運用治療性遊戲於一位手指皮瓣移植兒童之護理經驗

Nursing Experience of Applying Therapeutic Play to a Child Who Has Undergone Finger Skin Graft Surgery

本文係探討運用治療性遊戲於一位手指皮瓣移植兒童之護理經驗。筆者2016年2月19至3月26日照護期間，藉由布偶與其互動，建立信任關係，並運用治療性遊戲互動溝通，經傾聽、觀察、臉譜疼痛評估表及以Gordon十一項健康功能性型態進行資料收集與整體性評估，確立個案有急性疼痛、組織完整性受損及照顧者角色緊張等健康問題。提供持續性關懷，與個案建立良好護病關係，藉由治療性遊戲方式使其接受及配合治療，經由玩偶互動、角色扮演及轉移注意力等，降低疼痛等不適。主要照顧者對個案照護層面具有深切影響，適時提供傾聽及關懷，教導傷口照顧等相關照護資訊，鼓勵參與護理過程，進而降低案母照顧者角色緊張，期許能提供臨床照護病童及其家屬之分享。

This article discusses the nursing experience of applying therapeutic games to a child who had undergone finger skin graft surgery. The nursing period was from February 19^(th) to March 26^(th), 2016. Using a doll, the author took the first step to interact with the child and built mutual trust. Subsequently, therapeutic games were used to increase interaction. Next, the author collected clinical data and accomplished a comprehensive evaluation through listening attentively, observing, and using a face rating scale. Furthermore, through using Gordon's 11 functional health pattern assessment tool, both health problems of acute pain and damage to tissue integrity and also the nervousness of the caregiver were identified. Through continuous care, a stable nurse-patient relationship, and therapeutic games, the child was able to accept and cooperate with the therapy. Moreover, through doll-aided interactions, role-playing games, and distraction, the child's pain was eased. In holistic health care, the primary caregiver plays a crucial role. To alleviate caregivers' nervousness, they should be provided with timely listening and care, taught how to care for wounds, encouraged to participate in nursing, and provided with timely encouragement. The author sincerely hopes that this article can help caregivers who are nursing or caring for children with disease.