過敏性鼻炎兒童醫療遵從行為及其相關因素之研究

Abstract

本研究目的在探討過敏性鼻炎兒童醫療遵從行為及其相關因素。以中部某醫學中心過敏性鼻炎兒童及其父母為研究對象，共得有效樣本 136人。主要結果如下：一、兒童醫療遵從行為，在兒童自我報告及其父母協同報告整體平均得分，分別為 33.27分、 33.33分（總分 50分），兩者具一致性。而在鼻阻力改善率方面，有改善只佔29.4％，疾病治療結果上改善不明顯。二、過敏性鼻炎兒童父母疾病認知偏高。自我效能及醫病互動關係偏正向。三、影響過敏性鼻炎兒童醫療遵從行為相關因素分析結果顯示：兒童年齡小、父母專科大學以上、中高社經地位其醫療遵從行為較佳。父母疾病認知、自我效能、醫病互動與醫療遵從行為呈顯著正相關。四、年齡、父母親教育程度、家庭社經地位、父母疾病認知、父母自我效能及父母醫病互動關係對過敏性鼻炎兒童「醫療遵從行為」的預測力為 35％，其中「自我效能」是最有力的預測因子。建議未來在推廣過敏性鼻炎衛生教育時，可藉由提升父母自我效能，增進執行的自信心，進而促進兒童醫療遵從行為。

The purpose of this study was to explore the medical adherence behavior and associated factors of children with allergic rhinitis. Further, the research objects focus on allergic rhinitis children and their parents from a medical center in central Taiwan, and 136 effective samples acquired.The main results are as follows: Firstly, the overall average scores of medical adherence behavior of allergic rhinitis and children self reports combined with their parents synergy reports show significant correlation with 33.27 scores and 33.33 scores respectively (of 50 perfect score). However, it is not significant in terms of treatment outcome as the improvement rate of Nasal resistance (nPEFR) acquired as 29.4% only. Secondly, the disease cognition from the parents of allergic rhinitis children presents as a high level, as well as the self-efficacy and client-professional interaction tend to be positive. Thirdly, according to the result of factors analysis associated with the children adherence behavior, it shows that adherence behavior would be higher depends on younger age of children (under 9 years old) and the parents with college academic background or in medium-to-high level of social or economic status. Further, the disease cognition from parents, self-efficacy and client-professional interaction displayed as a significant positive correlation . Finally, the predictive power reflected from the factors of「age」、「 parents’ academic background 」、「 family's social/economic status」、「 parents’ disease cognition」、「parents’ self-efficacy」、「 parents’ client-professional interaction」to「medical adherence behavior 」of children with allergic rhinitis presents 35% , and「selfefficacy」shows the best predictive factor. among these. Therefore, it suggests that medical adherence behavior of children could be improved by means of promoting parents’ self-efficacy and raising confidence of performance upon the promotion of hygiene education on allergic rhinitis in the future.