一位多次遭受家暴婦女之急診照護經驗

A Nursing Care Experience of a Woman Suffering from Multiple Incidents of Marital Violence and Seeking Emergency Medical Care

本文主要是描述一位45歲遭多次婚姻暴力婦女 急診求醫之照護經驗。筆者於2017年4月11日10點 50分至18點30分照護個案，於護理期間藉由實際照 護、會談、觀察、傾聽、身體檢查及電話訪談方式 收集資料，使用整體性護理評估進行生理、心理、 社會及靈性等層面對個案進行資料收集，確立個案 主要健康問題有：急性疼痛、恐懼、及無效性因應 能力。筆者身為急診護理師，照護期間安排溫馨舒 適且具隱密性的環境，增加其安全感及友善性並進 行醫療處置驗傷及通報流程。訪談期間透過肢體語 言來表達真誠的關懷，提供傷口照護與用藥指導， 緩解傷口疼痛，傾聽採不批評的態度，使個案有被 尊重及被關心的感覺，降低害怕及恐懼感受；藉由 提供家暴諮詢及社會救援資訊，來與個案建立良好 的社會支持系統，並推廣以家庭為中心的照護，透 過互相尊重、支持陪伴來協助個案產生正向的思考 去面對挫折，提升因應能力，規劃自我生活的目的 性及未來生活導向，提供急診護理人員面對家庭暴 力個案之照護參考。（澄清醫護管理雜誌 2020； 16（4）：79-87）

This article mainly describes the nursing care experience of a 45-year-old woman who had experienced multiple incidents of marital violence and was seeking emergency medical care. The author provided nursing care from 10:50 to 18:30 on April 11, 2017, during which data were obtained through practical nursing techniques, face-to-face interviews, observations, listening, physical examinations, and telephone interviews. The physical, psychological, social, and spiritual aspects of the patient were considered to achieve a holistic nursing assessment and the following health issues were identified: acute pain, fear, and ineffective coping ability. As an emergency ward nurse, the author arranged a warm, comfortable, and private environment for nursing care to increase the sense of security and friendliness, and conducted medical treatments, injury examinations, and notification procedures. During the interviews, body language was used to express sincere concern, injury care and medication guidance were provided, and pain from the wounds was relieved. Listening with an uncritical attitude also made the patient feel respected and cared for, thereby reducing fear and feelings of terror. Domestic violence counseling and information on social assistance helped build a healthy social support system for the patient. Family-centered care was encouraged. Through mutual respect, and support and companionship, the patient developed positive thinking to face setbacks, improved coping ability, and became capable of planing life goals and a life orientation for the future. This study provides a nursing care reference for emergency nursing personnel who face domestic violence cases. (Cheng Ching Medical Journal 2020; 16(4): 79-87)