協助一位因疑似約會強暴導致陰道裂傷年輕女性的急診護理經驗

Nursing Experience of Assistance to a Young Female with Vaginal Laceration Caused by Possible Date Rape

約會行為是兩性交往的必經過程，約會情境中，如一方不想進行某些性活動，且已清楚告知，但另一方仍堅持或強迫他或她進行時，即是約會強暴。本篇描述一位年輕女性，與初識男友約會並在疑似非完全志願下發生性行為，導致陰道裂傷出血的急診護理經驗。護理期間為2008年7月23日至7月24日，藉由觀察、會談與直接照護及之後電話追蹤等方式收集資料，以Gordon十一項健康功能型態評估其護理問題，結果發現個案有潛在危險性休克、急性疼痛與強暴創傷症候群等三項護理問題。照護過程除維持其心肺循環穩定、緩解傷口疼痛及傾聽負面心理感受外，同時與其共同討論兩性關係與女性身體與性自主權的觀點與看法。後續照顧則會同社工人員，以手機追蹤其自我照顧和生活適應情形。希望藉此護理經驗，提供急診護理人員日後協助疑似約會行為造成身體傷害病患時，能注意當事者自我感受的差異性，提供更專業化的護理照顧與維護其身體自主權益。

Dating behavior is a necessary interaction process between genders. However, if one forces the other one to do sexual intercourse during dating without permission, it can be considered as a “date rape”. The paper describes the nursing experience of a young female patient suffering vaginal laceration after having sexual intercourse unwillingly with her boy friend. During the period of nursing care from July 23 to 24, 2008, the information was collected by observation, interview, direct care, and telephone tracking. The Gorden’s 11 Functional Health Assessment Tool was used to assess the health problems of the patient. The results confirmed the patient experienced three health problems, including the risk for shock, acute pain, and rape trauma syndrome during her emergency stay. Besides maintaining the stability of the cardio-pulmonarycirculation, reducing acute pain, and listening negative psychological feelings, the author discussed the issue of the body and sexual independence during dating from the female point of view during the care process. Follow up of self care and life adjustment was accomplished by working with social worker via telephone consulting. This nursing experience provides emergency nurses with a reference of caring similar situation by considering patients’ individual differences and protecting patients’ their human rights of maintaining personal integrity.