综合干预改善学龄期住院患儿医疗恐惧的效果

李星慧　赵燕　王建军

[摘要] 目的 探讨综合干预在改善学龄期住院患儿医疗恐惧中的作用。 方法 选取2016年7～12月在川北医学院附属医院儿科住院患儿240例，按随机数字表法分为非干预组和干预组，每组各120例。非干预组患儿入住普通病房，干预组患儿入住改造过的乐园式病房，并对干预组患儿进行综合干预。对比两组患儿的医疗恐惧调查量表得分以及住院时间、住院费用。 结果 医疗恐惧调查量表4个维度中平均得分由高到低分别为医疗环境恐惧、人际关系恐惧、医疗操作恐惧、自我恐惧。干预组的医疗恐惧调查量表得分、住院时间、住院费用均低于非干预组（P < 0.05）。 结论 综合干预可以改善学龄期住院患儿医疗恐惧，减少住院时间及住院费用，值得临床推广使用。

[关键词] 学龄期；医疗恐惧；住院时间；住院费用

[中图分类号] R47 [文献标识码] A [文章编号] 1673-7210（2017）05（c）-0106-04

[Abstract] Objective To explore the role of comprehensive intervention in improving medical fear in hospitalized children. Methods From July to December in 2016， 240 cases hospitalized children in Affiliated Hospital of North Sichuan Medical College were selected and divided into non-intervention group and intervention group according to random number table， with 120 cases in each group. The children in the non-intervention group were stayed in public ward， and the children in the intervention group were stayed in the transformed fairyland ward. Besides， the children in the intervention group were given to comprehensive intervention. The scores of CMFS， length of stay and hospitalization costs of the two groups were compared. Results In the CMFS， the average scores of the four dimensions selected from highest to lowest were the medical environment fear， interpersonal fear， medical operation fear and self fear. The scores of CMFS， length of stay and hospitalization costs of the intervention group were shorter than those of the non-intervention group （P < 0.05）. Conclusion Comprehensive intervention can decrease the medical fear of hospitalized school-age children， reduce length of stay and hospitalization costs. It is worthy of clinical application.

[Key words] School-age； Medical fear； Length of stay； Hospitalization cost

医疗恐惧是对医疗经历及其相關事件的情感反应，是学龄期住院患儿常见的心理反应[1-2]，已成为患儿在接受治疗过程中严重的心理障碍，这种障碍不利于患儿的身心健康[3]。对医疗操作、医疗环境、人际关系、自我恐惧等均为医疗恐惧。医疗恐惧还可带来诸如加大心灵创伤、延迟正常生长发育等负面影响[4]。医疗恐惧可能降低患儿对医疗护理的依从性，对疾病、住院的适应性、对治疗和恢复产生影响。目前，国内对儿童医疗恐惧的原因及其影响因素进行有针对性的干预方法和措施的研究相对较少[5]。本研究拟探讨综合干预在改善学龄期住院患儿医疗恐惧中的作用。

1 资料与方法

1.1 一般资料

选取2016年7～12月在川北医学院附属医院（以下简称“我院”）儿科住院儿童240例，纳入标准：6～12岁住院患儿，具有正常的认知能力和表达能力，家长同意参加此项目研究。……