Stress Appraisals and Coping of Children with Restricted Behavior Related to the Care Environment

本研究以31名3 ~ 15岁的住院儿童为研究对象，探讨行为受限儿童的心理压力及因应方式，并探讨其因应方式与照护环境的关系。基于Lazarus的Transmittance模型，观察，结构化访谈或问卷调查（儿童、父母、护士）、Rutter A父母量表、测量尿中的儿茶酚胺和皮质醇以及心理测试采用STAI和CDI两种方法分两个阶段收集数据（限制性、非限制性），调查结果如下：当孩子受到限制时，他们的空间和人际关系受到限制，他们的父母更多地呆在家里或住在家里（通常），他们与医务人员和支持性护理的接触比他们不受限制时更多。他们的心理压力得分是显著的 关于我们 比没有限制的时候高，也比他们的母亲或护士认可的高。主要的压力源是被限制在床上或房间里，行动不便，无法与同龄人相处，以及无聊。当与压力和照顾环境，儿童的压力分数之间的关系与人员，房间与父母，和支持性护理的程度呈负相关。此外，Rutter A父母量表，STAI和CDI的平均得分和尿中的儿茶酚胺和皮质醇水平较高时，行为受到限制。结果表明，拓宽人际关系、提供与父母“同室”的关爱环境、提供父母关爱、感官刺激、创造性活动、鼓励儿童积极参与社会活动，并为游戏提供便利。少

The purpose of this study was to identify the psychological stress and coping of children with restricted behavior as it related to the care environment, and to discuss ways to alleviate stress and to support effective coping.The subjects were 31 hospitalized children ages 3 to 15 whose behavior was restricted (immobilized 13, isolated 18) between medical treatment. Based on the Transactional Model by Lazarus, observations, structured interviews or questionnaires (children, parents, nurses), Rutter A Parents Scale, measuring catecholamine and cortisol in urine, and psychological tests (STAI and CDI) were used to collect data in two phase (restricted, non-restricted).The findings were as follows : When the children were restricted, their space and personal relationship were limited, their parents stayd or roomed in more (frequently), their contact with medical personnel and supportive care was greater than when they were non-restricted. Their psychological stress scores were significant … More ly higher than when they were not restricted and higher than their mothers or nurses recognized. The main stressors were confinement to the bed or room, limited mobility, inability to relate to peers, and boredom. When relating stress and the care environment, children'stress scores showed a negative correlation between the degree of a relationship with personnel, room-in with parents, and supportive care. Moreover, mean scores on Rutter A parents scale, STAI,and CDI and catecholamine and cortisol levels in urine were higher when the behavior was restricted. Coping strategies used effectively by the children were reading, drawing, playing, playing games, watching TV and listening to music.The results indicated that the ways to alleviate children'stress caused by restricted behavior for medical treatment, and to support their effective coping were to broaden relationship with personnel and to provide the care environment of "room-in" with parents and parental care, sensory stimulation, creative activities, and facilitated paly. Less