MATSUMURA Minako Kobe University, Department of Medicine, Associate, 医学部, 助手 (60273794)
KUSABA Hifumi Kobe University, Department of Medicine, Associate Professor, 医学部, 助教授 (30153282)
澤田 珠実 神戸大学, 医学部, 助手 (00235467)
|Budget Amount *help
¥1,700,000 (Direct Cost: ¥1,700,000)
Fiscal Year 1995: ¥500,000 (Direct Cost: ¥500,000)
Fiscal Year 1994: ¥1,200,000 (Direct Cost: ¥1,200,000)
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
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