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http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/81971完整後設資料紀錄
| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 高碧霞(Bih-Shya Gau) | |
| dc.contributor.author | Hsuan-Yi Chen | en |
| dc.contributor.author | 陳軒儀 | zh_TW |
| dc.date.accessioned | 2022-11-25T05:33:22Z | - |
| dc.date.available | 2027-02-08 | |
| dc.date.copyright | 2022-02-21 | |
| dc.date.issued | 2022 | |
| dc.date.submitted | 2022-02-09 | |
| dc.identifier.citation | 王靜慧（2015）・探討幼兒住院行為反應與主要照顧者焦慮程度之相關研究[碩士論文，私立長榮大學護理研究所]・華藝線上圖書館。 伍雁鈴（1994）・學前兒童住院後的行為改變與母親焦慮程度之相關性探討[未出版之碩士論文]・國防醫學院護理學研究所。 余玉眉、田聖芳、蔣欣欣（2008）・質性研究——田野研究法於護理學之應用・巨流圖書公司。 兒童醫學及健康研究中心（2020年10月31日）・中心成果・https://chrc.nhri.org.tw/introductions/achievement.html 國立臺灣大學醫學院附設醫院兒童醫院（無日期）・兒童醫院簡介・https://www.ntuh.gov.tw/ntuch/Fpage.action?muid=3117 fid=2904 彭淑華（2015）・貳、2015台灣兒童人權指標分析報告・臺灣兒童人權指標調查報告（2015）・https://www.AiritiLibrary.com/Publication/Index/P20150513009-201511-201512290027-201512290027-7-16 蔡綠蓉（2017）・住院兒童之反應及其護理・於陳月枝總校閱，實用兒科護理（八版，177—198頁）・華杏。 衛生福利部疾病管制署（2020年1月20日）・疾管署宣布成立「嚴重特殊傳染性肺炎中央流行疫情指揮中心」，全面防範中國大陸新型冠狀病毒肺炎疫情，確保我國防疫安全・https://www.cdc.gov.tw/Bulletin/Detail/32NPG1QX-FhAmaOLjDOpNmg?typeid=9 衛生福利部疾病管制署（2020年1月24日）・我國新增確診二例嚴重特殊傳 染性肺炎境外移入個案，指揮中心持續中港澳旅客主動關懷機制，全力守護國內防疫安全・https://www.cdc.gov.tw/Bulletin/Detail/ozDpnZZxwakBKTXbdS0Kw?typeid=9 衛生福利部疾病管制署（2020年1月28日）・中央流行疫情指揮中心公布國內本土嚴重特殊傳染性肺炎病例，衛生單位已依相關處置流程啟動防治・https://www.cdc.gov.tw/Bulletin/Detail/1T3s2mxcCjqlE0MczXRD8w?typeid=9 衛生福利部疾病管制署（2021年4月30日）・指揮中心因應本次防疫旅宿員工確診事件，將進行相關應變措施及防疫旅宿總體檢・https://www.cdc.gov.tw/Bulletin/Detail/l2eaz5it22nn-0P-Oa4WyA?typeid=9 衛生福利部疾病管制署（2021年5月11日）・全國醫院及長照機構即日起至6月8日止，除例外情形，停止開放探病及探視，陪病及陪伴者仍為1人・https://www.cdc.gov.tw/Bulletin/Detail/_98GNqT8vqtJYxt5PTn5Jw?typeid=9 衛生福利部疾病管制署（2021年5月19日）・因應本土疫情持續嚴峻，指揮中心自即日起至5月28日止提升全國疫情警戒至第三級，各地同步加嚴、加大防疫限制，嚴守社區防線・https://www.cdc.gov.tw/Bulletin/Detail/abDtRS-xzztQeAchjX9fqw?typeid=9 衛生福利部疾病管制署（2021年7月27日）・7月27日全國防疫會議後記者會報告・https://www.cdc.gov.tw/Bulletin/Detail/nv3f0VFT8XYvVFzppkHOPw?typeid=9 衛生福利部疾病管制署（2021年8月24日）・全國醫院自今(2021)年8月24日起，有條件開放探病，並調整風險縣市住院病人及陪病者篩檢措施・https://www.cdc.gov.tw/Bulletin/Detail/HByI1XXj0j0uRCXlxEbkYA?typeid=9 衛生福利部疾病管制署（2021年10月11日）・指揮中心有條件開放全國醫院慢性病房探病・https://www.cdc.gov.tw/Bulletin/Detail/mrmmcXanDV9TQnzX-aN9cA?typeid=9 衛生福利部醫事司（2013年10月8日）・設立兒童醫院 衛生福利部嚴格把關・https://www.mohw.gov.tw/cp-3217-22817-1.html衛生福利部醫事司（2014年4月3日）・設立兒童醫院 守護兒童健康・https://www.mohw.gov.tw/cp-3200-22104-1.html 謝宜娟、劉惠姿、卓燕華（2012）・降低學齡前期兒童接受靜脈注射恐懼程度之專案・護理雜誌，59（3），79—86。 Abulawi, R., Walker, S., Boyko, C. 