應用Rogers理論於一位手術後黏連性腸阻塞引起疼痛之學齡前期兒童的護理經驗

An Experience of Caring for a Pre-school Child with Post-operative Abdominal Adhesion by Applying Rogers Theory to Clinical Setting

疼痛是一種主觀的經驗，兒童會因認知發展階段及成熟度的不同，而影響其對於疼痛的表達，但疼痛又是困擾著許多兒童及父母的健康問題，因此對於兒科護理人員來說，如何正確的評估疼痛和給予適當的護理措施，是一大挑戰。本篇個案報告為一位六歲的學齡前期兒童，因右腎切除手術後，造成腹痛而入院的照護經驗。護理過程中，運用Rogers所提出整體人類之理論為主體，配合認知發展理論，形成本文之學理架構，其中探討環境、護理與個案之間能量的交換，並應用理論中的共振原則、螺旋原則及圓滿原則來評估及處理個案的疼痛問題，護理過程是以非藥物性的疼痛控制法，如放鬆技巧、遊戲治療以及運用家庭支持系統，與個案產生持續性的互動和能量交換，進而協助個案以適當的波型反應疼痛，呈現一個健康的能量場。

Pain is a subjective experience. The expression of pain among children differs depending on stages of cognition development and level of maturation. However, many child and parents are persecuted by pain and it has been a baffling health problem. Assessing pain correctly and delivering proper care hence become a challenge for pediatric nurses. This case report shares an experience of caring a 6-year-old preschool child who suffered from abdominal pain with intermittent hospitalization after right renal resection. The theoretical framework of this nursing process is formed by Rogers whole human being theory in conjunction with cognition development theory. Exchange energy among the environment, nursing and the patient is explored and Principles of Resonance, Helicy and Integrity are applied to assess the patient’s pain problem. Non-medical pain management approaches are employed in this study such as relaxation skills, play therapy and family support. By sustaining interaction and exchanging energy, the patient responded with a proper wave to pain and showed a healthy energy field.