一位學齡前期兒童燙傷之護理經驗

A Nursing Experience of a Preschool Child with Burn Injury

張堯婷(Yao-Ting Chang) ； 葉明珍(Ming-Chen Yeh) ； 張峰玉(Fung-Yu Chang)

《志為護理-慈濟護理雜誌》 17卷1期 (2018/02) Pp. 119-129

摘要

本文描述一位3歲男童因熱水燙傷，造成全身2~3度16％體表面積損傷之護理經驗，照護期間為2015年1月27日至3月5日，以全人評估工具，運用觀察、遊戲互動等方式收集資料；藉由治療性遊戲讓個案表達內心感受、轉移傷口疼痛注意力，同時整合醫療團隊改善營養問題，促使傷口癒合，使其順利渡過煎熬的治療歷程。個案與案母關係緊密，但母親因工作無法陪伴，使得個案有分離焦慮，加上環境陌生及傷口疼痛，治療時多以哭泣、逃避等行為來表現，此為照護過程最困難部分。建議案母可錄製影片，必要時播放影片緩解個案思念母親的情緒，同時會診藝術治療師，提供心理支持，舉辦家屬座談會，建立良好溝通管道，以提升醫病間的信任關係。

關鍵字

學齡前期 ； 燙燒 ； 住院壓力

並列摘要

This article described a nursing experience of a 3-years-old boy with second to third degree burns covering 16% of the total body surface area. The nursing period was from January 27^(th) to March 5^(th), 2015. With holistic assessment tool as framework, data were collected via observation and play interaction. Nursing interventions, including therapeutic role play that encourages the patient to express his feelings, distraction from wound pain, integration of medical team to address the nutritional issues and facilitate wound closure, were implemented to assist the patient in enduring the excruciating treatment process. The patient was attached to his mother and exhibited separation anxiety when the mother was away for work and could not accompany him during hospitalization. Coupled with unfamiliar environment and wound pain, the patient displayed avoidance behaviors like crying and escape during treatment. It was the most challenging task throughout the nursing period. We recommend the patient's mother to prerecord videos to be played when she is away to relieve the patient's anxiety, to consult with art therapist to provide psychological support, and to hold family symposium to establish appropriate communication channels and improve trust in the provider-patient relationship.

並列關鍵字

burn ； hospitalization stress ； preschool