Gulla Kari, Fenheim Gred Eva, Myhre Arne K, Lydersen Stian
Children's Clinic, Trondheim University Hospital, Trondheim, Norway.
Child Abuse Negl. 2007 Aug;31(8):885-94. doi: 10.1016/j.chiabu.2007.03.017. Epub 2007 Sep 6.
An anogenital examination is usually part of the standard medical assessment in children evaluated for suspected sexual abuse, and the emotional impact on the child has been studied. The primary aim of this study was to assess non-abused preschool children's responses to an anogenital examination.
One hundred and fifty-eight children (119 girls), aged 5-6 years old, were recruited by self-selection from a town community in Norway. After a full medical "top-to-toe" examination, including an anogenital examination with use of a colposcope, the children were asked for their reactions to different parts of the examination. The instrument used was a Faces Rating Scale with five faces, ranging from smiling to crying. Parents and nurses also completed questionnaires regarding their perceptions of the children's reactions.
The results from the self-report scales showed that only 7.7% of the children rated the anogenital examination as somewhat negative, but the children rated the anogenital part of the examination as significantly more distressing than the examination of their ears and mouth. Microbiological swabbing from the anogenital area was most frequently mentioned as something the children disliked. Complementary data from the parents supported the children's responses regarding the anogenital part, but also emphasized the importance of good preparation and a "child-friendly" atmosphere when performing the examination.
Most preschool children, who have no history of sexual abuse do not find an anogenital examination traumatic if the examination is well planned and performed by experienced professionals in a supportive atmosphere.
对疑似遭受性虐待的儿童进行医学评估时，肛门生殖器检查通常是标准医疗评估的一部分，且对儿童的情感影响已得到研究。本研究的主要目的是评估未受虐待的学龄前儿童对肛门生殖器检查的反应。
从挪威一个城镇社区通过自我选择招募了158名5至6岁的儿童（119名女孩）。在进行全面的“从头到脚”医学检查，包括使用阴道镜进行肛门生殖器检查后，询问孩子们对检查不同部分的反应。所使用的工具是一个有五张面部表情的面部评分量表，从微笑到哭泣。家长和护士也完成了关于他们对孩子反应看法的问卷。
自我报告量表的结果显示，只有7.7%的儿童将肛门生殖器检查评为有点负面，但孩子们认为检查的肛门生殖器部分比检查耳朵和嘴巴更令人痛苦。从肛门生殖器区域采集微生物样本是孩子们最常提到不喜欢的事情。来自家长的补充数据支持了孩子们对肛门生殖器部分的反应，但也强调了在进行检查时做好准备和营造“儿童友好”氛围的重要性。
如果检查计划周密且由经验丰富的专业人员在支持性的氛围中进行，大多数没有性虐待史的学龄前儿童不会觉得肛门生殖器检查造成创伤。