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L., Foley, J. M. (1966). Changes in Children's Behavior After Hospitalization: Some Dimensions of Response and Their Correlates. American Journal of Diseases of Children, 111(6), 581–593. doi:10.1001/archpedi.1966.02090090053003 Wang, C. J., Ng, C. Y., Brook, R. H. (2020). Response to COVID-19 in Taiwan: Big Data Analytics, New Technology, and Proactive Testing. JAMA, 323(14), 1341–1342. doi:10.1001/jama.2020.3151 WHO. (June 16th, 2012). Ottawa charter for health promotion. https://www.who.int/publications/i/item/ottawa-charter-for-health-promotion WHO. (February 4th, 2022). WHO Coronavirus (COVID-19) Dashboard. https://covid19.who.int Wilson, M. E., Megel, M. E., Enenbach, L., Carlson, K. L. (2010). The Voices of Children: Stories About Hospitalization. Journal of Pediatric Health Care, 24(2), 95–102. doi:https://doi.org/10.1016/j.pedhc.2009.02.008 Woo, J.-C., Lin, Y.-L. (2016). Kids’ Perceptions toward Children’s Ward Healing Environments: A Case Study of Taiwan University Children’s Hospital. Journal of Healthcare Engineering, 2016, 8184653. doi:10.1155/2016/8184653 Yount, G., Rachlin, K., Siegel, J. (2013). Expressive arts therapy for hospitalized children: a pilot study measuring cortisol levels. Pediatric Reports, 5(2), 28–30. Zhou, F., Yu, T., Du, R., Fan, G., Liu, Y., Liu, Z., ... Cao, B. (2020). Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet, 395(10229), 1054–1062. doi:https://doi.org/10.1016/S0140-6736(20)30566-3 | |
| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/81971 | - |
| dc.description.abstract | 背景：近年兒童友善醫療逐漸成為各國兒科醫療的照護共識，且將兒童的觀點和經驗納入醫療計畫的規劃及成效評值普遍被認為十分重要。兒童作為身心較為脆弱的族群，學齡前期的兒童尤其容易因住院壓力受到傷害，但由於其理解及表達能力上的限制，現有之文獻較缺乏自學齡前期兒童觀點了解其需求和期望，及對兒童友善醫療現況的評值之研究。 目的：由學齡前期住院兒童的觀點及行為來探討目前友善醫療臨床施行的現況，並了解其對兒童友善醫療的期望和需求。 方法：以質性研究為主，量性研究為輔，運用混合研究方法之聚合平行設計，採立意取樣選擇個案。在2021年10月至11月間共有11組年齡介於3–6歲之學齡前期兒童及其父母參與研究。透過半結構式訪談、臨床觀察及量表蒐集研究資料。訪談時研究者會提供白紙、彩色筆、色紙及角色圖卡等表達性創作工具作為訪談之輔助工具，並讓兒童自由選擇使用與否；臨床觀察中，研究者採觀察者及參與者的角色型態觀察兒科醫療執行的臨床情境；量表使用經過良好信、效度檢查共27題項的兒童住院之行為量表，以一般焦慮、分離焦慮、睡眠焦慮、飲食紊亂、攻擊行為及冷漠退縮等六個面向，評估兒童住院之行為變化。研究資料採用內容分析法將質性資料進行有系統的歸類和分析，並使用SPSS for Mac 28.0版套裝軟體進行量性資料的統計分析。 結果：共歸納出三個主題，分別為：一、住院兒童仍為人，此主題描述以下三個重點：(1)尊重兒童的身體自主能增加其對於醫療行為的掌控感和配合度，且年齡較小兒童的自主性在臨床上更容易被忽視，因此較易表現出攻擊行為、(2)兒童受限於COVID-19疫情的防疫規範、疾病狀況和身上管路等原因，認為住院是不自由且無聊的、(3)兒童希望面對醫療時身心都是被準備好的，且無過去就醫經驗的兒童較容易出現睡眠焦慮；二、住院兒童仍為兒童，此主題描述了以下三個重點：(1)以兒童為中心對兒童而言是更為友善的、(2)住院兒童的疼痛問題並未獲得良好控制、(3)住院過程中應滿足兒童娛樂、陪伴及安撫等特殊需求；三、聽見兒童的聲音，描述兒童對於不同醫療角色的距離及恐懼感受的差異和來源，以及兒童對醫院顏色及裝飾物的重視。目前臨床兒童友善醫療施行現況上，在尊重兒童自主及參與自身醫療的權利、醫療人員的直接和有效溝通、滿足兒童陪伴和娛樂需求等方面仍有改善空間。此外，本研究期間正逢台灣COVID-19疫情，其對兒童友善醫療產生的衝擊，影響到兒童感覺住院不自由及陪伴和娛樂需求的不滿足。 結論：建議未來可透過跨病房的交叉訓練、跨領域的案例討論會及教育課程，加強醫療人員對不同年齡層兒童的適性照護和溝通技巧，並強化其尊重兒童基本權利的概念，以提供更為友善的兒科醫療照護。此外，在醫院針對傳染病的防疫規劃時，應同時將兒童之身心需求納入考量，盡可能以較少限制的手段達到防止病毒傳播的相同目的。本研究結果可提供未來醫療人員在教育與實務上的建議，並作為未來規劃更完善兒童友善醫療計畫的參考，以提升兒科醫療照護的品質，增進兒童的健康與福祉。 | zh_TW |
