照護一位受家暴致全身多處刀傷婦女之照護經驗

A Nursing Experience of Caring for a Woman with Multiple Stab Wounds Resulting from Domestic Violence

本文探討一位30歲女性因受到前夫家暴致全身多處撕裂刀傷之護理經驗，個案除縫合修補術後的生理不適外，更受暴力事件產生的急性壓力反應所擾，依貝克焦慮量表（Beck Anxiety Inventory，BAI）評估後顯示有嚴重焦慮困擾，故引發筆者選案動機，護理期間自2023年12月3日至12月14日，以Gordon十一項功能性健康型態為指引，透過直接照護、傾聽、會談、身體評估及病歷查閱方式收集資料，確立健康問題為：急性疼痛、睡眠型態紊亂、焦慮等。照護期間的疼痛問題，除藥物治療外，亦提供舒適握位、深呼吸放鬆等另類療法緩解不適；睡眠型態紊亂問題，透過給予安眠藥、提供安全感，並鼓勵使用耳塞、眼罩、夜間集中護理、足浴等方式，增進睡眠品質；焦慮方面，將自己作為「工具」，使個案有傾吐心聲的對象，教導正向理念、芳香療法、音樂療法等方式，改善焦慮情形，且啟動跨團隊照護，提供社福資源與情境演練，引導個案走出心理創傷，提高生活品質。家暴事件受社會文化影響使國人多認為「清官難斷家務事」，故如何幫助受害者化解危機為重要議題，因此建議本院應多開設心理評估與措施應用於家暴之相關課程，提供醫護人員在職教育，賦予個案正能量與自我保護能力，並整合相關資源介入，以達全人護理。

This article describes the nursing experience of a 30-year-old woman who sustained multiple lacerations due to domestic violence inflicted by her ex-husband. In addition to postoperative discomfort following wound repair, the patient experienced acute stress responses related to the traumatic event. The Beck Anxiety Inventory (BAI) indicated significant anxiety, which motivated this case selection. Nursing care was provided from December 3 to December 14, 2023, guided by Gordon's eleven functional health patterns. Data were collected through direct care, observation, interviews, physical assessment, and chart review. The major health problems identified were acute pain, disturbed sleep pattern, and anxiety.
Pain was managed with both pharmacological treatment and non-pharmacological interventions, including comfortable positioning and deep breathing relaxation techniques. Sleep disturbances were improved by administering hypnotics, enhancing a sense of safety, and encouraging the use of earplugs, eye masks, cluster ed nighttime care, and foot baths. To alleviate anxiety, a therapeutic nurse–patient relationship was established, allowing emotional expression, along with interventions such as positive reinforcement, aromatherapy, and music therapy. Multidisciplinary collaboration was initiated to provide social resources and coping strategies, facilitating psychological recovery and improving quality of life.
It is recommended that healthcare institutions strengthen education on psychological assessment and interventions for domestic violence, integrate relevant resources, and promote holistic nursing care to enhance patients' self-protection and coping abilities.