運用治療性遊戲於一位學齡前期幼童之住院經驗：病例報告

Applying Therapeutic Play in the Admission Experience of a Preschooler: A Case Report

徐雅婷(Ya-Ting Shiu) ； 李歡芳(Huan-Fang Lee)

《南臺灣醫學雜誌》 5卷1期 (2009/04) Pp. 42-49

https://doi.org/10.6726/MJST.200904_5(1).0008

摘要

本文描述運用治療性遊戲協助一位學齡前期幼童配合治療之照護經驗。自2006年7月25日至8月2日護理期間，以生理、心理、社會、靈性四層面為評估架構，經由身體評估、非結構性的會談、觀察、治療性遊戲過程等活動收集相關資料，發現個案因生理不適、對陌生環境及未知情境感到的退縮、害怕、打人、哭鬧及依賴行為的增加，進而導致治療的延宕，故確立護理問題為：體溫過高、腹瀉、與親密家屬的分離焦慮。於護理過程中筆者運用治療性遊戲，以角色扮演、圖書投射的方式、與個案建立信任關係並提供一個情緒發洩及轉移注意力的管道，最後讓個案能遵從治療。增進案母相關的疾病知識與技巧，如發燒及腹瀉時之處置、用藥、環境與皮膚的照護，並付諸同感心關懷個案及案母，降低個案之住院壓力與案母的擔憂，成功地幫助個案恢復健康。

關鍵字

治療性遊戲 ； 學齡前期幼童 ； 分離焦慮

並列摘要

This case report is to describe the nursing experiences of applying the therapeutic play in assisting a preschooler for treatment. The author took care of the patient from July 25th to August 2nd in 2006. Data was collected by using observation, non-structural interview, physical assessment, and the process of therapeutic play. The assessment tool of nursing care was employed to evaluate the patient's physiological, psychological, social and spiritual reactions. Data showed that the treatment has delayed due to the patient's reaction of flinch, fear, attack, crying, and increased of the dependent behaviors. The nursing problems were identified as follows: hyperthermia, diarrhea, and separation anxiety with initiatives. During the nursing process, the author applied the role-play, and projection of drawing book to build the trust relations between the author and patient. The emotion outlet and attention transition were also provided. Finally, the patient may obey the treatment plan. The caregiver's e knowledge of diseases and skill such as the interventions of fever and diarrhea, medication, and the environment and skin care was enhanced. Moreover, the author gave empathy to the patient and his mother to decrease the stress of patient in hospitalization and caregiver's worry. Then he recovered from his illness successfully.

並列關鍵字

therapeutic play ； preschooler ； separation anxiety