egehfd Ege Üniversitesi Hemşirelik Fakültesi Dergisi 2147-3463 2667-6648 Ege Üniversitesi ÇOCUK CİNSEL İSTİSMARINA PSİKODİNAMİK BAKIŞ AÇISI VE HEMŞİRELİK YAKLAŞIMI Gülseren KESKİN PSYCHODINAMIC ASPECTS OF CHILD SEXUAL ABUSE Keskin Gülseren Ege Üniversitesi İzmir Atatürk Sağlık Yüksekokulu, 35100 Bornova/İZMİR Çam Olcay Ege Üniversitesi Hemşirelik Yüksekokulu, 35100 Bornova/İZMİR 01 01 2005 21 2 191 208 Copyright © 2011, Ege Üniversitesi Hemşirelik Fakültesi Dergisi 2011 Ege Üniversitesi Hemşirelik Fakültesi Dergisi

Psikiyatri hemşiresi, travma sonucu acı çeken bireylerle sık sık karşı karşıya kalır. Psikiyatri hemşiresi mağdur ve geride kalanlara terapötik bakım vermede önemli bir role sahiptir. Bu gözden geçirme yazısında çocukluk çağı cinsel istismarı yaşamış bireylerde hemşirenin danışmanlık rolünü açıklamak amaçlanmaktadır. Bu gözden geçirme yazısında çocukluk çağı cinsel saldırısı son literatürlere dayanılarak değerlendirilmiş ve yaygınlığı, risk faktörleri, çocuk üzerindeki psikodinamik etkileri, terapötik girişimler yeni bulgulara dayanılarak özetlenmiştir. Cinsel istismar çocuklarda akut psikiyatrik semptomlara yol açabilmektedir, yetişkinlik döneminde istismarın tıbbi ve psikiyatrik spekturumda yer alabilen etkileri olabilmektedir. Terapist hemşirenin psikolojik desteği, travmaya uğramış çocuk için bütüncül bakım açısından önemlidir. Çocukluk çağı cinsel istismarında travmatik dinamiğin ve sonraki döneme yansıyan etkilerinin anlaşılması, çocuğun kendini açması ve girişimlerin planlanması sırasında terapist hemşireye yaklaşımda kolaylık sağlar. Cinsel travmanın pek çok psikopatolojik sonuçları vardır, fakat psikopatoloji üzerindeki etkisi, çocuğun psikodinamik yapısını bütünüyle bozmaz. Bununla birlikte psikodinamik yapıda iyileşmenin sağlanmasıyla birlikte cinsel istismarın psikopatolojisi azalma eğilimi göstermektedir

Psychiatric nurses are confronted oftenly with individuals who are suffering from the consequences of trauma. Psychiatric nurses have a genuine role in offering therapeutic care to victims and survivors. The aim of this paper is to review the nurse's role in counselling survivors of child sexual abuse. In this review, we examine the most recent literature on child sexual assault, and summarize new findings regarding prevalence, risk factors, psychodinamic effect on child and therapeutıcs interventions. Sexual abuse is associated with acute psychiatric symptomatology in children, possible effects of abuse on health in adult life and may progress to a spectrum of psychiatric post-traumatic stress disorder and medical disorders in adults. Psychological support by Therapist nurse are important in comprehensive care of traumatized child. Understanding the traumagenic dynamics of childhood sexual abuse and its after effects provides direction for the nurse therapist during both the child's disclosure and intervention planning. Sexual trauma status was associated with most of the psychopathology outcomes, but its impact on psychopathology was largely unmoderated by child psychodinamic structure. In addition to this the increased well-being of the child’s psychodinamic structure was generally associated with lower psychopathology for sexual abuse sample

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