運用「治療性遊戲」降低門診手術學齡前期病童於恢復室疼痛哭鬧行為反應

Using Therapeutic Play in Reduction of Preschooler's crying Behavior in Post-Anesthesia Care Unit after Ambulatory Surgery

陳秀玲(Hsiu-Ling Chen) ； 余佩青(Pei-Ching Yu) ； 石惠美(Whei-Mei Shih) ； 李夢英(Meng-Ying Lee) ； 賀倫惠(Lun-Hui Ho) ； 吳寶媛(Pao-Yuan Wu)

《健康科技期刊》 3卷2期 (2016/10) Pp. 1-20

https://doi.org/10.6979/TJHS.201610_3(2).0001

摘要

住院或手術對兒童而言是一個充滿壓力與威脅的經驗，而門診手術病童在未經溝通準備下，於術後恢復室常出現哭鬧、抗拒行為，透過術前提供訊息能增加家屬因應，並運用治療性遊戲於手術後照護過程中，提供病童更好的支持與整體性照護，降低術後哭鬧與焦慮。現況中72.5%學齡前期病童，術後疼痛行為反應4分以上之哭鬧超過15分鐘；病童家屬對恢復室照護認知準備度70.5%。本專案為運用「治療性遊戲」降低門診手術學齡前期病童於恢復室術後疼痛行為反應之哭鬧，運用改善方案：修訂門診術前衛教單張、制訂恢復室兒科衛教本、規劃恢復室兒科術後照護空間、設置遊戲輔助工具、籌備童書玩具。實施後，學齡前期病童疼痛行為反應4分以上哭鬧人數於15分鐘時，由72.5%降至32.5%；家屬對恢復室照護認知準備度由70.5%提升至89%，達專案目標。透過介入措施降低術後哭鬧行為，以提升病童手術之品質。

關鍵字

學齡前期 ； 恢復室 ； 疼痛 ； 治療性遊戲

並列摘要

Being hospitalized or having to undergo an operation is an extremely stressful, frightening experience for children. It is very common for children to display crying and resisting behavior in the Post-Anesthesia Care Unit (PACU) after an operation if advance preparation and communication have not been carried out properly. The provision of adequate information prior to the operation (so as to enhance the ability of children's parents or guardians to respond effectively to the situation) and the use of therapeutic play in the postoperative care process can enhance the level of support that children receive and the improve the overall quality of care, leading to a reduction in crying behavior and anxiety. 72.5% of preschoolers undergoing ambulatory surgery who had a pain score of 4 or higher reacted by crying for over 15 minutes; the awareness rate among parents and guardians with respect to PACU care was 70.5%. In the present study, therapeutic play was used to reduce crying and screaming in response to pain among preschool children in the PACU following an ambulatory operation. The following improvement measures were implemented: the content of the advice leaflet distributed to parents and guardians prior to the operation was revised; teaching materials were prepared for pediatric care in the PACU environment; planning was undertaken for the creation of a pediatric care space within the PACU environment; equipment was installed to support game implementation; the provision of toys and books was arranged. Following implementation of these measures, the percentage of preschoolers undergoing ambulatory surgery with a pain score of 4 or higher who reacted by crying for over 15 minutes fell from 72.5% to 32.5%, and the awareness rate among parents and guardians with respect to PACU care rose from 70.5% to 89%. The project goals were thus achieved successfully. The results obtained in the present study showed that intervention measures can reduce crying and screaming behavior, thereby enhancing the overall quality of the operation experience for preschool children.

並列關鍵字

Preschooler ； post-anesthesia care unit ； pain ； therapeutic play

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