運用治療性遊戲照護一位腎病症候群學齡前期病童之照護經驗

Nursing Experience of Using Therapeutic Play to Reduce the Stress of a Preschool Child with Nephrotic Syndrome

10.6142/VGHN.33.3.320

陳千琪(Chian-Chi Chen)；陳倩芳(Chien-Fang Chen)；莊小玲(Hsiao-Ling Chuang)

學齡前期 ； 治療性遊戲 ； 住院壓力 ； 腎病症候群 ； preschooler ； therapeutic play ； hospitalized stress ； nephrotic syndrome

榮總護理

33卷3期（2016 / 09 / 01）

320 - 326

繁體中文

本文描述運用治療性遊戲，協助一位腎病症候群學齡前期兒童緩解住院壓力的過程。照護期間為2012年12月1日至12月8日，以參與式觀察方法收集資料、紀錄與兒童及家屬間互動，共得7篇行為過程紀錄並加以分析，結果發現個案的壓力有分離焦慮、侵入性治療恐懼、失去控制感及不遵從行為。因此，筆者依據學齡前期兒童認知發展特質與需求，將情緒宣洩、指導性與生理健康促進性遊戲融入護理措施中，協助兒童紓解內在衝突與壓力，建立信任與增加自我控制感，進而協助個案順利接受治療，增進在住院期間及出院後的正向適應能力。

This article describes the process of using therapeutic play to reduce the stress of a preschool child at a hospital. Data were collected through participant observation and interviews between December 1 and 8, 2012. Seven processing regarding the reaction of the child and the interaction between the child and the family were analyzed. The results indicated that the child's stress of hospitalization included separation anxiety, fear of invasive treatment, and loss of control. On the basis of preschool children's cognitive development characteristics, the author used emotional outlets and incorporated instructional and physiologically enhanced play into the nursing process to assist children in relieving internal conflicts and stress, thereby improving self-confidence and self-control. Such play could help children accept various treatments and promote children's adaptation during hospitalization and after discharge.

1. 許家樺、馮瑞鶯(2015)。運用治療性遊戲於一位患有噬血症候群學齡前期兒童之加護照顧經驗。護理雜誌，62(2)，96-102。
   連結：
2. Duffin, C.(2012).Not just fooling around: How play can help young patients overcome their fears.Nursing Children and Young People,24(10),6-7.
3. Hockenberry, M. J.,Wilson, D.(2011).Wong's nursing care of infants and children.Saint Louis:Mosby.
4. Santrock, J. W.(2015).Life-span development.Boston:Mcgraw-hill Humanities.
5. Vessey, J. A.,Mahon, M. M.(1990).Therapeutic play and hospitalized child.Journal of Pediatric Nursing,5(5),328-333.
6. 康建文(2014)。疑似源發性腎病症候群之案例。藥學雜誌，30(2)，85-90。
7. 張祐瑄、戴玉慈(2011)。應用治療性遊戲於肝臟移植術後學齡前期兒童之護理經驗。護理雜誌，58(3)，79-84。
8. 張翠茹、梁蕙芳(2013)。照護一位患有蕁麻疹之學齡前期兒童的護理經驗。長庚護理，24(4)，463-472。
9. 陳月枝校閱(2012)。實用兒科護理。台北:華杏。
10. 劉妍彣、李長菁(2011)。運用「治療性遊戲」於手術後學齡前期病童的護理經驗。源遠護理，5(1)，85-92。
11. 劉家宏(2011)。認識小兒腎病症候群。中國醫訊，99，25-26。
12. 謝宜娟、劉惠姿、卓燕華(2012)。降低學齡前期兒童接受靜脈注射的恐懼程度之專案。護理雜誌，59(3)，79-86。

1. 鄭淑貞,黃佳如,張華蘋(2022)。運用治療性遊戲於學前病童噴霧治療之成效。長庚護理，33(3)，15-27。