運用「治療性遊戲」於手術後學齡前期病童的護理經驗

Applying Therapeutic Play for a Preschooler during Post-operative Period

劉妍彣(Yen-Wen Liu) ； 李長菁(Chang-Ching Lee)

《源遠護理》 5卷1期 (2011/05) Pp. 85-92

https://doi.org/10.6530/YYN.2011.5(1).11

摘要

本文係描述運用治療性遊戲照護一位年僅五歲患有盲腸炎手術病童的護理過程。個案右下腹有一個開刀縫線傷口及一條Penrose留置、靜脈注射針留置，每次換藥時總是大哭、罵人、及身體抗拒行為等反應，藉由觀察與評估方式收集並分析病童的住院行為，進而發現病童住院壓力是來自治療帶來的身體傷害與疼痛、對未知的恐懼、對疾病不了解及自我心像感受、陌生環境及陌生人所產生的害怕等。筆者護理過程中依學齡前期兒童之身心發展階段與特質，運用各種遊戲作為溝通方式包括娛樂性遊戲如繪畫、玩電腦等及治療性遊戲如角色扮演、擬人化、說故事，指導性及投射性遊戲溝通技巧，深入了解其內心感受，取得病童的信任感，引導情緒壓力之宣洩，減少心理傷害，紓解病童住院壓力並願意接受治療。

關鍵字

學齡前期 ； 治療性遊戲 ； 住院壓力 ； 手術

並列摘要

This article describes the nursing care experience of applying therapeutic play for a post appendectomy preschooler. The patient had a Penrose drainage on right lower abdomen at the suture site. The patient screamed at people loudly and made strong physical resistance during dressing changes. Through observation and analysis of the patient's behavior, the nurse recognized that the reactions were caused by bodily harm, pain during procedures, a lack of knowledge of the surgery expectations, fear of the strange environment, and strangers in the hospital. Based on the preschooler's psychosocial, cognitive and physical developmental stage, to communicate with the patient, the nurse applied therapeutic play such as drawing, computer games, role-play, story telling, instructional and projection type games, which helped the nurse to understand how the patient felt and to gain trust. This approach allowed the patient to release emotional pressure related to the surgery and hospitalization and to minimize psychological damage from this experience. The patient subsequently was able to stay calm during the dressing changes.

並列關鍵字

preschooler ； therapeutic play ； hospitalization stress ； operation