基于舒适理论的学龄期骨折患儿围术期治疗性游戏方案设计与应用

doi:10.3761/j.issn.16725-9234.2023.03.016

摘要/Abstract

摘要：

目的探讨学龄期四肢骨折患儿围术期治疗性游戏方案的应用效果。方法通过深入访谈、文献分析和专家会议法构建学龄期四肢骨折患儿围术期治疗性游戏方案。选取山西省某三级甲等医院骨科2020年10月—2021年10月入院的92例骨折患儿为研究对象，并根据入院时间分为试验组（n=47）和对照组（n=45），试验组实施治疗性游戏干预，对照组实施常规护理，比较两组术后不同时间点的疼痛程度、术前及麻醉诱导期焦虑水平、麻醉诱导依从性。结果干预后，两组Wong-Baker疼痛评分组间与时间有交互效应（F_交互=3.277，P=0.015），简单效应分析显示试验组在术后3 h、6 h、12 h、24 h的疼痛评分均低于对照组（P<0.05）。试验组在术前及麻醉诱导期的焦虑程度低于对照组，差异具有统计学意义（P<0.05）。试验组麻醉诱导依从性评分低于对照组（P<0.05）。结论围术期治疗性游戏方案具有较高的科学性和可靠性，可有效缓解患儿围术期焦虑，减轻术后疼痛，提高麻醉诱导依从性，从而提升患儿舒适体验，促进术后康复。

关键词: 游戏疗法, 骨折, 围手术期, 儿童, 学龄期

Abstract:

Objective To explore the effectiveness of a perioperative therapeutic play program for school-aged children with extremity fractures. Methods The final therapeutic play program was developed through in-depth interviews，literature analysis and expert meeting. From October 2020 to October 2021，a total 92 school-aged children who suffered orthopedic surgery in a tertiary hospital in Shanxi Province were recruited as participant and divided into intervention or control group according to the time of admission. The experimental group received the therapeutic play intervention while the control group received routine care. The level of postoperative pain，perioperative anxiety，and anesthesia induction cooperation were compared between two groups. Results After the intervention，there was an interaction effect between the two groups of Wong-Baker pain scores and time（F_interaction=3.277， P=0.015）. The simple effect analysis showed that the pain scores of the test group were lower than those of the control group at 3 h，6 h，12 h and 24 h after the operation（P<0.05）. The anxiety level of the test group before operation and during anesthesia induction was lower than that of the control group，and the difference was statistically significant（P<0.05）. The score of anesthesia induction compliance in the test group was lower than that in the control group（P<0.05）. Conclusion The perioperative therapeutic play program is scientific and reliable，which can effectively relieve the perioperative anxiety，reduce postoperative pain，improve anesthesia induction compliance，so as to improve child’s comfort level and facilitate post-operative recovery.

Key words: Play Therapy, Fractures, Bone, Perioperative Period, Child, School-Age

张倩, 郭锦丽, 程宏, 黄永波, 白帆, 向泳燕. 基于舒适理论的学龄期骨折患儿围术期治疗性游戏方案设计与应用[J]. 中华护理教育, 2023, 20(3): 333-337.

ZHANG Qian, GUO Jinli, CHENG Hong, HUANG Yongbo, BAI Fan, XIANG Yongyan. Design and application of a perioperative therapeutic play program for school-aged children with fractures based on comfort theory[J]. Chinese Journal of Nursing Education, 2023, 20(3): 333-337.

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