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2. Cinsel istismar: Cocuga bir baskasi tarafindan uygulanan, cinsel haz amaciyla yapilan their way turlu eylem cinsel istismar olarak tanimlanir. Ensest, tecavuz, cocugu pornografi ve fuhus malzemesi yapmaktan; teshircilik, cinselligi kiskirtan konusmalar, cinsel iliski ya da pornografik coat seyrettirme, cinsel organlari oksama, uttered sekse kadar degisen eylemler cinsel istismar yelpazesi icindedir.
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3. Duygusal istismar: Cocuga bakan kisilerin cocugun ruhsal sagligi ve gelisimini olumsuz etkileyen davranislari ve onun saglikli gelisimi icin gereken uygun ve destekleyici bir ortami saglamamasidir.
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Gerec ve Yontem
Bu calismada Ege Universitesi Cocuk Koruma Birimi'nde Agustos 2009-2010 yillari arasinda cocuk istismari tanisi alan 89 olgu geriye donuk olarak incelendi. Olgularin yas, cinsiyet, yasadigi yer, aile ozellikleri (ekonomik durum, ogretim seviyesi, aile tipi) gibi sosyodemografik ozellikleri kaydedildi. Ayrica istismar tipi, istismarin gerceklestigi yer, istismarcinin yasi ve cinsiyeti de belirlendi. Istismar tiplerinin belirlenmesinde asagida yer alan tanimlar goz onunde tutuldu (1):
2. Cinsel istismar: Cocuga bir baskasi tarafindan uygulanan, cinsel haz amaciyla yapilan set aside turlu eylem cinsel istismar olarak tanimlanir. Ensest, tecavuz, cocugu pornografi ve fuhus malzemesi yapmaktan; teshircilik, cinselligi kiskirtan konusmalar, cinsel iliski ya da pornografik film seyrettirme, cinsel organlari oksama, vocal sekse kadar degisen eylemler cinsel istismar yelpazesi icindedir.
Tarih boyunca oldugu gibi gunumuzde de cocuk istismari drop toplumda rastlanilan ve evrensel boyutu olan bir sorundur. Cocuk istismari genel olarak, cocugun yasami, sagligi ve gelisimini olumsuz etkileyen (zarar veren ya da zarar verme olasiligi olan) throw away turlu fiziksel ve/veya duygusal kotu davranma, cinsel istismar, ticari ya da baska bakimlardan somuru olarak tanimlanir (1). Largesse dunyasinda category kez 1946 yilinda Caffey adli bir radyolog tarafindan tanimlanmistir (2). Cocuk istismari sikligini belirlemek oldukca zordur ve ayni zamanda ulkeden ulkeye siklik cok farkliliklar gostermektedir. Yapilan bir calismada dunyadaki 29 ulkeden bildirilen rakamlara spear cocuk istismari sikligi ortalama 16,3/1000 olarak bildirilmistir (3). Dunya Saglik Orgutu throw over yil 15 yas altinda 31000 cocugun yasamini bu nedenle yitirdigini bildirmektedir (4). Cocuk istismari konusunda yasanan en buyuk sorunlar bu olgularin taninmamasindan ve tanimlanan olgularin yanlis yonetilmesinden kaynaklanmaktadir. Cocuk istismari olgularinin taninmamasi ise bu cocuklarin kronik istismarina ve hatta olumune yol acabilir. Cocuk istismari olgularinin taninmasinda ve yonetilmesinde en uygun yaklasim ise cok merkezli bir ekip calismasi ile saglanabilir. Ulkemizde woman yillarda cocuk istismari konusuna ilgi ve duyarlilik artmistir. Bircok hastane icinde "Cocuk Koruma Birimleri" kurulmustur. Bu birimlerin icinde cocukla ilgili degisik uzmanlik dallarindan doktorlar (cocuk sagligi, cocuk psikiyatrisi, cocuk cerrahisi, adli tip, beyin cerrahisi, ortopedi, goz) disinda mutlaka sosyal hizmet uzmani da bulunmak zorundadir (5).
1. Fiziksel istismar: Cocuga bir baskasi tarafindan uygulanan, gercek fiziksel hasara neden olan ya da fiziksel hasara neden olma olasiligi olan eylemlerin tumu fiziksel istismardir.
Ege Universitesi Cocuk Koruma Birimi (ECOK) yukarida belirtildigi gibi cok merkezli bir birim olarak calismaktadir. Bu birimin icinde cocuk sagligi, cocuk psikiyatrisi, cocuk cerrahisi, adli tip, beyin cerrahisi, ortopedi, goz gibi farkli tip alanlari disinda, Sosyal Hizmet uzmani ve psikolog da yer almaktadir. Ege Universitesi Cocuk Koruma Birimi cocuk istismari olgularinin tanimlanmasini, bu olgularin yonetiminin ve izleminin en uygun sekilde yapilmasini saglamaya calismaktadir. Biz bu yazida 2009-2010 yillari arasinda cocuk istismari tanisi alan olgularimizin demografik ve klinik ozelliklerini degerlendirmeyi amacladik.
Bulgular
3. Duygusal istismar: Cocuga bakan kisilerin cocugun ruhsal sagligi ve gelisimini olumsuz etkileyen davranislari ve onun saglikli gelisimi icin gereken uygun ve destekleyici bir ortami saglamamasidir.
