運用Watson關懷理論照護一位婚姻暴力個案之急診護理經驗

本文乃描述一位21歲女性因害怕及認知不足，刻意隱瞞遭受婚姻暴力之事實，筆者期望運用護理關懷人性化的照護，協助穩定個案情緒及增加對婚姻暴力的認知等。照護期間自2016年1月5日2時15分至2016年1月5日6時30分，藉由觀察、會談等方式收集資料，運用「整體性護理評估」確立個案有「急性疼痛」、「恐懼」、「知識缺失」、「無效性因應能力」等健康問題。筆者運用「Watson關懷照護理論」為指引於護理過程，協助緩解害怕恐懼之情緒、提昇自我保護因應能力、增加對婚姻暴力的認知、主動尋求社會資源，引導其學習正向因應行為來面對後續家庭、社會及心理的調適，進而擁有更佳的生活品質。建議急診重視此類個案，舉辦有關婚姻暴力的相關在職教育課程、制定標準作業流程及提供相關之衛教宣導單張等，供臨床人員運用，以提昇照顧此類個案的專業度及敏銳度，藉此照護經驗與護理同儕分享。

關鍵字

Watson關懷理論；婚姻暴力；無效性因應能力

並列摘要

This article discribed a 21 year-old female hided the truth of marital violence due to fear and insufficent cognition. The author hoped that ths using of nursing care of humanity could help the case to stabilize her emotion and increase her recognition of marital violence. The peroid of nursing care was since 2 am to 6:30 am on 5th January 2016,. The data was collected by observation and conversation to the case. Using ＂whole nursing assessment＂, health problems such as ＂Acute pain＂, ＂Fear＂, ＂insufficient knowledge＂, ＂ineffective ability of response＂ were confirmed. The author used 'Watson theory＂ as a guideline, to help she to release emotion of fear, to upgrade ability of self care, to estabish recognition of marital violence, and to actively reseach for social help. She learned about correct attitute to adjust further family, society and psychological problems. therefore, better quality life would be got. The author suggested concern such cases in emergency department. In-service education of marital violence must be held. Standard flow chart must be established. Patient education sheets has been obtained. The author shared this experience of nursing care for early discovery of marital violence and better quality of nursing care.

並列關鍵字

Watson concern theory ； marital violence ； ineffective ability of response

參考文獻

Leppakoski, T., Paavilainen, E., Å stedt-Kurki, P.： Experiences of emergency care by the women exposed to acute physical intimate partner violence from the Finnish perspective. International Emergency Nursing. 2011；19(1)： 27-36.doi：10.1016/j.ienj.2010. 02.006.

Choo,E.K., Nicolaidis,C., Newgard, C.D., Hall,M.K., Lowe,R.A., Mc Connell,M.K., &McConnell,K.J. ：Associatio-n between emergency department resources and diagno-sis of intimate partner violence. European Journal of Emergency Medicine,.2012；19 (2)：83-88. doi：10.1097/MEJ.0b013e328348a 9f2

衛生福利部統計處（2016年，11月30日）‧家庭暴力事件通報案件統計‧取自http://www.mohw.gov.tw/cht/DOS/Statistic.aspx?f_list_no=312&fod_list_no=4188