協助一位遭性侵個案之護理經驗

The Nursing Experience of Caring for a Sexual Assault Victim

隨著科技進步，網路世界增加青少年的誘惑，也滿足了青少年的幻想空間，但也充斥許多潛在危機。本文描述一位藉由網路交友的17歲青少女，因好奇心驅使與網友見面進而遭受到性侵的護理經驗，護理期間為2006年4月27日至6月1日，從個案入急診之後並運用電話訪談與返診時間收集資料，收案地點為急診室，筆者運用羅氏適應理論為護理架構，利用在急診期間個案返家後電話訪談與返回門診時間，藉由觀察與會談方式進行資料收集，經護理評估分析發現個案有「睡眠形態紊亂」、「低自尊」、「社交互動障礙」、「強暴創傷症候群」四項健康問題，依健康問題提供合宜的個別護理措施，包括鼓勵個案情緒疏發與耐心傾聽心中感受，適時提供支持與提供相關社服資源，並透過個案、家屬與醫療團隊三方面的努力，協助個案走出性侵陰霾，協助個案以正向態度面對且重新找到人生目標，同時透過與個案建立關係、採檢、協助走出創傷、提供相關資料、提供一個安全的人際環境、協助恢復人際關係等具體措施，進而接受電訪與門診追蹤評值結果，個案逐漸恢復生活，希望此報告能提供護理人員在照護類似個案之參考。

The more advancements in technology, the more temptations there are for teenagers on the Internet. Despite satisfying the fancies of juveniles, the Internet predisposes them to many kinds of danger. In this article, a seventeen-year-old girl met a net pal on the Internet, went out with him out of curiosity, and was sexual assaulted. The Roy's adaptation model was applied to the victim. Further, all data were collected by observation and conversation in the emergency room, during routine outpatient follow-up and through phone conversations from April, 27, 2006 to June, 1, 2006. Sleep pattern disturbance, situational low self-esteem, impaired social interaction, and Rape-trauma syndrome were diagnosed after nursing assessment. In accordance with these diagnoses, individualized nursing implementation was performed, including encouraging her to express herself, listening to her patiently, and providing her with support as well as social welfare resources. Finally, the victim was assisted not only to overcome the dark shadow of her assault but to develop a positive attitude and set a new goal through the cooperation of her family, our medical group, and herself. This nursing experience may provide some helpful information for us to share in caring for such cases.