80 practice play construction combinatorial pretend games with rules Schaefer, 1992 Parten 1932 unoccupied behavior onlooker Schaefer, 1992 game

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1 79 治療性遊戲王月伶駱麗華 * 摘要 : 無創傷性照護是兒科照護的重要原則之一, 然而兒童未成熟的認知發展與有限的壓力因應能力, 促使兒童在疾病與住院的過程更顯緊張治療性遊戲已經被證實是住院兒童的有效介入措施, 可幫助兒童表達及處理所承受的壓力, 協助照護人員評估其對壓力事件的認知觀感與需要, 並從中協助調適本文藉文獻查證統整治療性遊戲相關概念, 裨益讀者對此有一完整認識, 進而落實此行動於兒童照護過程, 朝無創傷性照護的理想邁進關鍵詞 : 治療性遊戲無創傷性照護住院兒童 Tiedeman, Simon, & Clatworthy, 1990 Ball & Bindler, 1995 Haiat, Bar- Mor, & Schochat, 2003Bolig, Yolton, & Nissen, 1991 Tiedeman et al., 1990 Betz, Hunsberger, & Wright, 1994; Tiedeman et al., 1990 Bolig et al., 1991 Sheridan, 2002 McCue, 1988 Whaley & Wong, 1991 Schaefer, 1992 Schaefer, 1992 Schaefer, 1992 Piaget 1951 *

進關鍵詞 : 治療性遊戲無創傷性照護住院兒童 Tiedeman, Simon, & Clatworthy, 1990 Ball & Bindler, 1995 Haiat, Bar- Mor, & Schochat, 2003Bolig, Yolton, & Nissen, 1991 Tiedeman et al.

2 80 practice play construction combinatorial pretend games with rules Schaefer, 1992 Parten 1932 unoccupied behavior onlooker Schaefer, 1992 game Schaefer, 1992 DelPo & Frick, 1988 Ball & Bindler, 1995; Hunsberg, 1988; Tiedeman et al., 1990 DelPo & Frick, 1988 Vessey Mahon 1990 play therapy medical play Betz et al., 1994 Betz et al., 1994; Hunsberg, 1988; Schaefer, 1992 McCue 1988 ㈠ role rehearsal medical play role reversal medical play

3 81 ㈡ medical fantasy play 汽車有受傷嗎? 那受傷的汽車要怎麼辦? 去看醫生啦! 進醫院! ㈢ indirect medical play ㈣ medically related art 當您在做這件事情的時候想到什麼? 這是什麼? Betz et al., 1994 Bolig et al., 1991 Schaefer 1992 Betz et al., 1994; Sheridan, 2002 Bolig et al., 1991; Tiedeman et al., 1990 Tiedeman, Simon, & Clatworthy, 2001 Betz et al., 1994

Betz et al., 1994 Bolig et al., 1991 Schaefer 1992 Betz et al.

