運用治療性溝通協助結腸造口個案及家屬學習照護之經驗

Experience in Using a Therapeutic Communication Technique to Assist a Patient and His Family During Colostomy Care

繪畫可以促進兒童正常發展，幫助兒童瞭解健康照護、表達情緒與經驗、作為協助調適與療癒的媒介或介入活動。兒童繪畫的發展反映出個體身心的發育狀態，Lowenfeld與Brittain(1987)對2歲到17歲兒童的創造性提出的藝術發展的六個階段。此六階段廣為神經科學、心理、健康領域作為瞭解或詮釋孩子視覺表達藝術作品的內涵。此理論架構可引領我們進入兒童內心世界，也可對兒童有一全人的瞭解。本文將簡介各個發展階段的認知發展能力、身心發展能力與繪畫表現的關係，列舉實際兒童畫作進行說明。此外，針對藝術發展六個階段的特色提出護理照護的建議。臨床護理人員運用繪畫與病童進行評估或療癒治療時，能運用此藝術發展架構，由其身心與認知發展的狀態進行詮釋與應用。

Drawing can be used as a mediator and a nursing intervention to enhance child development, health care knowledge, expression of emotions and experiences, coping, and healing. The stages of artistic development reflect physical and mental development statuses. Lowenfeld and Brittain (1987) proposed 6 distinct stages of artistic development that define the creative growth of children from ages 2 to 17 years. These 6 stages have been explored to understand and interpret the nature of children's expressive art in the neuroscience, psychology and health care fields. This framework enabled us to understand the cognitive processes of children and to provide a holistic view of individual children. This article discusses child cognitive and physical-psychological development at the 6 stages of artistic development based on drawing expression, and provide several examples to illustrate the frameworks of the 6 stages. Based on these stages of artistic development, from the perspectives of physical-psychological and cognitive development, the clinical implementation of the use of drawing skills to assess and provide curative care to children are discussed.