運用治療性遊戲於一位骨母細胞瘤學齡期病童接受手術之護理經驗

Nursing Experience of Using Therapeutic Play for a School-age Child with Osteoblastoma Undergoing Surgical Treatment

涂岑俞(Tsen-Yu Tu) ； 謝春金(Chun-Chin Hsieh) ； 王文燕(Wen-Yen Wang) ； 王玉真(Yu-Jen Wang)

《長庚護理》 26卷1期 (2015/03) Pp. 77-90

https://doi.org/10.3966/102673012015032601008

摘要

本文是描述運用治療性遊戲於一位骨母細胞瘤學齡期病童接受手術之護理經驗。照護期間自2012年1月6日至1月14日，使用Gordon十一項功能性健康評估指引，藉由觀察、會談及理學檢查等方式收集資料，確立焦慮、急性疼痛及身體活動功能障礙等護理問題。筆者於此護理過程中運用多項治療性遊戲，包括使用角色扮演說明疾病與手術過程、協助個案體驗換藥活動及注射治療、吹氣球練習深呼吸運動，並且，提供按摩、音樂、卡通影片及電動遊戲等措施轉移注意力，上述措施可有效緩解焦慮與疼痛，並增進復健治療成效。期此經驗能提供護理人員照護此類病童之參考，並建議未來應成立兒童醫療輔導師，統整手術全期照顧，提升兒童友善醫療之品質。

關鍵字

骨母細胞瘤 ； 治療性遊戲 ； 學齡期兒童

並列摘要

This article described the nursing experience of using therapeutic play for a school-age child with osteoblastoma undergoing surgical treatment. The nursing period was from January 6 to January 14, 2012. The Gordon's 11-item functional health assessment guidelines were applied to collect data through observations, interviews, and physical examinations. The nursing problems were identified as follows: anxiety, acute pain, and impaired physical mobility. The author employed a series of therapeutic play in the nursing process, including using role-playing for illustrating disease and surgical procedures; aiding this child to experience change dressing and injection therapy; and blowing balloons for practicing deep-breathing exercise. Moreover, massage, music, cartoons, and video games were provided to distract this child's attention. These interventions were effectively alleviated anxiety and pain, and promoted the effect of rehabilitation therapy. This nursing experience provides references for nursing staff to care similar children. In addition, child life specialist should be established to integrate the perioperative nursing care and enhance the quality of child friendly medical care in the future.

並列關鍵字

osteoblastoma ； therapeutic play ； school-age child

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