性暴力被害直後の女性支援において産婦人科医療で求められる看護実践能力

Nursing Competencies Required in Obstetrics and Gynecology in Supporting Female Victims Immediately after Being Subjected to Sexual Violence

要旨

　目的：性暴力被害直後の女性が産婦人科医療を受診した際に求められる看護実践能力を明らかにする．

　方法：性暴力被害女性，支援経験のある看護職者，産婦人科医，支援員ら合計21名に半構造化面接にてデータを収集し，質的記述的に分析した．

　結果：求められる看護実践能力は，【支援者としての準備】を基盤とし，自身の安全が著しく脅かされた性暴力被害女性への【被害者の安全・安心を守るための対応】であり，【被害者への法医学的なアセスメントとケア】とともに【被害者の回復を見据えた支援】を実践する能力であった．被害者支援における支援者自身のセルフケアと自己研鑽として【支援者自身を支える手立て】も求められていた．

　結論：求められる看護実践能力は，性暴力の専門的な知識や技術を身に付け，トラウマの影響に配慮した被害者中心の支援を実践するためのものであり，被害者の回復を支援することが示唆された．

　Purpose: This study aims to identify the nursing competencies required in supporting female victims of sexual violence who visit obstetrics and gynecology clinics immediately after the occurrence.

　Methods: Semi-structured interviews were conducted with a total of 21 female victims of sexual violence, nurses with support experience, obstetricians and gynecologists, and support staff. The interview data were analyzed qualitatively and descriptively.

　Results: Nursing competencies required in caring for female victims of sexual violence feeling their own security seriously threatened were based on ‘preparation as a supporter’, and included the following skills: ‘responding to protect the safety and security of victims’, ‘forensic assessment and care for victims’, and ‘providing support with a view to the recovery of victims’. Nurses were also required to have the competence to take ‘measures to support themselves’ as self-care and self improvement to support victims.

　Conclusions: The aim of the required nursing competencies was to acquire specialized knowledge and skills related to dealing with sexual violence, and to practice victim-centered support while paying attention to the effects of trauma. The findings suggest that these nursing skills enable nurses to support the recovery of victims.