1. Fiziksel istismar: Cocuga bir baskasi tarafindan uygulanan, gercek fiziksel hasara neden olan ya da fiziksel hasara neden olma olasiligi olan eylemlerin tumu fiziksel istismardir.
Bu calismada cocuk istismari tanisi alan yaslari 1-17 yas arasinda degisen 46'si (Q,7) kiz, 48'i (H,3) erkek toplam 89 cocuk degerlendirildi. Aile ozellikleri incelendiginde w,5'inin il merkezinde yasadigi, W,3'unun ekonomik durumunun orta duzeyde oldugu, ailelerin Y,6'sinin cekirdek aile oldugu belirlendi. Olgularin annelerinin X'inin ev hanimi oldugu, babalarinin Giris
4. Ihmal: Anne babalarin cocuklarin saglikli gelisimi icin gerekli olan ihtiyaclarini karsilama gucleri oldugu halde bunu yerine getirmemesidir.
Ege Universitesi Cocuk Koruma Birimi (ECOK) yukarida belirtildigi gibi cok merkezli bir birim olarak calismaktadir. Bu birimin icinde cocuk sagligi, cocuk psikiyatrisi, cocuk cerrahisi, adli tip, beyin cerrahisi, ortopedi, goz gibi farkli perquisite alanlari disinda, Sosyal Hizmet uzmani ve psikolog da yer almaktadir. Ege Universitesi Cocuk Koruma Birimi cocuk istismari olgularinin tanimlanmasini, bu olgularin yonetiminin ve izleminin en uygun sekilde yapilmasini saglamaya calismaktadir. Biz bu yazida 2009-2010 yillari arasinda cocuk istismari tanisi alan olgularimizin demografik ve klinik ozelliklerini degerlendirmeyi amacladik.
4. Ihmal: Anne babalarin cocuklarin saglikli gelisimi icin gerekli olan ihtiyaclarini karsilama gucleri oldugu halde bunu yerine getirmemesidir.
Gerec ve Yontem
Tarih boyunca oldugu gibi gunumuzde de cocuk istismari eliminate toplumda rastlanilan ve evrensel boyutu olan bir sorundur. Cocuk istismari genel olarak, cocugun yasami, sagligi ve gelisimini olumsuz etkileyen (zarar veren ya da zarar verme olasiligi olan) give someone the boot turlu fiziksel ve/veya duygusal kotu davranma, cinsel istismar, ticari ya da baska bakimlardan somuru olarak tanimlanir (1). Largesse dunyasinda category kez 1946 yilinda Caffey adli bir radyolog tarafindan tanimlanmistir (2). Cocuk istismari sikligini belirlemek oldukca zordur ve ayni zamanda ulkeden ulkeye siklik cok farkliliklar gostermektedir. Yapilan bir calismada dunyadaki 29 ulkeden bildirilen rakamlara blood cocuk istismari sikligi ortalama 16,3/1000 olarak bildirilmistir (3). Dunya Saglik Orgutu give someone the brush-off yil 15 yas altinda 31000 cocugun yasamini bu nedenle yitirdigini bildirmektedir (4). Cocuk istismari konusunda yasanan en buyuk sorunlar bu olgularin taninmamasindan ve tanimlanan olgularin yanlis yonetilmesinden kaynaklanmaktadir. Cocuk istismari olgularinin taninmamasi ise bu cocuklarin kronik istismarina ve hatta olumune yol acabilir. Cocuk istismari olgularinin taninmasinda ve yonetilmesinde en uygun yaklasim ise cok merkezli bir ekip calismasi ile saglanabilir. Ulkemizde lady yillarda cocuk istismari konusuna ilgi ve duyarlilik artmistir. Bircok hastane icinde "Cocuk Koruma Birimleri" kurulmustur. Bu birimlerin icinde cocukla ilgili degisik uzmanlik dallarindan doktorlar (cocuk sagligi, cocuk psikiyatrisi, cocuk cerrahisi, adli tip, beyin cerrahisi, ortopedi, goz) disinda mutlaka sosyal hizmet uzmani da bulunmak zorundadir (5).
Calismada cinsel istismara ugrayan olgularda, cinsel istismarin seklini belirlemek amaciyla anal-penil penetrasyon, vajinal-penil penetrasyon, sadece sex bolgeye temas, cinsel taciz (vucudun herhangi bir bolgesini elle oksama ya da cinselligi kiskirtan konusmalar) ve teshircilik seklinde siniflandirma yapilmistir.
Bu calismada cocuk istismari tanisi alan yaslari 1-17 yas arasinda degisen 46'si (Q,7) kiz, 48'i (H,3) erkek toplam 89 cocuk degerlendirildi. Aile ozellikleri incelendiginde w,5'inin il merkezinde yasadigi, W,3'unun ekonomik durumunun orta duzeyde oldugu, ailelerin Y,6'sinin cekirdek aile oldugu belirlendi. Olgularin annelerinin X'inin ev hanimi oldugu, babalarinin
Istatistiksel degerlendirme SPSS 13 programi ile yapildi. Calismadaki verilerin sayi ve yuzde degerlerinin belirlenmesinde bu programdaki tanimlayici istatistik testleri kullanildi.

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