照顧一位長期遭受家庭暴力致跳樓發生重大外傷個案之護理經驗

The Nursing Experience of a Long-term Victim of Domestic Violence Who Sustained Major Traumatic Injuries and Was Hospitalized After Committing Suicide

10.6540/NTJN.202103_23(1).0011

蔡毓珍(Yu-Chen Tsai)；林任雋(Jen-Chun Lin)；方素瓔(Su-Ying Fang)

家庭暴力 ； 重大外傷 ； violence ； suicide

新臺北護理期刊

23卷1期（2021 / 03 / 01）

111 - 120

繁體中文

本文主要描述一位長期遭受家庭暴力，而跳樓導致重大外傷住院，又因傷口感染再次入院之個案；由於筆者發現個案第二次住院期間仍屢次出現自殺意圖，故引起照護動機，筆者協助個案面對家暴所致的身心靈情緒困擾、減輕自殺意念的照護經驗，於2018年6月20日至7月10日，運用身、心、靈、社會四層面，經由身體評估、直接觀察、個案及家屬會談、病歷查閱、實際照護等方式進行資料收集，確立健康問題為：潛在危險性自殺、無望感、長期性低自尊等；照護期間利用主動關懷以及同理技巧，針對個案各項健康問題提供家暴受害支持、無望感消除、低自尊的人格重建強化等個別性護理措施，使個案勇於面對壓力，降低自我否定、悲觀、憂鬱、消沈等負面情緒及自殺意念，同時提供更多社會資源資訊，協助其脫離自殺意念之憂鬱情緒，有意願尋求社交、經濟支持而避免再度深陷困境；建議在臨床照護上，護理師可參加相關的在職教育，以增強溝通能力及提升對於家庭暴力受害者的敏銳度，使醫療團隊儘早期介入處理，防止憾事發生。

This article tells the story of a long-term victim of domestic violence who sustained major traumatic injuries and was hospitalized after jumping off the roof of a building. After being discharged from the hospital, he was admitted again due to infection. As the author found that the case still repeated suicidal thoughts during the course of second admission, the author assisted the case in the face of physical and mental emotional distress caused by domestic violence, and attempted to alleviate thoughts and ideations of suicide from the patient. From June 20 to July 10, 2018, the author utilized the body, mind, spirit, and social aspects to collect data through physical assessment, direct observation, case and family interviews, medical record review, and clinical care. The chief nursing issues established in this process included potential self-harm risks, hopelessness, and low self-esteem. During the course of care, it was undertaken active care and the same skills during nursing, and provided domestic violence support for the patients' various nursing issues, including eliminating hopelessness, taking individual self-care measures such as low self-esteem personality reconstruction, empowering the case and bestowing courage to face the stress, and reducing negative emotions such as self-denial, pessimism, depression, and suicidal ideations. Various social resources and relevant information were also provided to the patient at the same time in order to eradicate negative emotions or suicidal ideations and make the patient willing to seek social and financial support and avoid being in deep trouble again. It is recommended that in clinical care, nursing staff can participate in relevant on-the-job education to augment communication skills and enhance the sensitivity and clinical acuity of victims of domestic violence, so that the medical team can intervene early to prevent regrets.

1. 彭美蓮,李衛華,賴芊孝(2018)。一位多次遭受家庭暴力的外籍配偶之急診護理之經驗。領導護理，19(1)，40-52。
   連結：
2. 葉思妤,余美蓮(2015)。一位新住民婦女受家庭暴力之急診護理經驗。若瑟醫護雜誌，9(1)，135-145。
   連結：
3. Al‐ Natour, A.,Qandil, A.,Gillespie, G. L.(2016).Nurses' roles in screening for intimate partner violence: a phenomenological study.International Nursing Review,63(3),422-428.
4. Avdibegovic, E.,Brkic, M.,Sinanovic, O.(2017).Emotional profile of women victims of domestic violence.Materia Socio-Medica,29(2),109-113.
5. Devries, K. M.,Mak, J. Y.,Bacchus, L. J.,Child, J. C.,Falder, G.,Petzold, M.,Watts, C. H.(2013).Intimate partner violence and incident depressive symptoms and suicide attempts: Asystematic review of longitudinal studies.Plos Medicine,10(5),e1001439.
6. Karakurt, G.,Smith, D.,Whiting, J.(2014).Impact of intimate partner violence on women's mental health.Journal of Family Violence,29(7),693-702.
7. Mitchell, J.,Wight, M.,Van Heerden, A.,Rochat, T. J.(2016).Intimate partner violence, HIV, and mental health: Atriple epidemic of global proportions.International Review Of Psychiatry,28(5),452-463.
8. Teixeira, S. V. B.,Moura, M. A. V.,Silva, L. R.,Queiroz, A. B. A.,Albuquerque, L. N.(2015).Intimate partner violence against pregnant women: the environment according to Levine’s nursing theory.Revista Da Escola De Enfermagem Da U S P,49(6),882-889.
9. 內政部家庭暴力及性侵害防治委員會（2018）‧家庭暴力事件通報案件統計 ‧ 取自https://dep.mohw.gov.tw/DOPS/lp-1303-105-xCat-cat01.html
10. 徐鳳蘭,鄭秀瑮(2017)。一位遭受家庭暴力女性之急診護理經驗。澄清醫護管理雜誌，13(4)，55-62。
11. 張秀吟,陳雅惠(2014)。照護一位Guillain-Barré症候群病人無望感之護理經驗。澄清醫護管理雜誌，10(4)，54-61。
12. 蔡宜秀,郭佳薰,許翠華(2014)。照護一位外籍配偶遭受家庭暴力之急診護理經驗。志為護理，13(5)，108-109。
13. 衛生福利部統計處（2018，11月30日）‧家庭暴力事件通報案件統計‧取自 https://dep.mohw.gov.tw/DOS/lp-2981-113.html。