Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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A multidisciplinary approach for the treatment of child abuse in Korea

병원 기반 학대아동보호팀의 20년간의 활동 경험

  • Song, Bong Kyu (Department of Emergency Medicine, College of Medicine Seoul National University) ;
  • Kim, Do Kyun (Department of Emergency Medicine, College of Medicine Seoul National University) ;
  • Park, Hye Young (Child Protection Team, Seoul National University Children's Hospital) ;
  • Hwang, Jun Won (Department of Psychiatry, College of Medicine Seoul National University) ;
  • Kwak, Young Ho (Department of Emergency Medicine, College of Medicine Seoul National University)
  • 송봉규 (서울대학교 의과대학 응급의학교실) ;
  • 김도균 (서울대학교 의과대학 응급의학교실) ;
  • 박혜영 (서울대학교 어린이병원 학대아동보호팀) ;
  • 황준원 (서울대학교 의과대학 정신과학교실) ;
  • 곽영호 (서울대학교 의과대학 응급의학교실)
  • Received : 2009.06.04
  • Accepted : 2009.10.08
  • Published : 2009.11.15
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Abstract

Purpose:To review and determine the complications in 76 child abuse cases recorded by a multidisciplinary hospital-based child protection team between 1987 and 2007. Methods:We retrospectively reviewed the reports and medical records of child abuse cases maintained by a university hospital-based child protection team. We devised a questionnaire for standardized interviews with the victims' guardians to determine the current physical and mental status of the children; questionnaires were answered by social workers of the child protection team who interviewed the present fosterers of 24 (35.8%) children. Results:Of the 76 children, 6 were infants, 10 were 1-3 years old, were 3-10 years old, and 19 were over 10 years old. Seven children (9.2%) were neglected and 27 (35.5%) and 44 (57.9%) were sexually and physically abused, respectively. In more than half of the cases, the perpetrators were the father or mother of the children. Most children (41 cases, 53.9%) were abused at their homes. The mean follow-up duration from the time of abuse infliction was $54.3{\pm}49.2$ months, and the current mean age of the children was $8.3{\pm}6.4$ years. Moderate and severe developmental delay and physical disability were observed in 6 (25.0%) and 3 (12.5%) cases, respectively. In 13 children (54.2%), the Global Assessment of Functioning Scale (GAF) score was less than 60, which indicates mild mental disability. Conclusion:A hospital-based child protection team may witness the different proportion of abuse types and patterns by conducting a nation-wide survey of child abuse cases.

목 적:학대아동보호팀은 아동학대 의심 사례를 평가/판정하고, 이를 아동보호전문기관이나 경찰에 신고하는 역할을 하는 병원 내 기관이다. 연구자들은 1개 병원 학대아동보호팀에서 20년간(1987-2007) 경험한 76건의 사례를 분석하여 학대 아동의 현황과 후유증을 알아보고자 하였다. 방 법:학대아동보호팀의 사례 기록과 의무기록, 아동보호전문기관의 기록을 함께 분석하였으며, 별도 제작한 양식에 맞추어 현재 보호자들과 사회복지사의 인터뷰를 통해 후유증을 조사하였다. 결 과:총 76건(남아 28명, 여아 48명)의 사례 중, 연령별로는 1세 미만이 6명(7.9%), 1-3세 10명(13.2%), 3-10세 41명(53.9%), 10세 이상 19명(25.0%)이었다. 학대 유형별로는 방임이 9건(11.8%), 성학대 27건(35.5%), 신체학대 44건(57.9%)이었다. 가해자는 친부모가 절반 이상이었으며, 학대 장소는 가정 내가 41건(53.9%)으로 가장 많았다. 총 24명(31.6%)의 아동들에 대하여 후유증에 대한 답변을 받았으며, 평균 추적 기간은 58.5개월이었고 평균 연령은 $8.3{\pm}6.4$세이었다. 이들 중 중등도 이상의 발달장애와 신체적 후유증을 보이는 아이가 각각 6명(25.0%), 3명(12.5%)이었으며, 정신과적 후유증을 총괄 기능 평가 척도(GAF)로 판정하였을 때 가벼운 우울증과 사회적/직업적 기능의 약간의 곤란을 의미하는 70-61보다 악화된 아이들이 13명(54.2%)이었다. 결 론:병원에 기반한 학대아동보호팀이 개입할 아동학대 사례는 전국 범위의 아동학대 사례들과 차이가 있을 수 있다. 이러한 차이점을 감안하여 보다 효과적으로 병원에서 발견, 신고되는 아동학대 사례에 대처하기 위한 노력이 필요하다.

Keywords

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