Çocuk İstismarı ve İhmali Sonrası Psikolojik Sağlamlık: Koruyucu Faktörlere Dair Sistematik İnceleme

Öz

Çocuk istismarı ve ihmali yaşantıları ruh sağlığı üzerinde bozucu etkiler yaratsa da koruyucu faktörlerin varlığı bireylerin psikolojik sağlamlığına olumlu katkı sağlayabilmektedir. Bu sistematik gözden geçirmenin amacı, çocuk istismarı ve ihmali sonrası psikolojik sağlamlıkla ilişkili koruyucu faktörlere genel bir bakış açısı sağlamak ve seçilen çalışmaların yöntemsel niteliklerini ve genel özelliklerini özetlemektir. Bu çalışmada PRISMA-P rehberi göz önünde bulundurulmuştur. Çalışmaların yöntemsel niteliklerinin değerlendirilmesi için Nitelik Değerlendirme Kontrol Listesi oluşturulmuştur. Alan yazın taraması Ocak 2016 ile Temmuz 2021 tarihleri arasında yayınlanan çalışmalara erişmek için üç veri tabanında (PubMed, Ulakbim ve Web of Science) İngilizce ve Türkçe dillerinde yapılmıştır. İlk taramada veri tabanlarından 4094 makaleye erişilmiştir ve dört makale ulaşılan makalelerin kaynakçalarından yararlanılarak eklenmiştir. Tüm makaleler dâhil edilme ve dışlama kriterlerine göre incelenerek toplam 39 çalışma gözden geçirmeye dâhil edilmiştir. Ele alınan çalışmaların niteliği oluşturulan kontrol listesi ile incelenmiştir. Koruyucu faktörler ise ekolojik yaklaşım ve çocuk istismarı ve ihmali sonrası psikolojik sağlamlığı inceleyen öncül araştırmaların kavramsal temellerine göre sınıflandırılarak (bireysel, ailesel/ilişkisel, çevresel/toplumsal) incelenmiştir. Sonuçlara göre, araştırmaların çoğunluğu orta düzey niteliktedir. Çocuk istismarı ve ihmali sonrası genç yetişkinlik ve yetişkinlik dönemlerinde koruyucu rolü en sık araştırılan ve tutarlı şekilde anlamlı bulunan değişkenler bireysel faktörlerden psikolojik sağlamlık puanı ve ailesel/ilişkisel faktörlerden algılanan sosyal destektir. Çevresel/toplumsal faktörlerin koruyucu rolü az sayıda araştırmada ele alınmıştır. Yalnızca cinsel istismarı ele alan görece az sayıda araştırmada bireysel, ailesel/ilişkisel ve çevresel/toplumsal koruyucu faktörlerin psikolojik sağlamlığa katkısı anlamlı bulunmamıştır. Çocuk istismarı ve ihmali yaşayanlarda psikolojik sağlamlığa dair koruyucu faktörler incelenirken çevresel/toplumsal faktörlerin daha çok araştırılması ve cinsel istismarın ayrı tutulması önerilmektedir.

Anahtar Kelimeler

• Çocuğa yönelik kötü muamele
• olumsuz çocukluk yaşantıları
• koruyucu faktörleri
• psikolojik sağlamlık
• sistematik derleme
• nitelik değerlendirmesi

Resilience after Child Abuse and Neglect: A Systematic Review of Protective Factors

Öz

Despite their harmful effects on mental health, experiences of child abuse and neglect can be influenced by protective factors that contribute to psychological resilience. This systematic review of protective factors associated with psychological resilience after child abuse and neglect summarizes the methodological quality and general characteristics of selected studies. The PRISMA-P guide and a qualitative assessment control list were used to assess the methodological quality of the studies. Three databases (PubMed, Ulakbim, and Web of Science) were searched in English and Turkish to identify studies published between January 2016 and July 2021. We identified 4094 articles in the initial search. Four additional articles were included using references from these articles. Thirty-nine studies were included based on inclusion and exclusion criteria. The quality of the studies was assessed with the developed control list. Protective factors were classified according to the conceptual foundations of preceding studies that examined resilience after child abuse and neglect using an ecological approach (individual, family/relational, environmental/community). Most of the included research was of moderate quality. The most frequently studied variables consistently found to have a protective role in individuals with a history of child abuse and neglect during young adulthood and adulthood were resilience scores from individual factors and perceived social support from family/relational factors. A limited number of studies addressed the protective role of environmental/community factors. In relatively few studies that focused only on child sexual abuse, the contributions of individual, family/relational, and environmental/community protective factors to resilience were not significant. Based on our results, it is recommended to examine environmental/community factors and consider child sexual abuse separately when investigating protective factors related to resilience in individuals who have experienced child abuse and neglect.

Anahtar Kelimeler

• Child maltreatment
• adverse childhood experiences
• protective factors
• resiliency
• systematic review
• quality assessment

Kaynakça

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