運用Watson’s關懷理論照護一位多次遭受親密伴侶暴力之急診經驗

Application of Watson’s Theory of Caring to a Case of the Emergency Care Experience of a Patient Suffering from Repeated Intimate Partner Violence

本文描述一位多次遭受親密伴侶暴力女性之急診照護經驗，個案因多次遭受男友暴力，導致身心受創無法承受，初始陳述肢體受傷過程，表現出畏縮及恐懼模樣，透過主動關懷後，才坦承遭受暴力對待。照護期間2023年2月7日17：48-20：31，運用會談、傾聽、觀察、身體評估及四大層面整體性評估，收集生理、心理、社會和靈性等資料，發現主要健康問題為急性疼痛、恐懼及無效性因應能力。照護過程運用Watson’s關懷理論提供安全環境、建立治療性人際關係、疼痛管理與心理支持及整合社會資源，以強化個案暴力危機的敏感度及認知，增強支持系統，勇於面對暴力，避免再陷入暴力環境中，建議急診配置心理師及強化在職教育，提升護理師心理層面的評估與溝通能力。

This article describes the emergency care experience of a female patient who repeatedly suffered from intimate partner violence. Due to multiple bouts of violent treatment from her boyfriend, the patient suffered unbearable physical and psychological trauma. Initially, she only described how she received the injuries. Only later, during treatment and active care, did she admit to being the victim of violent treatment. The care period was from 17:48 to 20:31 on February 7, 2023. Through interviews, listening, observations, physical assessment, and a holistic assessment across four dimensions to collect physical, psychological, social, and spiritual data, her main health problems were identified as acute pain, fear, and ineffective coping abilities. During the care process, Watson’s Theory of Caring was employed to provide a safe environment, establish therapeutic interpersonal relationships, provide pain management and psychological support, and integrate social resources. In order to enhance the patient’s sensitivity to and awareness of violence crises, strengthen her support system, encourage her to confront the violence, and avoid revictimization in a violent environment. We recommend having psychologists on staff in emergency departments and strengthening in-service education, to improve nurses’psychological assessment and communication skills.