一位腦瘤術後併發後顱窩症候群病童之護理經驗

Nursing Experience of a Child with Posterior Fossa Syndrome after Brain Tumor Surgery

10.6142/VGHN.202006_37(2).0004

陳怡潔(Yi-Jie Chen)；劉（王靈）美(Ling-Mei Liu)；柯識鴻(Shih-Hung Ke)

兒童腦瘤 ； 後顱窩症候群 ； 治療性遊戲 ； brain tumor ； posterior fossa syndrome ； therapeutic play

榮總護理

37卷2期（2020 / 06 / 01）

137 - 144

繁體中文

本文為照護一位腦瘤術後併發後顱窩症候群病童之護理經驗。筆者於2018年1月17日至2月14日照護期間，於觀察、身體評估及會談過程中，運用羅氏適應模式評估病童及其家庭所面臨的健康問題有高危險性感染、言詞溝通障礙、害怕及家庭因應能力失調。筆者首先運用治療性遊戲、紅鼻子醫師活動及鼓勵病童參與美術教室等策略，緩解病童因表達性失語症所產生的情緒調適障礙，及改善治療性人際關係，再教導病童與父母使用非語言溝通技巧重建溝通管道，重獲因應能力及家庭動力，最終能讓家庭回到原運作過程。期盼將此護理經驗，作為其他護理人員照護之參考。

This article presents the nursing experience of caring for a child with posterior fossa syndrome after brain tumor surgery. Roy's adaptation model was used to evaluate the main health problems of children and their families during observation, physical evaluations, and interviews throughout the care period from January 17 to February 14, 2108. The identified health problems were high-risk infection, a speech communication disorder, fear, and family coping dysfunction. First, strategies including therapeutic play, interaction with a clown doctor, and participation in art classrooms were adopted to alleviate emotional adjustment disorders caused by expressive aphasia and to improve therapeutic interpersonal relationships. Subsequently, the child and parents were taught to rebuild communication channels by applying nonverbal communication skills; thus, they could regain their ability to cope with illness and restore their original family operations. This nursing experience can serve as a reference for other nursing staff.

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