運用治療性遊戲於一位COVID-19學齡前期兒童之護理經驗

Nursing Experience of Using Therapeutic Play for a Preschool Child with COVID-19

徐佩瑜(Pei-Yu Hsu) ； 陳曉梅(Hsiao-Mei Chen) ； 廖曉雯(Hsiao-Wen Liao) ； 盧美玲(Mei-Ling Lu)

《領導護理》 23卷2期 (2022/06) Pp. 44-57

https://doi.org/10.29494/LN.202206_23(2).0004

摘要

本文描述一位5歲確診COVID-19兒童在案父主要照顧者陪同下，初次入住負壓隔離病房之護理經驗。護理期間自2020年3月21日至5月17日，運用Gordon十一項功能性健康型態評估工具，利用觀察、溝通、身體評估、家屬會談、直接照護等方式收集與分析資料，發現主要健康問題有三項：體溫過高、恐懼、照顧者角色緊張等。照護期間，協助因個案出現體溫過高時，教導案父如何使用耳溫槍，監測體溫變化、適度增減衣物、溫水拭浴等方式退燒，並依學齡前期兒童發展特性，運用治療性遊戲融入護理措施，紓解個案對陌生環境及治療處置的不適應；鼓勵主要照顧者共同參與照護，並提供心理支持、主動關懷、同理心、鼓勵表達內心感受、耐心傾聽及醫療訊息的提供，降低主要照顧者的心理衝擊，增加調適力，進而順利渡過疾病治療過程。COVID-19兒童照護是屬於全新的照護經驗，透過此篇照護經驗分享，期望能夠提升此類個案的照護品質之參考。

關鍵字

新型冠狀病毒肺炎 ； 體溫過高 ； 恐懼 ； 照顧者角色緊張

並列摘要

This article describes the nursing care experience of a 5-years-old preschool child with confirmed COVID-19, accompanied by her father as the primary caregiver, first admitted to the negative pressure isolation ward. During the nursing period, from March 21 to May 17, 2020, Gordon's Eleven Functional Health Assessment Tools were used to collect and analyze data by means of observation, communication, physical assessment, family interviews, and direct care. Three major issues discovered including hyperthermia, fear, and caregiver role tension. During the nursing period, in order to reduce temperature when the case has fever, teach the case father how to use an ear thermometer, monitor body temperature changes, moderately add or take off clothing, bathe with warm water, use therapeutic games according to the characteristics of preschool children development, and integrate nursing measures to relieve the unfamiliar environment and treatment. Encourage primary caregiver to participate during the caring process, and provide psychological support, active care, empathy, encouraging expression of actual feelings. Listen patiently, provide medical information, relief the psychological impact of primary caregiver, improve resilience, and successfully overcome the disease therapy procedure. COVID-19 child care is a brand new care experience, through sharing this care experience we hope to upgrade the quality of care for similar cases.

並列關鍵字

COVID-19 ； hyperthermia ； fear ； caregiver role strain

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