4 82 Sheridan, 2002 hospital play specialist 1975 National Association of Hospital Play Staff, n.d. Haiat et al., Ball, J. W., & Bindler, R. C. (1995). Nursing consideration for the family: Hospital and home. In J. W. Ball & R. C. Bindler (Eds.), Pediatric nursing: Caring for children (pp ). Norwalk, CT: Appleton & Lange. Betz, C. L., Hunsberger, M. M., & Wright, S. (1994). Familycentered nursing care of children: Promotion healthy play (pp ). New York: W. B. Saunders. Bolig, R., Yolton, K. A., & Nissen, H. L. (1991). Medical play and preparation: Questions and issues. Children s Health Care, 20(4), DelPo, E. G., & Frick, S. B. (1988). Directed and nondirected play as therapeutic modalities. Children s Health Care, 16(4), Haiat, H., Bar-Mor, G., & Schochat, M. (2003). The world of the child: A world of play even in the hospital. Journal of Pediatric Nursing, 18(3), Hunsberg, M. M. (1988). Promoting healthy play and exercise. In R. L. Foster & J. J. T. Anderson (Eds.), Family-centered nursing care for children (pp ). Philadelphia: W. B. Saunders. McCue, K. (1988). Medical play: An expanded perspective. Children s Health Care, 16(3), National Association of Hospital Play Staff. (n.d.). About NAHPS. Retrieved October 18, 2005, from Schaefer, C. E. (1992). The therapeutic powers of play. Northvale, NJ: Jason Aronson. Sheridan, E. A. (2002). Care of children who are hospitalized. In L. P. Potts & B. L. Mandleco (Eds.), Pediatric nursing: Caring for children and their families (pp ). New York: Delmar. Tiedeman, M. E., Simon, K. A., & Clatworthy, S. (1990). Communication through therapeutic play. In M. J. Craft & J. A. Deneny (Eds.), Nursing interventions for infants and children (pp ). Philadelphia: W. B. Saunder. Tiedeman, M. E., Simon, K. A., & Clatworthy, S. (2001). Therapeutic play. In M. Craft-Rosenberg & J. Denehy (Eds.), Nursing interventions for infants, children, and families (pp ). Thousand Oaks, CA: Sage. Vessey, J. A., & Mahon, M. M. (1990). Therapeutic play and hospitalized child. Journal of Pediatric Nursing, 5(5), Whaley, L. F., & Wong, D. L. (1991). Growth and development of children. In L. F. Whalry & D. L. Wong (Eds.), Nursing care of infants and children (4th ed., pp ). St. Louis, MO: Mosby.

L., Hunsberger, M. M., & Wright, S. (1994). Familycentered nursing care of children: Promotion healthy play (pp. 620 623). New York: W. B. Saunders. Bolig, R., Yolton, K. A., & Nissen, H. L. (1991).

5 83 Yueh-Ling Wang Li-Hua Lo * Abstract: Atraumatic care is one of the important principles in pediatric nursing. Immature cognitive development, however, and limited coping ability exacerbate tension when children are ill and require hospitalization. Therapeutic play has been demonstrated as an effective nursing intervention. Through therapeutic play, children can acquire opportunities to express themselves and deal with stress related to health experiences. Also, nurses can gain insights into children s cognition, perception, and needs. This paper introduces concepts of therapeutic play. We hope that nurses will be able to incorporate it into pediatric nursing practice and provide care as atraumatically as possible. Key Words: therapeutic play, atraumatic care, hospitalized children. RN, MSN, Formerly Adjunct Instructor, Department of Nursing, Chang Jung Christian University; *RN, PhD, Associate Professor, Department of Nursing & Institute of Allied Health Sciences, Medical of College, National Cheng Kung University. Received: August 31, 2005 Revised: November 3, 2005 Accepted: January 12, 2006 Address correspondence to: Li-Hua Lo, No. 1, Ta-Hsueh Rd., Tainan 70101, Taiwan, ROC. Tel: 886(6) ext. 5845; lhlo@mail.ncku.edu.tw

Therapeutic play has been demonstrated as an effective nursing intervention.

自傷行為 67 難化個人化及妄下結論等皆是有系統的邏輯謬誤吳陳 4 羅 6 憂鬱患者的症狀困擾自我情緒人際及生活品質若只靠個人意志是無法自行恢復通常需要藥物或心理治療才能恢復健康而照顧憂鬱症患者護理人員需維持溫暖接納與尊重的態度利用治療性溝通技巧引導表達感受以提高健

自傷行為 67 難化個人化及妄下結論等皆是有系統的邏輯謬誤吳陳 4 羅 6 憂鬱患者的症狀困擾自我情緒人際及生活品質若只靠個人意志是無法自行恢復通常需要藥物或心理治療才能恢復健康而照顧憂鬱症患者護理人員需維持溫暖接納與尊重的態度利用治療性溝通技巧引導表達感受以提高健 66 Self-Mutilation 日間病房反覆自傷之憂鬱症患者的護理經驗蔡佳吟余靜雲文獻查證摘要本文描述在日間病房照顧一位反覆出現自傷行為之憂鬱症個案的護理經驗筆者自8年月日開始照護個案發現個案6年月8日住院迄今無效性因應能力及自傷行為實質改善情形不佳故除了平時的復健與團體護理治療之外於8年月日至4月4日介入十次個別治療性會談與個案討論日記會談中運用認知行為改