ARTICLE INFO

Article Type

Descriptive & Survey Study

Authors

Abbasi   A. (1)
Azimi   Kh. (*2)
Poorbakhtiar   M. (3)
Azimi   R. (4)






(*2) Nursing & Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran
(1) Legal Medicine Research Center, Iranian Legal Medicine Organization, Tehran, Iran
(3) Midwifery Department, Faculty of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
(4) Psychology Department, School of Psychology & Educational Sciences, Yazd University, Yazd, Iran

Correspondence

Address: Mazandaran Legal Medicine Office, End of Besat Street, Azadi Boulevard, Sari, Mazandaran, Iran. Postal code: 4814856874
Phone: +98 (11) 33398630
Fax: +98 (11) 33398630
khadijehazimi88@gmail.com

Article History

Received:  April  6, 2020
Accepted:  April 16, 2020
ePublished:  April 18, 2020

BRIEF TEXT


Childhood is one of the most important stages of life, the quality of which is directly related to the quality of life and well-being of adults [1, 2].

… [1-17]. Child abuse has different definitions in different societies; it may even vary in different parts of a community, such as a child protection centers, legal and medical communities, public health, researchers, professionals and advocates for children's rights, and even in each center over different years [18]. Each of these sections covers an aspect of child abuse as a profound and widespread phenomenon [19]. … [20].

This study was conducted to investigate child abuse cases referred to forensic medicine centers in Mazandaran province and the challenges of recording child abuse cases in forensic medicine files.

This research was a cross-sectional descriptive retrospective study.

This study was carried out on all of the referred cases of child abuse to the forensics centers of Mazandaran province in 2015 and 2016.

Sampling was done by census method and the information of all cases was extracted from the files in the archives of forensic medicine departments of Mazandaran (84 cases) and recorded.

The researcher-made form was used to extract information from the archived files. To prepare the form, first the information of 10 child abuse cases was extracted and the form was adjusted based on the most information that could be extracted from the files. In order to confirm the reliability of the information, the same 10 files were extracted by another researcher using the form and the agreement percentage was calculated to be 98%. Data were analyzed using SPSS 16 software and descriptive statistics, including absolute and relative frequency, mean and standard deviation, and presented by tables.

40 cases of child abuse in 2015 and 44 cases in 2016 and a total of 84 cases of child abuse were referred to the forensic medicine offices of Mazandaran province for examination. Out of 15 forensic medicine departments in Mazandaran province, 6 centers did not have any registered cases of child abuse during these two years. The mean total age of children was 97.08 ±45.63 months (about 8 years), the mean age of children in 2015 was 96.17 ±43.83 months and the mean age of referred children in 2016 was 97.93 ±47.74 months. The age of most cases was between 3 and 12 years. The youngest case was an 11-month-old girl and the oldest case was a 16-year-old girl. The sex of the patients referred for examination was almost equal and boys were slightly more than girls (Table 1).According to the referrals in the file, 77 cases (91.7%) from the police station, 4 cases (4.8%) from the district attorney, and 3 cases (3.6%) from the security police, police criminal investigation department, and dispute resolution council were referred for examination. The company in most cases was the mother of the child. The father accompanied the child in one-fifth of cases, and in some cases, others, such as a stepmother or aunt accompanied the child. In 44% of cases, it was not mentioned who came with the child. Only 51.2% of the reviewed cases indicated who had caused the damage. In the mentioned cases, in most cases, the child abuse of the father was reported. The mother, stepmother, and stepfather, as well as others, such as uncles, grandparents, or uncles, were among those who harmed the child. The time between the injury occurrence and the referral was not recorded according to the statements of the child or companion in about one-fourth of the files. In the cases where the distance was mentioned, most of the cases were referred less than 72 h after the occurrence (Table 2).According to the physician’s view, most of the injuries occurred during the last 2 to 5 days. Also, most of the injuries were caused by hitting a hard object. Edged/sharpened objects and hot objects or liquid were other causes of occurrence recorded in the files. Most of the damages were related to bruises and scratches (Table 3).In cases of burns, most burns were second-degree burns and the rate of burns was reported up to 3% of the body surface. The number of reported cases of pain in 2015 and 2016 were 11 and 4 cases, respectively. The most involved organs were upper limbs, face, lower limbs, trunk, and head and neck, respectively. Also, according to the physician, the most bruises and swelling were on the face, head and neck, the highest number of scratches and burns were on the upper limbs, and the highest number of pain was in the trunk (Table 4).A case of disturbance of consciousness and claiming to give medication to a child was recorded with a negative urine test. One case was seen twice for about two months as a result of two separate episodes of conflict, as well as one case of a referral by siblings simultaneously, one case of anal injuries, and one case of bruising of the gums and loose teeth were recorded.

The mean age of the referred children was about 8 years and the number of boys was slightly more than girls. In the study by Hagdon et al., the average age of children who were physically abused was 10.6 years and the number of boys was more than girls [21]. In a study by Mian et al., the age of the abused children was about 5 years and the number of boys was more than girls [22]. … [23-29].

It is recommended to conduct prospective studies on child abuse cases referred to forensic medicine.

One of the limitations of this study was the defects in the records registered in forensic medicine, which did not allow a comprehensive review of the data.

The observed physical injuries were mostly consistent with the proven patterns of child abuse. Considering the flaws in recording the information, it is necessary to develop and apply standard forms using international protocols.

The observed physical injuries were mostly consistent with the proven patterns of child abuse. Considering the flaws in recording the information, it is necessary to develop and apply standard forms using international protocols.

None to declare.

This research was carried out with the permission of the Ethics Committee of the Forensic Medicine Organization (15852-162781).

This project was funded by the Forensic Medicine Research Center.

TABLES and CHARTS

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