兒童虐待之概念分析

Concept Analysis of Child Abuse

兒童虐待屬嚴重的健康問題，不僅造成兒童身心難以彌補的傷害，甚至影響家庭及社會。國內外雖有許多關於兒童虐待之研究，卻無一致的定義及概念分析，因此造成臨床上辨識疑似個案之困難，且限制了科學性研究的執行。本文運用Walker及Avant (1995)所提出之概念分析步驟，以1960年至2008年之相關文章(n=32)，歸納出兩種不同層面之兒童虐待定義性特徵，即客觀生理層面（20歲以下的兒童，身上出現重覆性傷痕、或病史與身體檢查不一致）及主觀心理層面（施虐者以不平等方式待之且具有負向的動機、或受虐者出現負向感受）。同時，確認兒童虐待之先決條件及後果，運用不同案例說明分析，並分享兒童虐待之參考指標及測量的工具，以協助兒童保護專業人員對此概念有更深之認識。

Child abuse is a serious health problem, which threatens children and has a wide reaching effect on family and society. While the concept of child abuse and related factors have been widely explored in interdisciplinary studies, a definition of ‘child abuse’ that is both precise and consistent has yet to be given. Lack of such limits the ability of clinicians to identify child abuse in clinical settings, and creates difficulties in conducting rigorous scientific research studies. Therefore, the purpose of this paper was to analyze the concept of child abuse based on literature published between 1960 and 2008 (n = 32) using Walker and Avant’s concept analysis model in which child abuse is determined along two dimensions. These dimensions include the objective physical dimension, which addresses children younger than 20 years of age who experience repeated injuries or whose history of injury is incompatible with the findings of physical examinations, and the subjective psychological dimension, which addresses children who were treated unfairly or malevolently and their subsequent subjective feelings. Antecedents consist of abuser, victim, and environmental characteristics. Consequences include both physical and psychological aspects. Nurses and other professionals should benefit from a clearer definition of child abuse in their clinical and research settings.