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題名：以實證為基礎的兒童氣喘急性發作之照護處理
書刊名：護理雜誌
作者：蔣立琦／溫子寧／田炯璽／黃璟隆
作者(外文)：Chiang, Li-chi／Wen, Tzu-ning／Tien, Chiung-hsi／Huang, Jing-long
出版日期：2012
卷期：59:1
頁次：頁16-23
主題關鍵詞：氣喘；兒童；發作；處理；Asthma；Child；Exacerbation；Management
原始連結：連回原系統網址new window
相關次數：
  • 被引用次數被引用次數:期刊(3) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:3
  • 共同引用共同引用:0
  • 點閱點閱:98
氣喘是台灣兒童常見的慢性疾病，急性發作常是氣喘兒童與父母最大的懼怕來源，也是兒科醫護人員在照護上的挑戰。本文回顧兒童氣喘急性發作之評估與處理的相關資訊，依據美國氣喘教育與預防計畫（ National Asthma Education and Prevention Program, 2007）及參考全球氣喘創議組織（ Global Initiative for Asthma [GINA], 2010）所發展的氣喘指引建議，運用敏感度佳的氣喘嚴重度評估工具，並依據不同嚴重度所建議使用之氣喘藥物，將可降低兒童急診與住院次數。目前最常建議使用的氣喘急性發作用藥為速效型支氣管擴張劑合併系統性類固醇用藥，其他氣喘藥物仍需更多兒童族群之相關研究證實。教育父母自我處理，特別是給孩子正確的氣喘藥物是最重要影響氣喘復發急診之因素。有關兒童氣喘急性發作時兒童與父母的護理研究仍在質性研究之階段，待更多建立實證基礎之研究，才能發揮兒科護理人員在氣喘兒童的急性照護之獨立角色功能。
Asthma is a common chronic disease among children in Taiwan. Acute asthma exacerbation is a cause of strong concern for children and parents and represents a challenge for pediatric healthcare providers. This review summarizes the most up-to-date information on assessing and managing acute asthma exacerbations in children. The latest guidelines (National Asthma Education and Prevention Program, Expert Panel Report 3, 2007 and the Global Initiative for Asthma, 2010) recommend using sensitive instruments to assess asthma exacerbation severity and administering early treatment in order to avoid emergency outpatient visits and hospitalizations. SABA (short acting β-agonist) in combination with systematic cortisone is the most widely prescribed pharmaceutical intervention for acute asthma management. Other pediatric asthma medications are still in the trial stage. Educating parents on self-management techniques, especially with regard to the correct application of asthma medication on children, is crucial to reducing relapse incidents and visits to the emergency ward. Nursing studies addressing the issue of asthma exacerbation in children and parents are currently at the initial, qualitative stage. More evidence-based studies are necessary to explore and understand the independent role and function of nurses in acute pediatric asthma care.
期刊論文
1.Guevara, J. P.、Wolf, F. M.、Grum, C. M.、Clark, N. M.(2003)。Effects of educational interventions for self management of asthma in children and adolescents: Systematic review and meta-analysis。British Medical Journal，326(7402)，1308-1315。  new window
2.Butler, K.、Cooper, W. O.(2004)。Adherence of pediatric asthma patients with oral corticosteroid prescriptions following pediatric emergency department visit or hospitalization。Pediatric Emergency Care，20(11)，730-735。  new window
3.Chen, S. H.、Yin, T. J.、Huang, J. L.(2002)。An exploration of the skills needed for inhalation therapy in schoolchildren with asthma in Taiwan。Ann Allergy Asthma Immunology，89(3)，11-15。  new window
4.Gordon, S.、Tompkins, T.、Dayan, P. S.(2007)。Randomized trial of single-dose intramuscular dexamethasone compared with prednisolone for children with acute asthma。Pediatric Emergency Care，23(8)，521-527。  new window
5.Harmanci, K.、Bakirtas, A.、Turktas, I.、Degim, T.(2006)。Oral montelukast treatment of preschool-aged children with acute asthma。Annual Allergy, Asthma Immunology，96(5)，731-735。  new window
6.Huang, L. H.、Shyur, S. D.、Wen, D. C.、Chang, Y. C.、Ma, Y. C.、Lin, S. C.、Wu, J. Y.(2007)。Prednisolone oral solution plus inhaled procaterol for acute asthma in children: A double-blind randomized controlled trial。Acta Paediatrics Taiwan，48(5)，257-262。  new window
7.Jonas, A.(2000)。Outcomes research in review: Impact of stress on children’s asthma attacks。Journal of Clinical Outcomes Management，7(11)，8-11。  new window
8.Langhan, M. L.、Spiro, D. M.(2009)。Portable spirometry during acute exacerbation of asthma in children。Journal of Asthma，46(2)，122-125。  new window
9.Rachelefsky, G.(2003)。Treating exacerbations of asthma in children: The role of systematic corticosteroids。Pediatrics，112(2)，382-397。  new window
10.Rowe, B. H.、Sevcik, W.、Villa-Roe, C.(2011)。Management of severe acute asthma in the emergency department。Current Opinion in Critical Care，17(4)，335-341。  new window
