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童年期反复性虐待和延迟报告性虐待的临床特征及危险因素

Clinical characteristic and risk factors of recurrent sexual abuse and delayed reported sexual abuse in childhood.

作者信息

Hu Mei-Hua, Huang Go-Shine, Huang Jing-Long, Wu Chang-Teng, Chao An-Shine, Lo Fu-Sung, Wu Han-Ping

机构信息

Division of Pediatric General Medicine, Chang Gung Memorial Hospital Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University Study Group for prevention and Protection Against Child Abuse and Neglect, Chang Gung Memorial Hospital at Linkou, Taoyuan Department of Anesthesiology, Tri-Service General Hospital, National Defense Medical Center, Taipei Division of Pediatric Allergy, Asthma and Rheumatology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital and Chang Gung University, Linkou Medical Center Division of Endocrinology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.

出版信息

Medicine (Baltimore). 2018 Apr;97(14):e0236. doi: 10.1097/MD.0000000000010236.

Abstract

Child sexual abuse (CSA) is a global problem that affects children of all ages, and the evaluation of these victims by psychologic and gynecologic experts in pediatric emergency departments is an important issue. Few data are available on the characteristics of children admitted to pediatric emergency department with recurrent CSA and delayed reported CSA. The aim of the present study was to describe the clinical features of, and risk factors for, recurrent CSA and delayed reported CSA. The study retrospectively analyzed victims of CSA who were admitted to a pediatric emergency department. Chi-square tests and univariate analyses were performed to assess the risk factors of recurrent or delayed reported CSA. Of the 91 CSA cases, 32 (35.2%) were recurrent assaults. Of the 70 cases recorded the duration of the event, 22 (31.4%) were delayed report cases. Comparisons of the non-recurrent and recurrent CSA assault groups revealed a significant increase in comorbidities (odds ratio [OR]: 4.46, 95% confidence interval [CI]: 1.54-12.93), acute psychiatric problems (OR: 3.18, CI: 1.26-8.06), attempted suicide (OR: 4.23, CI: 1.28-13.99), and the need for treatment with antipsychotic medications (OR: 5.57, CI: 1.37-22.65). Compared with non-delayed reported cases, the delay reported cases of CSA were significantly more likely to have anxiety (P < .05). The CSA victims in the present study exhibited acute medical and/or psychosocial problems, which indicate that pediatric emergency professionals have a responsibility to look for and recognize particular characteristics in these victims.

摘要

儿童性虐待(CSA)是一个全球性问题,影响着各个年龄段的儿童,而儿科急诊科的心理和妇科专家对这些受害者的评估是一个重要问题。关于因反复遭受CSA和延迟报告CSA而入住儿科急诊科的儿童特征的数据很少。本研究的目的是描述反复遭受CSA和延迟报告CSA的临床特征及危险因素。该研究回顾性分析了入住儿科急诊科的CSA受害者。进行卡方检验和单因素分析以评估反复或延迟报告CSA的危险因素。在91例CSA病例中,32例(35.2%)为反复性攻击。在记录了事件持续时间的70例病例中,22例(31.4%)为延迟报告病例。非反复性和反复性CSA攻击组的比较显示,合并症(优势比[OR]:4.46,95%置信区间[CI]:1.54 - 12.93)、急性精神问题(OR:3.18,CI:1.26 - 8.06)、自杀未遂(OR:4.23,CI:1.28 - 13.99)以及使用抗精神病药物治疗的需求(OR:5.57,CI:1.37 - 22.65)显著增加。与未延迟报告的病例相比,CSA延迟报告病例出现焦虑的可能性显著更高(P < 0.05)。本研究中的CSA受害者表现出急性医疗和/或心理社会问题,这表明儿科急诊专业人员有责任在这些受害者中寻找并识别特定特征。

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