醫療遊戲主題之改變歷程分析：以一個住院焦慮唇顎裂兒童為例

Analysis of the Change Process of the Medical Play Themes in the Play Threrapy a Case Study of Child with Cleft Palate

鄭如安(Ju-An Cheng)

《諮商輔導學報：高師輔導所刊》 22期 (2010/06) Pp. 123-163

https://doi.org/10.6308/JCG.22.04

摘要

本研究先根據文獻確定醫療遊戲主題之分析單位及分析方法，然後以一位唇顎裂兒童爲研究對象，在其23次的遊戲單元中，篩選出七個醫療遊戲主題並進行分析。以樣版式分析法針對此七個醫療遊戲主題進行資料分析。研究發現可以從個案醫療遊戲主題之改變歷程，看到個案的復原與轉變。研究者並根據分析結果提出五點結論：1.從住院情緒量表上的前後測以及主要照顧者的訪談內容，得知遊戲治療的介入對個案有正向影響。2.從遊戲玩具象徵意義的變化過程可以看到個案內在的轉變。3.醫療遊戲主題內容的變化呈現出個案內在的轉變歷程。4.從個案醫療遊戲情緒感受的正向轉變看到個案的復原。5.個案可以自發的玩出七個醫療遊戲主題，印證創傷後遊戲的概念。同時也提出六點建議：1.面對有特殊議題或特殊事件創傷的兒童進行遊戲治療時，宜準備與議題或創傷相關的遊戲玩具，會有助於兒童接觸與處理其議題。2.瞭解遊戲治療歷程中，兒童所使用玩具的象徵意義及該玩具象徵意義的改變，有助於對遊戲主題的瞭解。3.參酌本研究遊戲過程描述的四個向度，作爲遊戲治療記錄的參酌。4.參酌本研究有關遊戲主題的分析向度，進行個案概念化的架構。5.兒童重複出現的遊戲行爲都值得每位實務工者進一步瞭解其背後的意義。6.遊戲主題的研究值得在兒童遊戲歷程研究推廣。

關鍵字

唇顎裂兒童 ； 醫療遊戲主題

並列摘要

First of all, the analysis unit and analysis method for the play theme were made sure based on the literatures and then a child with cleft palate was selected as the study subject. Seven medical play themes were selected from 23 play sections and analyzed. Four dimensions, type of toy, process of play, interaction with therapist, and turning point, were chosen for the outlines of the analysis of the play themes. And then the descriptions and interpretations for the seven medical play themes were made. The recovery and change of the case child could be seen from the change process of the medical play themes. Three conclusions, submitted in accordance with the analysis results, were stated as follows. 1.) The internal change of the case child was indicated in the change process of the meaning symbolized by the play toys. 2.) The change of the content of the medical play themes suggested the internal turning process of the case child. 3.) The recovery of the case child was observed in the positive change of the medical play themes. And there were five suggestions: 1.) Prepare relevant play toys for the specific issues or traumas of case children. 2.) Understand the symbolized meaning of the toys and the change process of the symbolized meaning. That would help understand the play theme. 3.) Take the four dimensions described for the play process of this study as a reference in recording the play therapy. 4.) Refer to the analysis dimensions, of this study, about the play theme in setting up the structure of case conceptualization 5.) The study of play theme is worth advocacy in researching the play process of children the play process for children.

並列關鍵字

Child with Cleft Palate ； Play Theme

參考文獻

余瑞宏(2005)。一位國小一年級喪親兒童在遊戲治療中復原力與悲傷調適歷程之研究(碩士論文)。國立屏東師範學院教育心理與輔導研究所。

林家如(2005)。身體受虐兒童在遊戲治療中改變歷程之分析研究(碩士論文)。國立高雄師大學輔導研究所。

周黃麗梅(2006)。探究低成就學童之遊戲治療歷程與自我效能之變化(碩士論文)。國立新竹教育大學。

施怡菱(2007)。性虐待受害兒童在遊戲治療歷程改變之研究(碩士論文)。國立新竹教育大學教育心理與諮商研究所。

財團法人羅慧夫顱顏基金會(2000)。唇顎裂照顧須知。臺北:財團法人羅慧夫顱顏基金會。