應用治療性遊戲於肝臟移植術後學齡期兒童之護理經驗

Therapeutic Play in Nursing Care: One Experience with a School-Age Liver Transplant Recipient

本文以個案研究法探討一位學齡期接受活體肝臟移植手術後的兒童之護理經驗，主要採用治療性遊戲來進行對個案的照護。首先利用個案喜愛的遊戲，建立治療性關係；其次從其喜好中發展出治療性遊戲藉以觀察個人的健康與生活習慣，並且評估其對住院的感受和對自我照護的了解；最後藉由遊戲來引導個案更熟悉自我照顧的細節，同時當個案在加護病房面臨與父母的分離焦慮時，引導其說出內心感受並宣洩負向情緒。過程中，筆者深感治療性遊戲對兒童在住院期間的重要，其可作為與兒童溝通的工具及提升對治療的順從性，護理人員應適時將遊戲納為護理措施，協助兒童減輕住院期間面臨的各種壓力。

This case report described an experience using therapeutic play in the care of a school-age living donor liver transplant recipient. A first intervention employed playing the patient's favorite game in order to create a therapeutic relationship. The author then introduced therapeutic play elements into the game to observe the patient's personal health behaviors, evaluate patient perception of hospitalization and assess the knowledge of self-care protocols. Therapeutic play was then used to raise patient familiarity with daily care specifics. The author found therapeutic play also helpful in persuading the patient to share deep feelings on the anxiety of separation from her parents while in the ICU. During the nursing process, the author recognized therapeutic play as an effective tool to communicate with children and improve treatment protocol compliance. The author recommends that nurses incorporate therapeutic play in clinical practice to reduce children's stress during hospitalization.