運用治療性遊戲照護一位肺膿瘍術後兒童及其照顧者的經驗

Experiences of Nursing Care a Child after Surgical Removal of Lung Abscess and his Caregiver by Therapeutic Play Interactions

本文是運用治療性遊戲照護一位肺膿瘍術後兒童及其照顧者的經驗。筆者於2014年12月3日至2014年12月28日照護期間，藉由直接照護、觀察、傾聽、會談等方式及整體性評估，確立個案及其主要照顧者的主要護理問題，包括：恐懼、呼吸道清除功能失效、疼痛，以及主要照顧者出現角色緊張的問題。護理過程中筆者以治療性遊戲為基礎，同時運用治療性遊戲達到教與學，促進個案及主要照顧者與醫療人員間的互動，讓個案利用宣洩性的治療性遊戲做護病角色互換的扮演，藉此讓個案了解醫療過程降低恐懼並配合治療。加上新住民媽媽因語言、文化差異及認知不足等問題，在醫療資源運用時造成臨床照護的困難，因此提供相關的疾病資訊，協助使用翻譯軟體譯成越南文，增加對醫療過程的瞭解，另搭配實際操作指導，使案母了解學習照顧技巧，以減輕其焦慮緊張，藉由這些醫療照護措施的介入，因而減緩個案及主要照顧者因住院所帶來的壓力，引發信心與希望而促進與維持健康信念，讓個案能順利出院，希望將此護理經驗，與其他護理人員分享。

This article depicted the experiences of nursing care a child after surgical removal of lung abscess and his caregiver by therapeutic play interactions. The duration of nursing care was from December 3rd 2014 to December 28th 2014. The methods of data collection included direct care, observations, listening, interviews and nursing assessment to build the main health related problems of the patient and caregiver. The health related problems including fear, impaired secretion clearance of the respiratory tract and pain; as well as, caregivers’ anxieties and strains. The author applied therapy play to teach and let the child learn, and make cooperation with the caregiver. After that, the patient decreased the mood of fear and improved the cooperation among patients and health professionals during nursing care by therapeutic plays. Through these plays, the interaction among the patient, nurses and caretaker was well improved. The therapeutic play offered emotional relief and playing interchanging roles. The language and cultural barrier encountered by a new immigrant mother and led her to incorrect medical information and ineffective medical resources. The communication was improved by the use of translational software. The mother was relieved from stressful to familiarized proper nursing skills by demonstration and repetition. The anxiety of the patient and the caretaker can be decreased through proper nursing care and intervention. This can further improve confidence, hope and faith in patient and his caregiver. Through the author’s efforts, the mother’s ability of child caring was improved significantly. The author hopes to share this experience with other health professionals.