一位於風災受傷與喪親孩童之護理經驗

The Caring Experience of a Child Traumatized by a Natural Disaster

10.6530/YYN.2012.6(2).08

李靜芳(Li-Ching Fang)

悲傷輔導 ； 喪親 ； 兒童 ； grief counseling ； bereavement ； child

源遠護理

6卷2期（2012 / 11 / 01）

59 - 65

繁體中文

本文為照護一位經歷風災致全身多處撕裂傷，左側脛骨、腓骨及右側跟骨骨折且目睹家人遭土石淹沒之11歲孩童護理歷程，親人刻意隱瞞雙親已死亡之事實，個案在住院20天後才得知父母雙亡。筆者照護期間由2009年8月14日至9月11日，以直接會談、觀察及記錄方式評估個案及主要照顧者，觀察個案知道雙親死亡訊息後，承受創痛及壓力，卻不知如何抒發心中的哀傷及思念，當論及死亡親人時，眼神迴避，且沉默不回應；個案的健康問題有疼痛、組織完整性受損、身體活動功能障礙、睡眠型態改變及創傷後反應。筆者依據皮亞傑認知發展理論及悲傷輔導概念，協同醫護團隊及社工師，給予情感支持並耐心陪伴，關注個案之生理及情緒需求，幫助其面對悲傷，在支持關懷和包容下，讓個案能釋放悲傷的情緒，協助渡過急性創傷的階段，使其有能力為逝去的親人哀悼，並維持正常生活功能。

This article describes the four weeks' nursing caring experience of an eleven year old boy injured in a natural disaster, sustaining multiple lacerations and fractures in left tibia, left fibula and right calcaneus. The child witnessed both parents buried in a mud slide but was not aware of their death until 3 weeks later; one week before his discharge from hospital. From direct care and interview with the child and his family, the nurse noted that the child suffered from this tremendous loss and was unable to channel his sadness. He avoided eye contact and became silent whenever the topic was about his parents. His health problems included pain, impaired tissue integrity, physical activity dysfunction, sleep patterns change and post-trauma reactions. Based on Piaget's theory of cognitive development and concept of grief counseling, the child was in an acute stage of psychological trauma. Nursing initiated a multidisciplinary team to address his physical and emotional needs. The emotional support and companionship helped the child to begin his grief process. Prior to his discharge he was able to express his feelings and show an attitude of moving forward.