治療性遊戲合併下肢運動訓練一位右肱骨骨折之學齡前兒童的護理經驗

A Nursing Experience of Applying Therapeutic Play and Lower Limb Training to a Preschool Child with Right Humerus Fracture

鄭嵓丹(Yen-Dan Cheng)；吳宜臻(Yi-Zhen Wu)；李亭葶(Ting-Ting LI)；林瑞萍(Jui-Ping Lin)；余幸宜(Hsing-Yi Yu)

治療性遊戲 ； 學齡前兒童 ； 骨骼牽引 ； 下肢運動 ； therapeutic play ； preschooler ； skeletal traction ； lower extremity activity

台灣健康照顧研究學刊

22期（2020 / 07 / 01）

107 - 123

繁體中文

本文為運用治療性遊戲協助一位右肱骨骨折執行90/90骨骼牽引之學齡前期兒童進行下肢運動以增強肌力。護理期間為2019年4月10日至17日，照護期間運用觀察、身體評估、溝通及治療性遊戲方式等進行資料收集，並以治療性遊戲合併下肢運動訓練進行介入。確認個案有潛在危險性廢用症候群的健康需求。故研究者結合關節肌肉運動學理依據、學齡前期兒童發展特色、個案喜好及以家庭為中心的護理照護理念，以「我與佩佩豬的大冒險」為主題，設計及進行此治療性遊戲，其目的在協助個案主動執行下肢主動運動、抗阻力運動及靜態肌肉收縮以維持及強化肌力。最後，在案父的共同參與下，個案主動完成每日的運動目標，也避免肌肉廢用症候群的出現。此照護經驗可提供未來兒科骨科照護臨床參考，並有助於提升護理照護品質。

The article described the nursing experience of applying a therapeutic play to assist a preschool aged child with right humerus fracture and 90-90 skeletal traction performing lower extremity activities. The period of nursing care was from April 10 to 17, 2019. Data were collected through observation, physical assessment, conversation, and therapeutic play. A therapeutic play combined lower limb training was applied in this study. The health problem was identified as risk for disuse syndrome. A therapeutic play (the title is 〞My adventure with Peppa Pig〞) which developed based on principle of joint and muscle activities, family center care, preschool children's developmental features and consideration of child's favorite cartoon of Peppa Pig was applied. The purpose of this intervention was to assist the preschool child actively performing lower extremity joint and muscle activities to increase and maintain muscle strength. Finally, with the involvement of child's father, the child actively completed the daily exercise continuously to avoid muscle disuse syndrome. The care experience is helpful to serve a reference for future pediatric orthopedic care and increase the care quality.

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