Campbell Rebecca, Patterson Debra, Dworkin Emily, Diegel Renae
Department of Psychology, Michigan State University, Michigan, USA.
J Forensic Nurs. 2010 Winter;6(4):188-95. doi: 10.1111/j.1939-3938.2010.01084.x.
Medical forensic exams for victims of childhood sexual abuse (CSA) can be a helpful resource for addressing patients' complex medical, psychological, and legal needs. These exams can be performed by physicians or forensic nurses to identify and treat injuries, evaluate the risk for sexually transmitted infections and pregnancy, and collect evidence. In this study, we examined CSA cases treated in a midwestern, community-based forensic nurse examiner (FNE) program to document rates of anogenital injury and identify what factors predict the presence of such injuries (N= 203). Overall, 39% of the cases had anogenital injury. Victims who were examined for suspected vaginal and/or anal assault were significantly more likely to have anogenital injuries, and patients examined within 24 hours of an assault were also significantly more likely to have documented injuries. Patients who were seen for vaginal and/or anal assaults and who had bathed since the assault were significantly less likely to have injury. Nurses who had less experience with pediatric medical forensic exams were somewhat more likely to document anogenital injuries. Findings suggest that clinical pediatric practice would benefit from additional practitioner training in injury detection to avoid false positives.
针对儿童性虐待（CSA）受害者的法医医学检查，对于满足患者复杂的医疗、心理和法律需求而言，可能是一项有益的资源。这些检查可由医生或法医护士进行，以识别和治疗损伤、评估性传播感染和怀孕风险，并收集证据。在本研究中，我们调查了中西部一个基于社区的法医护士检查项目（FNE）所处理的CSA案例，以记录肛门生殖器损伤的发生率，并确定哪些因素可预测此类损伤的存在（N = 203）。总体而言，39%的案例存在肛门生殖器损伤。因疑似阴道和/或肛门性侵而接受检查的受害者出现肛门生殖器损伤的可能性显著更高，且在性侵发生后24小时内接受检查的患者有记录损伤的可能性也显著更高。因阴道和/或肛门性侵而就诊且在性侵后洗澡的患者出现损伤的可能性显著更低。对儿科法医医学检查经验较少的护士记录肛门生殖器损伤的可能性略高。研究结果表明，临床儿科实践将受益于针对损伤检测的额外从业者培训，以避免假阳性。