11.Sandberg, S.、Paton, J. T.、Ahola, S.、McCann, D. C.、McGuiness, D.、Hillary, C. R.、Oja, H.(2000)。The role of acute and chronic stress in asthma attacks in children。The Lancet，356(9234)，982-987。  new window
12.Simon, K. J.、Simon, F. E. R.(2010)。Epinephrine and its use in anaphylaxis: Current issues。Current Opinion in Allergy and Clinical Immunology，10(4)，354-361。  new window
13.Trollvik, A.、Nordbach, R.、Silen, C.、Ringsberg, K. C.(2011)。Children’s experiences of living with asthma: Fear of exacerbations and being ostracized。Journal of Pediatric Nursing，26(4)，295-303。  new window
14.Tzeng, L. F.、Chiang, L. C.、Hsueh, K. C.、Ma, W. F.、Fu, L. S.(2010)。A preliminary study to evaluate a patient-centered asthma education programme on parental control of home environment and asthma signs and symptoms in children with moderate-to-severe asthma。Journal of Clinical Nursing，19(9/10)，1424-1433。  new window
15.Volovitz, B.(2008)。Management of acute asthma exacerbations in children。Expert Review of Respiratory Medicine，2(5)，607-616。  new window
16.Wong, G.、Gunasekera, K.、Hong, J.、Hsu, J.(20080200)。AIRIAP 2: Childhood asthma control in Asia according to the Global Initiative for Asthma (GINA) criteria。The Journal of Allergy and Clinical Immunology，121(Suppl. 2)，S95。  new window
17.Yeh, K. W.、Chen, S. H.、Chiang, L. C.、Chen, L. C.、Huang, J. L.(2006)。Survey of asthma care in Taiwan: A comparison of asthma specialists and general practitioners。Annals of Allergy Asthma & Immunology，96(4)，593-599。  new window
18.Yeh, K. W.、Chao, S. Y.、Chiang, L. C.、Lai, S. R.、Chen, S. H.、Chen, L. C.、Huang, J. L.(2006)。Increasing asthma care knowledge and competence of public health nurses after a national asthma education program in Taiwan。Asian Pacific Journal of Allergy and Immunology，24(4)，183-189。  new window
19.Yeh, K. W.、Chiang, L. C.、Huang, J. L.(2008)。Epidemiology and current status of asthma and associated allergic diseases in Taiwan - ARIA Asia-Pacific workshop report。Asian Pacific Journal of Allergy and Immunology，26(4)，257-264。  new window
學位論文
1.何心磊(2005)。氣喘住院病人醫療照護品質測量之先導性研究(碩士論文)。國立臺灣大學。  延伸查詢new window
2.孫海倫(2005)。以健保資料庫論氣喘的處方型與費用兼論氣喘急性發作的危險因子(博士論文)。中山醫學大學，台中市。  延伸查詢new window
圖書
1.Cincinnati Children‘s Hospital Medical Center(2010)。Acute asthma guideline: Evidence-based care guideline for management of acute asthma exacerbation in children asthma exacerbation in children pediatric evidence based care guidelines(Guideline 4)。Cincinnati, OH：Cincinnati Children‘s Hospital Medical Center。  new window
其他
1.台灣氣喘諮詢協會(2010)。台灣氣喘診療指引，http://www.taiwanasthma.com.tw/download/Pocket%20Guidelines.pdf]。  延伸查詢new window
2.行政院衛生署國民健康局(2006)。校園氣喘學童氣喘照護及管理工作指引，http://www.health99.doh.gov.tw/media/public/pdf/21465.pdf， 。  延伸查詢new window
3.Boyd, M.，Lasserson, T. J.，McKean, M. C.，Gibson, P. G.，Ducharme, F. M.，Haby, M.(2010)。Interventions for educating children who are at risk of asthma-related emergency department attendance(CD001290.pub2)。  new window
4.Chiang, L. C.(2009)。Caring experiences of parents with asthmatic children-Meta-synthesis，Reykjavik。  new window
5.Global Initiative for Asthma(2010)。Global strategy for asthma management and prevention，http://www .ginasthma.org/pdf/GINA_Pocket_2010a.pdf。  new window
6.Manning, P.，Gibson, P. G.，Lasserson, T. J.(2008)。Ciclesonide versus other inhaled steroids for chronic asthma in children and adults(CD007031)。  new window
7.McDonald, N.，Bara, A.，McKean, M. C.(2010)。Anticholinergic therapy for chronic asthma in children over two years of age(CD003535)。  new window
8.National Asthma Education and Prevention Program: Expert panel report III(2007)。Guidelines for the diagnosis and management of asthma，Bethesda, MD：National Heart, Lung, and Blood Institute。，http://www.nhlbi.nih.gov/guidelines/asthma/ asthgdln.pdf。  new window
9.Rowe, B. H.，Spooner, C.，Ducharme, F.，Bretzlaff, J.，Bota, G.(2001)。Early emergency department treatment of acute asthma with systematic corticosteroids(CD002178)。  new window
 
 
 
 
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