocol: including preparing three meals, the issues of children’s academy and recreational activities, and income loss due to parents have to leave from work place during the period. (4) The change of interpersonal relationships: the coping strategies included keeping secretes, covering up and stay away from stressors for the time being. The needs and expectations of caregiver for children with acutely contagious disease including five parts: family life, information, health care systems, job support and the epidemic condition in school. Conclusion and suggestion: Parents play multiple roles when caring children with H1N1, and thus raise needs. When having to face influenza or similar disease outbreak again in the future, these needs can provide as a reference for the government to offer proper services for parents.