儿童生活计划干预在住院患儿静脉留置针穿刺中的应用研究

Application of child life program intervened in children's intravenous indwelling needle puncture

目的探讨儿童生活计划干预在住院患儿静脉留置针穿刺中的应用效果。方法收集安徽医科大学第一附属医院2019年2月25日—2021年6月12日年龄3~10岁需行静脉留置针穿刺的新入院患儿120例,采用随机数字表法分为2组,干预组61例,对照组59例。对照组留置针穿刺前采用常规护理和健康教育,干预组在此基础上采用儿童生活计划干预。采用疼痛行为评估量表(FLACC)和面部表情疼痛量表(Wong-Baker)对患儿留置针穿刺时疼痛程度进行评分,比较2组患儿的疼痛评分、留置针穿刺依从性和一次穿刺成功率。结果在静脉条件良好的患儿中,干预组FLACC量表得分[2(1,3)分]和面部表情疼痛得分[2(2,3)分]均显著低于对照组[5(2,8)分和6(4,8)分,Z=-4.335、-5.802,均P<0.001]。在穿刺护士年资为N3(6~10年)、N4(>10年)的患儿中,干预组FLACC量表得分低于对照组[2(1,3)分vs.4(2,8)分,Z=-3.022,P=0.003;2(1,3)分vs.5(2,7)分,Z=-2.975,P=0.003),面部表情疼痛得分也显著低于对照组[2(2,4)分vs.6(3.5,10)分,Z=-4.760,P<0.001;2(2,2)分vs.6(4,10)分,Z=-4.431,P<0.001]。干预组患儿留置针穿刺依从性及一次穿刺成功率明显高于对照组(均P<0.05)。结论儿童生活计划干预可减轻儿童对静脉留置针穿刺的疼痛反应,提高留置针穿刺的依从性和一次穿刺成功率。

Objective Child Life Program intervened the use of various measures to reduce children's stress during medical processes.This study aimed to investigate the application effect of child life program intervened in children's intravenous indwelling needle puncture.Methods From February 25,2019 to June 12,2021,120 newly admitted children aged 3 to 10 years who underwent intravenous indwelling needle puncture from the First Affiliated Hospital of Anhui Medical University were collected and randomly divided into two groups by the radom number table method,with 61 cases in the intervention group and 59 cases in the control group.The control group used conventional children's indwelling needle pre-puncture care and health education methods,whereas the intervention group used child life program intervention with routine education.Using the FLACC(face,legs,activity,cry,and consolability)pain behaviour assessment scale and the Wong-Baker faces pain rating scale,the degree of children's pain during indwelling needle puncture was scored.The pain scores,compliance and one-time puncture success rate was compared.Results In children with good venous conditions at the puncture site,the FLACC scale scores[2(1,3)]points and the Wong-Baker FACES scale scores[2(2,3)]points of the intervention group were significantly lower than those of the control group[5(2,8)points,6(4,8)points,Z=-4.335,-5.802,all P<0.001];Among the children who were operated by nurses with 6 to 10 years or more of experience,the FLACC scale scores and were significantly lower than those of the control group[2(1,3)points vs.4(2,8)points,Z=-3.022,P=0.003;2(1,3)points vs.5(2,7)points,Z=-2.975,P=0.003];And Wong-Baker faces scale scores and of the intervention group were significantly lower than those of the control group[2(2,4)points vs.6(3.5,10)points,Z=-4.760,P<0.001;2(2,2)points vs.6(4,10)points,Z=-4.431,P<0.001].Moreover,the compliance of intravenous indwelling needle puncture and the one-time puncture success rate in the intervention group were significantly higher than those in the control group.Conclusion The application of child life program can reduce the pain response of children's intravenous indwelling needle puncture,improve compliance and increase the primary puncture success rate.