ÇOCUK VE ERGENLERDE CİNSEL KÖTÜYE KULLANIM VE HEMŞİRELİK YAKLAŞIMLARI Şeyda DÜLGERLER

Öz

Çocuk ve ergenin cinsel kötüye kullanımı, yetişkin bir kimsenin cinsel arzuları ve gereksinimi için çocuk veya ergeni, cinsel bir nesne olarak kullanması olarak tanımlanmaktadır. Cinsel kötüye kullanımının çocuk ve ergenlerde çeşitli olumsuz sonuçları vardır. Cinsel kötüye kullanımın olası sonuçları; cinsellik üzerine etkiler, emosyonel etkiler, depresif duygudurum, anksiyete, davranışsal etkiler, kişilik değişiklikleri ve diğer etkilerdir. Bu yazıda cinsel kötüye kullanıma uğramış çocuklar ve ergenlerdeki belirtiler, bulgular, olası sonuçlar,önleme ve hemşirelik yaklaşımları gözden geçirilmiştir. Cinsel kötüye kullanımın çocuk ve ergen üzerine etkilerini bilmek; değerlendirme, önleme, tedaviyi planlama ve uygun hemşirelik yaklaşımları geliştirmede önemlidir

Anahtar Kelimeler

• Cinsel kötüye kullanım,çocuk ve ergen,hemşirelik yaklaşımları

SEXUAL ABUSE OF CHILDREN AND ADOLESCENTS AND NURSING APPROACH

Öz

Child and adolescent sexual abuse is defined as the use of a child or an adolescent as an object of gratification for adult sexual needs and desires. There are a variety of negative consequences of sexual abuse for child and adolescents. The possible consequences of sexual abuse are sexualizing effects, emotional effects, depressed mood, anxiety, behavioral effects, personality alterations and other effects. In this article, we reviewed symptoms, findings, possible consequences and prevention in children and adolescents who had sexual abuse. Understanding of the consequences of sexual abuse on child and adolescent is important for assessment, prevention, therapeutic planning and nursing approach

Anahtar Kelimeler

• Sexual abuse,child and adolescent,nursing approach

Kaynakça

1. Adams J, McClellan J, Douglass D, McCurry C, Storck M. (1995). “Sexually İnappropriate Behaviors İn Seriously Mentally İll Children And Adolescents”. Child Abuse Negl;19:555-68.
2. Beitchman JH, Zucker KJ, Hood JE, DaCosta GA, Akman D, Cassavia E. A(1992) “Review Of The Long-Term Effects Of Child Sexual Abuse”. Child Abuse Negl;16:101- 18.
3. Beitchman JH, Zucker KJ, Hood JE, DaCosta GA, Akman D. A(1991) “Review Of The Short Term Effects Of Child Sexual Abuse”. Child Abuse Negl;15:537-56.
4. Bifulco A, Brown GW, Adler Z. (1991) “Early Sexual Abuse And Clinical Depression İn Later Life”. Br J Psychiatry: 159:115-22.
5. Briere J, Zaidi LY.( 1989) “Sexual Abuse Histories And Sequelae İn Female Psychiatric Emergency Room Patients”. Am J Psychiatry; 146:1602-6.
6. Canat S.(1994). “Ergenlerde Aile İçi Cinsel Taciz”. Çocuk ve Gençlik Ruh Sağlığı Dergisi;(1):18-22.
7. Chu JA, Dill DL.( 1990) “Dissociative symptoms in relation to childhood physical and sexual abuse”. Am J Psychiatry; 147:887-92.
8. Deblinger E, McLeer SV, Atkins M, Ralphe D, Foa E.( 1989). “Post-truamatic stress in sexually abused, physically abused, and nonabused children”. Int J Child Abuse Negl: 13 (3):403-8.

