| 中文摘要 |
目的：台灣有關婦幼保護相關法律已行之近二十年，這些法令改善了婦女的生命安全，但相關的醫療服務研究非常稀少。本研究目的在探究護理人員參與性侵害被害人司法醫療服務中之執行內容及經驗，以瞭解其角色功能。方法：採用焦點團體訪談及郵寄問卷調查兩階段。在焦點團體部份，以立意取樣邀請四家醫院護理人員及台灣北部一所大學教授急診護理課程教師執行焦點團體訪談，共計27名，第二部份係郵寄問卷調查，邀請台灣144家性侵害案件責任醫院的護理人員匿名填寫，實得有效問卷463份。結果：在焦點團體訪談部份，五個性侵害被害人護理核心概念為「護理人員是醫院性侵害司法醫療服務的啟動者」、「對自我的性侵害團隊成員角色感到困惑」、「司法證據鏈之監管者」、「對個案有文化上的性迷思」，但護理人員仍然會盡可能的「保持安靜與尊重個案的服務態度」。在問卷調查部份，多數護理人員皆有執行性侵害驗傷採證的相關經驗，如：拍照（73.1%）、抽血（91.2%）、毛髮（68.4%）、唾液（72.0%）、資料填寫（87.5%以上）等。然而，護理人員仍以急診護理工作者之角色功能為主，建議國內若能在多重專業團隊的合作條件下，司法護理人員之發展將深具潛力。
Purpose: Quite a few regulations of women and children have been prompted recently in Taiwan, and those regulations have improved their safety of life, but related nursing studies are very scanty. The current studies to provide a descriptive study of nurses perform their roles to handle sexual assault victim medical-legal service and to gain a body of opinions to identify the core sexual assault issues in emergency. Methods: The first, in adopting Focus Group, the purposive sample of twentyone nurses of four hospitals, and five teachers of a college in northern Taiwan. Focus group interviews were tapped and transcribed for further analysis and categorization. The second, a confidential survey addressing staff demographics, experience in sexual assault victim care is mailed to 144 responsibility hospitals for sexual assault. Findings: Five themes were extracted from the analysis of focus groups, inclusive of “ responding to the immediate needs of sexual assault victims after they come to the emergency room “, “ establishing and maintaining the chain of custody for this evidence”, “identity conflicts about nurse role in multi-discipline team work”, “cultural myths for sexual assault” and “accommodating and quiet”. Among participants of survey, of the 463 nurses, 62.6% were nurses, 20.8% were assistant head nurses, and 13.8% were head nurses. The nurse almost like a traditional role of nurse in the emergency department. Most nurses have the experience to deal with the lab specimens, photography (73.1%), collect the survivor's blood for type, and DNA screen (91.2%), comb the pubic hair for foreign hair and matter (68.4%), collect saliva for secretor status (72.0%) and the amount of documentation (87.5%). Those samples were labeled and placed in a rape kit and then was taken by the nurse to the evidence holding area for direct processing to the forensic laboratory. Then the collaboration of law enforcement, medical professionals, justice system and rape crisis programs is essential to meet the needs of rape victims. |
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