運用治療性遊戲協助一位性侵害兒童在急診之護理經驗

A Nursing Experience with a Child with Rape Trauma by Using Therapeutic Play in an Emergency Room

本篇採用治療性遊戲理論為架構，照護一位疑似遭性侵害之學齡前兒童於急診的蒐證護理過程，及在個案願意配合醫護人員蒐證的情況下，面對身處與事發時類似的空間情境及失去自我防線之安全維護的恐懼的護理過程。護理時間包括個案於急診留觀期間、返院門診及透過電訪追蹤，藉由觀察、角色扮演、繪畫引導及會談等方式，以皮亞傑兒童發展認知模式為基礎，輔以進戲治療理論，協助個案降低內心的恐懼及羞恥感，並引導其說出心中的迷惑進而完成蒐證過程。

This article conceptualized a therapeutic game theory to discuss the pickings process of a preschool sexually violated victim with respect to nursing care delivery in our department of emergency medicine. In cooperation with the victim, we offered support to prevent her from fearing loss of her capacity for self-defense when facing a similar scenario. The overall exercise included observation time, a return outpatient visit and a follow-up phone interview. By using observation, role-play, leading drawing and interviews, we used Piaget's Cognitive Child Development model and game therapy theory to reduce the victim's sense of fear and shame, inducing the victim to eliminate her confusion by talking and to complete the whole pickings process.