| dc.description.provenance | Made available in DSpace on 2022-11-25T05:33:22Z (GMT). No. of bitstreams: 1 U0001-0802202213490000.pdf: 12093167 bytes, checksum: db05c897f792c9017d0de1e1ab0e0aa2 (MD5) Previous issue date: 2022 | en |
| dc.description.tableofcontents | 口試委員審定書 I 謝辭 II 中文摘要 IV ABSTRACT VI 第一章 緒論 1 第一節 研究動機與重要性 1 第二節 研究目的 4 第三節 名詞界定 4 第二章 文獻查證 5 第一節 學齡前期兒童的發展與住院反應 5 第二節 兒童的權利於醫療照護 11 第三節 兒童友善醫療的概念與現況 13 第四節 兒童友善醫療的相關研究 16 第三章 研究方法 21 第一節 研究設計及步驟 21 第二節 研究對象 25 第三節 研究場所 28 第四節 研究工具 30 一、 質性研究工具 30 二、 量性研究工具 34 第五節 研究資料處理與分析 36 一、 質性資料處理與分析 36 二、 量性資料處理與分析方法 37 第六節 質性資料嚴謹度 41 第七節 研究倫理 43 第四章 研究結果 45 第一節 研究對象的基本屬性 45 第二節 訪談資料分析結果 49 一、 住院兒童仍為人 50 二、 住院兒童仍為兒童 63 三、 聽見兒童的聲音 73 四、 兒童的表達性創作 78 第三節 臨床觀察資料分析結果 85 第四節 量性資料分析結果 90 第五章 討論 95 第一節 住院兒童仍為人 95 第二節 住院兒童仍為兒童 99 第三節 聽見兒童的聲音 105 第四節 疫情對兒童友善醫療的衝擊 107 第六章 結論與建議 113 第一節 重要研究發現 113 第二節 護理應用 115 第三節 研究限制與建議 117 參考文獻 119 附錄一 兒童及其主要照顧者基本資料表 136 附錄二、兒童住院之行為量表 137 附錄三、兒童住院之行為量表同意授權證明 139 附錄四、研究倫理審查通過函 140 | |
| dc.language.iso | zh-TW | |
| dc.subject | 兒童友善醫療 | zh_TW |
| dc.subject | 護理照護 | zh_TW |
| dc.subject | 混合研究方法 | zh_TW |
| dc.subject | 住院 | zh_TW |
| dc.subject | 學齡前期兒童 | zh_TW |
| dc.subject | mixed methods research | en |
| dc.subject | child-friendly | en |
| dc.subject | preschool-aged children | en |
| dc.subject | hospitalization | en |
| dc.subject | nursing care | en |
| dc.title | 兒童友善醫療的現況與需求——由學齡前期住院兒童的觀點及行為來探討 | zh_TW |
| dc.title | Child-friendly Healthcare Needs from the Perspective and Behaviors of Hospitalized Preschool Children | en |
| dc.date.schoolyear | 110-1 | |
| dc.description.degree | 碩士 | |
| dc.contributor.oralexamcommittee | 吳維紋(Rui-Mo Huang),呂立(Wen-Yi Lin) | |
| dc.subject.keyword | 兒童友善醫療,學齡前期兒童,住院,護理照護,混合研究方法, | zh_TW |
| dc.subject.keyword | child-friendly,preschool-aged children,hospitalization,nursing care,mixed methods research, | en |
| dc.relation.page | 142 | |
| dc.identifier.doi | 10.6342/NTU202200373 | |
| dc.rights.note | 同意授權(限校園內公開) | |
| dc.date.accepted | 2022-02-09 | |
| dc.contributor.author-college | 醫學院 | zh_TW |
| dc.contributor.author-dept | 護理學研究所 | zh_TW |
| dc.date.embargo-lift | 2027-02-08 | - |
| 顯示於系所單位： | 護理學系所 | |
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