Nursing Intervention and Educational Program Based on Life Skills Development for chronically ill Children and their Families

摘要本研究的目的在于：为慢性疾病儿童及其家庭制定一套以生活技能建设为基础的干预与健康教育方案；以及评估干预与健康教育方案对促进慢性疾病儿童积极适应的效果。该方案旨在培养生活技能，以促进哮喘儿童及其家庭的社会心理适应能力，并促进哮喘的自我管理。研究对象为12个有8 - 12岁哮喘儿童的家庭（35名家庭成员），他们来自日本关西地区综合医院的儿科诊所。为他们提供了为期3天的方案，包括15小时的生活技能健康教育和护理干预，包括心理教育指导和支持、生活技能培训、促进活动和创造支持性环境。在项目开始前、项目结束时和项目结束后3个月的随访中，通过一份包含测量结果变量的问卷来评估干预和项目的效果。研究结果表明，通过程序干预，结果变量发生了显著的积极变化。这些变化包括哮喘儿童自我效能、压力管理和自尊的改善，哮喘自我管理和育儿态度的改善，家庭压力的减少，家庭应对、家庭支持和家庭力量的增强。本研究结果表明，基于生活技能发展的护理干预有可能促进哮喘儿童家庭的积极适应和功能。

The purposes of this study were 1)to develop an intervention and health educational program based on life skills building for chronically ill children and their families, and 2)to evaluate the effect of intervention and the program on the promotion of positive adaptation. The program was designed to develop life skills in order to facilitate psychosocial adaptability of children with asthma and their families and to promote self-management of asthma. The participants were 12 families (35 family members) with asthmatic children between 8 and 12 years old, who had recruited from pediatric clinics at general hospitals in the Kansai area of Japan. They were provided with 3-day program comprising 15 hours of health education based on life-skill and of nursing intervention comprising psycho-educational instruction and support, life-skills training, facilitating activities, and creating a supportive environment.The effects of intervention and the program were evaluated by means of a questionnaire containing scales to measure outcome variable before the program, at the end of the program and at follow-up 3 months after the program.The findings indicated significant positive changes in the outcome variables as a result of intervention by means of a program. The changes consisted of improved self-efficacy, stress management and self-esteem for the asthmatic children and also improved self-management of asthma and child-rearing attitudes, reduced family stress, enhanced family coping, family support and family strength.The results of this study showed that nursing interventions by means of a program based on life-skill development have the potential to promote positive adaptation and functioning by families living with asthmatic children.