针对儿童和青少年的非性暴力：拉丁美洲一所三级和大学医院的研究。
Nonsexual violence against children and adolescents: a study in a Latin American tertiary and university hospital.
机构信息
Universidade de São Paulo, São Paulo, SP, Brazil.
出版信息
Rev Paul Pediatr. 2022 May 6;40:e2021101. doi: 10.1590/1984-0462/2022/40/2021101IN. eCollection 2022.
OBJECTIVE
The objective of this study was to assess interpersonal nonsexual violence against children and adolescents in a tertiary university hospital.
METHODS
A cross-sectional study was performed in 240 patients under nonsexual violence situation for 15 consecutive years. Data analyses included demographic data, hospital referral site, type and author of nonsexual violence, legal referral, laboratorial and imaging examinations, and outcomes.
RESULTS
Nonsexual violence situation was diagnosed in 240 (0.1%) of 295,993 patients for 15 years: 148 (61.7%) in children and 92 (38.3%) in adolescents. Out of 240, the most frequent types of violence were negligence in 156 (65.0%), physical 62 (25.8%), psychological/emotional aggression 52 (21.7%), Munchausen by proxy syndrome 4 (1.7%), and bullying/cyberbullying in 3 (1.3%). Out of 123, the most common pediatric chronic conditions were chronic kidney disease 24 (19.5%), human immunodeficiency virus 14 (11.4%), prematurity 9 (7.3%), cerebral palsy 8 (6.5%), and asthma 8 (6.5%). Further comparison between children versus adolescent under nonsexual violence situation revealed significant difference between the hospital referral sites. The frequency of patients under violence referred from outpatient clinics was significantly reduced in children versus adolescents (27.7 vs. 62%), whereas emergency department was higher in the former group (57.4 vs. 25.0%; p<0.001). All types of violence situations and pediatric chronic conditions were similar in both groups (p>0.05).
CONCLUSIONS
Nonsexual violence against our pediatric population was rarely diagnosed in a tertiary hospital, mainly negligence, physical, and psychological/emotional aggression. Approximately two-thirds of violence diagnosis occurred in children, referred mainly by the emergency department. In contrast, approximately one-third of violence diagnosis occurred in adolescents, referred mostly by outpatient clinics.
目的
本研究旨在评估一所三级大学医院中儿童和青少年的人际非性暴力情况。
方法
对 15 年来 240 名遭受非性暴力的患者进行了横断面研究。数据分析包括人口统计学数据、医院转介地点、非性暴力的类型和作者、法律转介、实验室和影像学检查以及结果。
结果
在 295993 名患者中，15 年内诊断出 240 例（0.1%）非性暴力情况：儿童 148 例（61.7%），青少年 92 例（38.3%）。在 240 例中，最常见的暴力类型是疏忽 156 例（65.0%）、身体暴力 62 例（25.8%）、心理/情绪攻击 52 例（21.7%）、代理孟乔森综合征 4 例（1.7%）、欺凌/网络欺凌 3 例（1.3%）。在 123 例中，最常见的儿科慢性疾病包括慢性肾脏病 24 例（19.5%）、人类免疫缺陷病毒 14 例（11.4%）、早产 9 例（7.3%）、脑瘫 8 例（6.5%）和哮喘 8 例（6.5%）。进一步比较非性暴力情况下的儿童与青少年，发现医院转介地点存在显著差异。遭受暴力的儿童患者从门诊转介的比例明显低于青少年（27.7%比 62%），而前者从急诊转介的比例更高（57.4%比 25.0%；p<0.001）。两组患者的各种暴力情况和儿科慢性疾病相似（p>0.05）。
结论
在三级医院，儿童人群中非性暴力的诊断很少见，主要为疏忽、身体和心理/情绪攻击。大约三分之二的暴力诊断发生在儿童，主要由急诊转介。相比之下，大约三分之一的暴力诊断发生在青少年，主要由门诊转介。
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