9. Elliott DJ, Tarnowski KJ.( 1990) “Depressive characteristics of sexually abused children”. Child Psych Hum Dev; 21:37-48.
10. Everson MD, Boat BW.(1990) “Sexualized doll play among young children: implications for the use of anatomical dolls in sexual abuse evaluations”. J Am Acad Child Adolesc Psychiatry: 29 (5):736-42.
11. Fergusson DM, Horwood LJ, Lynskey MT.(1996) “Childhood sexual abuse and psychiatric disorder in young adulthood: II. Psychiatric outcomes of childhood sexual abuse”. J Am Acad Child Adolesc Psychiatry; 35(10):1365-74.
12. Fergusson DM, Lynskey MT, Horwood LJ.(1996) “Childhood sexual abuse and psychiatric disorder in young adulthood: I. Prevalance of sexual abuse and factors associated with sexual abuse”. J Am Acad Child Adolesc Psychiatry; 35(10):1355-64.
13. Finkelhor D, Hotaling G, Lewis IA, Smith C.(1990) “Sexual abuse in a national survey of adult men and women: prevalence, characteristics, and risk factors”. Child Abuse Negl;14 (1):19-28.
14. Fothergill J.(1994) Çocuğun kötüye kulllanımı. Pediyatrik İleri Yaşam Desteği II. Bozkurt K (çev.). İstanbul: Turgut Yayıncılık ve Tic.A.Ş, 233-42, 1994.
15. Friedrich WN, Grambsch P, Damon(1992). The child sexual behavior inventory: normative and clinical findings. Psychol Asses; 4:303-11.
16. Foye HR, Sulkes ZB. Sexual abuse. Behrman RE, Kliegman RM (ed.)( 1994). Nelson Essentials of Pediatrics. Second edition, Philadelphia: W.B.Saunders Company,: 81- 83.
17. Green AH.(1993) Child sexual abuse: immediate and long-term effects and interventions. J Am Acad Child Adolesc Psychiatry, 32 :890-902.
18. Heins T, Gray A, Tennant M.(1990) Persisting hallucinations following childhood sexual abuse. Aust NZ J Psychiatry, 24:561-65.
19. Hibbard RA, Brack CJ, Rauch S, Orr DP.(1988) Abuse, feelings and health behaviors in a student population. Am J Dis Child;142:326-330.
20. Hooper PD. (1990). Psychological sequelae of sexual abuse in childhood. Br J Gen Pract.; 40 (330):29-31.
21. Hymel KP, Jenny C.(1996). Child sexual abuse. Pediatrics in Review; 17 (7):236-49.
22. Kaplan HI(1994) . Sexual abuse. Kaplan and Saddock's Synopsis of Psychiatry, Kaplan HI, Saddock B (ed.). 7 th edition, Williams and Wilkins, Baltimore,1788-95.
23. Kohan MJ, Pothier P, Norbeck JS.(1987). Hospitalized children with a history of sexual abuse: incidence and care issues. Am J Orthopsychiatry; 57:258-64.
24. Kolko DJ, Moser JT, Weldy SR.(1988) Behavioral-emotional indicators of sexual abuse in child psychiatric inpatients: a controlled comparison with physical abuse. Child Abuse Negl; 12(4):529-41.
25. Koten Y, Tuğlu C, Abay E.(1996). Üniversite öğrencileri arasında ensest bildirimi. Özşahin A (yayın sorumlusu) XXXII Ulusal Psikiyatri Kongresi: Eylül 25-28; Ankara. GATA Basımevi1996;154.
26. McClellan J, McCurry C, Ronnel M, Adams J, Eisner A, Strorck M.(1996) Age onset of sexual abuse. Relationship to sexually inappropriate behaviors. Am Acad Child Adolesc Psychiatry:35(10):1375-83.
27. Monck E, Bentovim A, Goodall G, Hyde C, Lwin R, Sharland E.(1993) Child sexual abuse: A descriptive and treatment study. London: Her Majesty's Stationery Office.
28. Mullen PE, Martin JL, Anderson JC, Romans SE, Herbison GP.(1993) Childhood sexual abuse and mental health in adult life. Br J Psychiatry; 163:721-732.
29. Rogers CN, Terry T.(1984). Clinical interventions with boy victims of sexual abuse. Stuart IR and Greer JR (ed.). Victims of Sexual Aggression: Treatment of children, Women and Men .Newyork: Van Nostrand Reinhold press.
30. Romans S.(1995). Sexual abuse in childhood and deliberate self-harm. Am J Psychiatry;152:1336-42.
31. Sedney MA, Brooks B.(1984) Factors associated with a history of childhood sexual experience in a nonclinical female population. J Am Acad Child Psychiatry. 23: 215- 18.
32. Silk K.(1995).Borderline personality disorder symptoms and severity of sexual abuse. Am J Psychiatry;152:1059-64.
33. Singer MI, Patchers MK, Hussey D.(1989). The relationship between sexual abuse and substance abuse among psychiatrically hospitalized adolescents. Child Abuse Negl: 13(3):319-25.
34. Smith M, Bentovim A. Sexual abuse. Rutter M, Taylor E, Hersov L (ed.)(1994). Child and Adolescent Psychiatry. Third Edition, Newyork: Science Ltd, 230-43.
35. Stein M, Walker J, Anderson G.(1996). Childhood physical and sexual abuse and with anxiety disorders and in a community sample. Am J Psychiatry:153:275-77.
36. Summit RC.(1983). The child sexual abuse accommodation syndrome. Child Abuse and Negl; 7: 177-93.
37. Wurtele SK, Currien LL, Gillespie EI, Fraklin CF. (1987). The efficacy of a parent- implemented program for teaching preschoolers personal safety skills. Behaviour Therapy; 22:69-83.
38. Yalın A.(1995). Okul öncesi çocuklarda cinsel istismarı önleme programı. Çocuk ve Gençlik Ruh Sağlığı Dergisi; 2(1):19-27.
39. Yates A.(1991). Childhood Sexuality. Lewis M (ed.). Child and Adolescent Psychiatry. Baltimore, Williams and Wilkins, 195-215.