運用無創傷性照顧原則護理一位學齡前白血病童

Applying the Atraumatic Care Principle to Caring a Pre-school Patient with Acute Lymphobiastic Leukemia

本報告是運用「無創傷性照顧原則」，幫助一位四歲大的白血病病童，渡過治療及住院壓力的護理經驗。透過護理評估，以Gordon11項健康功能型態及學齡前期兒童發展特質為工具，分析發現病童呈排便型態改變、口腔黏膜改變、身體心像紊亂、恐懼、失去控制感等健康問題。筆者配合個案發展特性，將「無創傷性照顧原則」融入護理計劃，在護理活動中藉由一些「小改變」，和符合學齡前期兒童認知發展的「兒語」，幫助病童在接受治療的過程中，減低身體的損傷及疼痛，避免分離焦慮和控制感喪失，得以釋放住院治療帶來的壓力，習得忍耐和克服恐懼的經驗。

The purpose of this report was to describe the nursing experience of a four-year-old patient with Acute Lymphoblastic Leukemia. Base upon the Atraumatic Care Principle, the patient was able to get through the difficult treatment process and hospitalization stress. By means of Gordon's functional health assessment guide and pre-school child development characteristics, the patient was found to have symptoms such as constipation, altered oral mucus membranes, body-image disturbance, fear of losing sense of control. Therefore, the Atraumatic Care Principle was applied to the nursing plan for this patient. By employing strategies such as small changes in nursing activities and child-like language suitable to a pre-school child's cognitive development. It was expected to reduce the patient's body damage and pain, prevent him from feeling separation anxiety and losing sense of control, and to release his stress due to hospitalization and treatment. Furthermore, the patient was able to learn how to overcome fear during the treatment process.