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 * 94 8 31 95 1 12 70101 06 2353535 5845
80 practice play construction combinatorial 15 24 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
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
82 Sheridan, 2002 hospital play specialist 1975 National Association of Hospital Play Staff, n.d. Haiat et al., 2003 2005 10 18 http://www.playright.org.hk/services_01.htm 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. 161 169). Norwalk, CT: Appleton & Lange. Betz, C. 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). Medical play and preparation: Questions and issues. Children s Health Care, 20(4), 225 229. DelPo, E. G., & Frick, S. B. (1988). Directed and nondirected play as therapeutic modalities. Children s Health Care, 16(4), 261 266. 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), 209 214. 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. 683 685). Philadelphia: W. B. Saunders. McCue, K. (1988). Medical play: An expanded perspective. Children s Health Care, 16(3), 157 171. National Association of Hospital Play Staff. (n.d.). About NAHPS. Retrieved October 18, 2005, from http://www.nahps.org.uk/ 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. 465 467). 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. 93 109). 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. 299 314). Thousand Oaks, CA: Sage. Vessey, J. A., & Mahon, M. M. (1990). Therapeutic play and hospitalized child. Journal of Pediatric Nursing, 5(5), 328 333. 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. 135 137). St. Louis, MO: Mosby.
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)235-3535 ext. 5845; E-mail: lhlo@mail.ncku.edu.tw