Although, as eloquently stated by Swiss developmental psychologist Jean Piaget, "Children are not miniature adults" (Piaget, 2001), it remains common in pediatric clinical nursing practice to encounter viewpoints such as "Be patient and it will pass!" and "Is it really that bad?" as well as insensitive comments such as "Cry again, and I'll…" Dealing with children and their families during invasive treatments is a daily challenge as well as source of fulfillment for pediatric nurses. The concept of child-friendly care centers on providing support and care that addresses the needs of both the child and family to help them adapt to various situations within the healthcare environment (Lookabaugh & Ballard, 2018). Child-friendly healthcare must be grounded in the recognition of children's rights, which includes the right to health and the right to healthcare (Lenton & Ehrich, 2015). Strategies, policies, and environmental transformations are necessary to translate this concept into practice. One related strategy commonly used in pediatric nursing practice is therapeutic play, which encompasses instructional, cathartic, and physical health promotion categories (Hockenberry et al., 2023). By engaging in therapeutic play, hospitalized children can better comprehend the tests or treatments they are about to undergo, alleviate their fear and pain, and develop healthier behaviors. It is also crucial to approach long-debated issues such as whether children and adolescents should visit family members in intensive care units from a child-friendly perspective. German scholars Brauchle et al. (2023) proposed recommendations for child-friendly visitation policies that consider the prerequisites and responsibilities of medical staff, parents, and children. In recent years, Taiwan has made great strides in integrating child life specialists and art and music therapists into hospital medical teams. This inclusion is helping families better adapt to the medical environment and better cope with medical and treatment situations, fostering more-positive medical and nursing experiences (Fang et al., 2020). Furthermore, reconstructing the medical environment for children; designing safe and healing spaces (Chang, 2021); and providing overall-friendly physical, psychological, social, and spiritual care to children and their families are essential. Each of the three topics in this column reflect the relationships between pediatric emergency nurses and, respectively, patients, and the healing functions of music therapy and art therapy, and provide important insights into the world of children through the lens of child-friendly care.
Title: 小孩並非大人的縮影—兒童友善照護之實踐.
瑞士著名的發展心理學家皮亞傑（Jean Piaget）曾提出一句頗發人深省的話：「小孩並非大人的縮影」（Piaget, 2001）。但在兒科臨床照護實務中，仍常會見到有些觀點：「忍一忍就過去了！」、「有這麼可怕嗎？」、「再哭就…」等。如何面對須接受侵入性治療的兒童及其家庭是兒科護理師的日常挑戰，也是成就之所在。兒童友善照護的概念即提供以兒童與家庭為中心的需求支持與關懷，協助其面對醫護環境中各樣情境的調適（Lookabaugh & Ballard, 2018）。兒童友善照護需建立在兒童權利的認知之上，兒童所擁有的權利應包括二個層面：可達健康的權利（the right to health）以及可獲得醫療照護的權利（the right to health care; Lenton & Ehrich, 2015）。而轉化為實踐的過程中，則需要策略的運用、政策的制定與環境的改造。兒科護理實踐中經常採用的友善照護策略為治療性遊戲，包括：指導性、情緒宣洩性和生理健康促進性等類別（Hockenberry et al., 2023），期望讓住院病童可提升對須接受的檢查或治療理解程度，減輕疼痛、害怕或能採取更健康的行為。再者，更從兒童友善的觀點來檢視多年來一直存在爭論之議題，例如：兒童和青少年是否適合探視住在加護中心的家庭成員？藉由醫護人員、父母親和孩子須具備的先決條件和職責，德國學者Brauchle等人（2023）提出兒童友善探視政策之建議。而台灣近年來積極推動兒童醫療輔導師（child life specialist）、藝術及音樂治療師納入醫院編制下之醫療團隊，在支持家庭面對疾病與醫療環境中各樣情境的調適與需求，更能協助建立正向的醫療與照護經驗（方等，2020）。此外，在兒童就醫環境的改造方面，營造安全、療癒的設計與規劃（張，2021），更落實對兒童及其家庭提供身體、心理、社會、靈性的整體友善照護。在上述的實踐過程中，將藉由本專欄的三個主題，於兒科急診護病關係的反思、音樂治療以及藝術治療的療癒功能，帶領我們從兒童友善照護的觀點走入小孩的世界。.