بررسي كودك آزاري جسماني در مراجعان سه درمانگاه تخصصي اورژانس كودكان در شهرستان تهران

Physical Child-abuse in Tehran ,Iran

Child-abuse (physical, mental and sexual) is considered as one of the important problems faced by persons specialized in behavioral Sciences and Forensic Medicine, physicians and pediatricians. This cross-sectional study was conducted to determine the status of physical child-abuse in Tehran. Forty-five pediatric residents, trained for this purpose, conducted this ten-day study in three teaching hospitals (Childrenʹs Medical Center, Bahrami Hospital, Hazrat Ali-Asghar Hospital). A questionnaire on physical child-abuse, designed and proposed by the WHO, was completed for 3019 children (male =1578, 52.3%; female =1441, 47.7%) less than 18 years of age, who attended the emergency department of the above hospitals. The children and their parents were interviewed and physical examination .was performed for the children. A total of 347 children (male=14.5%, female =9.6%), which is 12.2% of the total number of children studied, were physically abused. Injuries were mostly present on the face, upper extremities, back and lower extremities, among which 12.8% of the cases were severe and 87.2% were moderate in intensity. Fathers and mothers were responsible for 51.2% and 34.1% of the cases of child-abuse respectively. Among the persons responsible for causing child-abuse, 34.1% had themselves been physically abused during their childhood period and 26.4% had physically abused children before. Hyperactivity, bed-wetting and an unwanted child were among the most common causes of child-abuse. Factors precipitating child-abuse included: large numbers of children in the family drug addiction of one of the family members, and acute or severe psychological stress during the past 6 months. Using the Chi-square test, a significant relationship (P value =0.001) was found to exist between physical child-abuse and demographic factors such as age, sex, site of residence, history of divorce or separation of the parents and history of physical abuse in the parentsʹ childhood days.