Amaç: Cinsel saldırı mağdurlarının sosyodemografik özellikleri, saldırı çeşidi, adli muayene bulguları ve aralarındaki ilişkinin değerlendirilmesidir. Gereç ve Yöntemler: Çalışmada, Etlik Zübeyde Hanım Sağlık Uygulama Araştırma Merkezi Acil Servisi'ne 1 Ocak 2014-30 Kasım 2017 tarihleri arasında adli makamlarca cinsel saldırı şüphesiyle gönderilen 18 yaş ve üzerindeki bireylerin geriye dönük bir şekilde incelenmesi esas alınmıştır. Hasta dosyaları ve adli raporları araştırmacılar tarafından tasarlanan bir form aracılığıyla değerlendirilmiştir. Bulgular: Çalışma kapsamında bildirilen 92 bireyden, araştırmacılar tarafından belirlenen kriterleri sağlayan 80 olgu çalışmaya dâhil edilmiştir. Bildirilen bireylerin tamamının kadın olduğu, %31,3'ünün ise bekâr olduğu saptanmıştır. Minimum yaşın 18, maksimum yaşın 68 ve ortalama yaşın 28,21±10,15 yıl olduğu belirlenmiştir. Cinsel saldırıların %56,2'sinin failin evinde veya aracında gerçekleştiği, bireylerin %32,5'inin saldırıdan 48 saat sonra bildirim yaptığı görülmüştür. Bireylerin %70'inde failin tanıdık, %10'unda failin birden fazla olduğu saptanmıştır. Mağdurların %85'i ile muayene öncesinde psikolojik ilkyardım görüşmesinin yapıldığı belirlenmiştir. Bu çalışmanın bulguları, evli mağdurların daha fazla tekrarlayan saldırıya, bekâr mağdurların ise daha yüksek düzeyde penetrasyon bulgusuna sahip olduğunu ortaya koymuştur. Yabancıya göre tanıdık saldırgan mağduru olmanın daha yüksek düzeyde tekrarlayan saldırı ile ilişkili olduğu saptanmıştır. Mağdurun yaşının cinsel saldırı çeşidi ve muayene bulgularıyla ilişkisiz olduğu belirlemiştir. Sonuç: Cinsel saldırı vakalarının gözden kaçırılması, mağdura ihtiyacı olan yardımı sunamama, şiddetin tekrar etmesine hatta dozajının artmasına neden olabilmektedir. Acil servisler cinsel şiddeti belgelendirme ve önlemede kilit role sahip kurumlardan biridir. Bulgular, cinsel saldırılarda faillerin sıklıkla mağdurların tanıdığı kişiler olduğunu, evli mağdurların bekârlara göre daha yüksek oranda tekrarlayan saldırıya maruz kaldığını ortaya koyması açısından önemlidir. Adli muayene işleminin multidisipliner yaklaşımla ele alınması, delillerin sağlıklı bir şekilde toplanmasının yanı sıra muayene sonrası mağdurun yaşamını planlamasına yardımcı olacaktır.
Anahtar Kelimeler: Adli tıp; jinekolojik muayene; psikolojik travma; cinsel saldırı
Objective: The aim of the study was to evaluate the sociodemographic characteristics of victims of sexual assault, types of assault, findings of the forensic examination and their relationship between them. Material and Methods: The study is based on a retrospective analysis for the cases of 18 years and older sent by the judicial authorities on the suspicion of sexual assault between January,1 2014-November 30, 2017 to the Emergency Services of Etlik Zübeyde Hanım Health Practice & Research Center. The patient files and the judicial reports were evaluated through a form designed by researchers. Results: The study consist of 80 cases of 92 reported cases meeting the criteria defined by the researchers. It has been determined that all of the reported cases were female, and 31.3% of them were single. The minimum age was 18, the maximum age was 68, and the mean age was 28.21±10.15. 56.2% of the sexual assaults occurred in the home or car of the perpetrator and 32.5% of the cases were reported 48 hours after the assault. The perpetrator was acquainted in 70% of the cases, and 10% of the cases involved more than one perpetrator. 85% of the victims have had psychological first aid interview before the forensic examination. Findings of this study show that the married victims were more likely to involve multiple episodes of assaults, and the singles were more likely to have penetration findings. Sexual assault by acquaintances, compared with strangers were more likely to involve multiple episodes. Age of victims was not associated with sexual assault type and examination findings. Conclusion: Oversight of sexual assault cases, failing to provide help the victim have needed may cause to recur the violence and even might increase its dosage. The Emergency Services is one of the key institutions for documenting and preventing sexual assault. The findings are important to present the perpetrators were often acquaintance to the victims and married victims were more likely to have multiple episodes of sexual assault. A multidisciplinary approach to the forensic examination will not only help to gather evidence properly and also enable to plan the victim's life after the examination.
Keywords: Forensic medicine; gynecological examination; psychological trauma; sexual assault
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