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研究生:劉秋平
研究生(外文):Chiu-PingLiu
論文名稱:於遊戲情境中應用神經心理治療對兒童術前情緒之改變成效
論文名稱(外文):The effects of neuropsychological treatment on preoperative emotion of children in play situations: a randomized controlled trial
指導教授:郭乃文郭乃文引用關係
指導教授(外文):Nai-Wen Guo
學位類別:碩士
校院名稱:國立成功大學
系所名稱:行為醫學研究所
學門:社會及行為科學學門
學類:心理學類
論文種類:學術論文
論文出版年:2012
畢業學年度:100
語文別:中文
論文頁數:73
中文關鍵詞:神經心理治療遊戲骨科兒童術前情緒情緒視覺類比量表
外文關鍵詞:Neuropsychological treatmentPlayPediatric OrthopedicsPreoperative emotionemotion visual analog scale
相關次數:
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目的:臨床上發現兒童於術前常出現術前焦慮,且研究發現術前的情緒狀態不僅會影響術中麻醉藥物的劑量,也會影響兒童術後的調適狀況。然國內甚少研究針對兒童的術前情緒狀態進行介入,故本研究旨在探討骨科手術兒童予以短時間的神經心理治療後,其術前情緒改變狀況。
方法:本研究收集36名4至12歲骨科手術兒童,於手術前一晚隨機分派至兩組,實驗組接受在遊戲情境的神經心理治療;對照組接受輕度互動式陪伴,各約一小時。療程主要應用神經心理機制中的知覺改變、認知彈性轉換、角色記憶重整、及自主性監控解決策略等,設計出醫療角色扮演等活動,使兒童在醫療經驗中擁有較正向的知覺和主動力。兩組皆於介入前後以視覺類比量表(Visual Analog Scale, VAS)評估情緒狀態和醫療事物接受程度。同時由照顧者填寫兒童氣質量表與文蘭適應行為量表,並以特質焦慮量表自評。
結果:應用神經心理治療於遊戲情境中確實能改變兒童的術前情緒狀態,可顯著降低術前的負向情緒(害怕、生氣、疼痛)與提升正向情緒(快樂),即使是輕度陪伴也能使兒童顯著較不害怕。
討論:於遊戲情境中應用神經心理介入技術對兒童術前情緒正向改變確有療效,唯需更多的樣本數與持續追蹤以驗證療效之穩定度,未來更可朝向追蹤治療效用持續度和運用於其他外科手術類型的兒童之療效。
Objective: Preoperative anxiety in children is a common emotional problem that was reported to associate with the dosage of medication for intraoperative anesthesia and postoperative adjustment. In order to improve such undesirable preoperative emotion, this study is designed to investigate the effects of neuropsychological treatment with role play in medical situations on preoperative children.
Methods: This study was conducted in 36 children aged 4-12 years who was planned to receive orthopedic surgery in the next day. They were randomly assigned into two different groups, the experiment group and the control group, when they were admitted to orthopedic ward and they were accompanied by a psychologist for one hour at the night before surgery. The experiment group was intervened with neuropsychological treatment that was designed as role play for the children in medical situation while the control group was interactively accompanied only. Emotion and medical situation acceptance of children were evaluated as preoperative adjustment with visual analog scale (VAS, ranged from 0-10) by themselves and the caregivers were asked to complete Temperament Questionnaire and Vineland Adaptive Behavior Scale for children and Trait Anxiety Inventory for themselves.
Result: Children in the neuropsychological treatment group were noted to have statistically significant lower negative emotions and greater positive emotions while those in the control group only had statistically significant less fear.
Discussion: The neuropsychological treatment with role play in medical situation does have a positive effect on the emotion of children before orthopedic surgery. Future studies should follow-up on its pervasive and long-term effect, and generalize its application to other operative patients.
第壹章 緒論 1
第一節、 兒童的情緒監控 1
第二節、 術前情緒 4
第三節、 術前介入方式 10
第四節、 神經心理治療 15
第五節、 研究動機與問題假設 22
第貳章 研究方法 25
第一節、 研究對象 25
第二節、 研究工具 26
第三節、 治療內容 32
第四節、 研究流程 36
第五節、 統計分析 39
第參章 研究結果 40
第一節、 人口學變項 40
第二節、 術前情緒相關之危險因子 41
第三節、 神經心理治療成效分析 43
第四節、 術後追蹤 46
第肆章 討論 48
第一節、 開刀組與正常組比較 48
第二節、 術前情緒之危險因子 51
第三節、 治療成效分析 53
第四節、 本研究治療特點 56
第五節、 研究限制 57
第六節、 研究貢獻與未來展望 58
參考文獻 59
中文部份 59
英文部份 61
附錄 72
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