以遊戲治療協助一位學齡期「週期性嘔吐」患孩度過身體─心理─社會危機之護理經驗

Applying Play Therapy in Helping a Cyclic Vomiting Schoolager to Pass through a Bio-Psycho-Social Crisis

本文以艾瑞克森（Erikson）之心理社會發展理論及皮亞傑（Piaget）之認知理論為臨床護理評估架構，藉由支持性心理治療會談與遊戲治療，協助一位罹患「週期性嘔吐」之6歲4個月患孩抒發內心感受及情緒，並學習面對生理壓力（嘔吐）及心理社會壓力（家庭問題）之因應技巧的護理過程。由於「遊戲」是兒童最自然的一種自我表現方式，藉遊戲治療探索患孩的感覺和態度，消除其鬱積的情緒，進而能幫助其學習生活適應困難的解決技巧。筆者由此次護理經驗中，深可感受到患孩面對心理社會發展及生命成長壓力之衝突，因而護理人員在遊戲治療上扮演的角色的功能，更是協助患孩因應困難的關鍵。

This case report presented the nursing process of helping a cyclic vomiting school-ager to ventilate her inner feelings and handle her physiological and psychological stressors. The techniques of play therapy and supportive psychotherapy were needed to help this six-year-old-four-month-old child, since child could express herself nicely during play. The result showed that the child could ventilate her sadness and understand the conflict situation through the nursing process. The significance of this case study was to expand nurse’s role and function in the field of child psychiatric nursing.