- 學位論文
親密伴侶暴力導致的常見傷害型態與傷害分佈之分析–以台北市某醫學中心為例
Common Types and Locations of Injuries in Intimate Partner Violence – A Study of a Medical Center in Taipei
摘要
親密伴侶暴力是全球性的社會問題，綜觀各國已有許多有關親密伴侶暴力傷害的研究，然而目前台灣對於親密伴侶暴力傷害型態的報告有限。因此，我們想藉由這次的研究統計來瞭解親密伴侶暴力傷害的特色，提供法醫師及臨床醫療人員做為參考，並能依據研究結果篩檢或評估親密伴侶暴力受害人，達到防治的目的。 本研究是收集2001年到2011年間到台大醫院診治的家庭暴力被害人(倖存者)個案的病歷資料。案件中被害者與加害者的關係為現有或過去曾有親密關係、約會對象或同居關係。本研究對照組為2001年至2011年間台大醫院的其他暴力受害人個案，其加害者與病患非親密關係、約會關係或同居關係者。傷害的依據主要為病患就診時的病歷、驗傷單、診斷證明、身體評估記錄。 我們共收集了親密伴侶暴力個案547件，其中女性佔95.4% (522/547)，平均年齡38.5歲，男性佔4.6%(25/547)，平均年齡43.2歲。對照組女性非親密伴侶個案共189件，平均年齡35.4歲。對照組男性非親密伴侶個案共103件，平均年齡38.1歲。分析其受傷部位，最常見有傷的部位在女性皆為臉部，其次為上肢。在親密伴侶暴力女性為55.4%(289/522)及52.7%(275/522)，而非親密伴侶暴力女性為52.4%(99/189)及46%(87/189)，兩組無明顯差異。在親密伴侶暴力男性受害人最常見有傷的部位是上肢(68%,17/25)其次是臉(40%,10/25)，而在非親密伴侶暴力男性受害人最常見為臉部(59.2%,61/103)其次是上肢(44.7%, 46/103)。親密伴侶組女性與非親密伴侶組女性比較，有顯著差異者為親密伴侶組臀部有傷之比率4.6% (24/522)較非親密伴侶組0.5%(1/189)高(P=0.009)；親密伴侶組下肢有傷之比率28.4% (148/522)較非親密伴侶組17.5% (33/189)高(P=0.003)、親密伴侶組左上臂有傷之比率20.3% (106/522)較非親密伴侶組6.9%(13/189)高(P<0.001)、親密伴侶組右上臂有傷之比率17.6% (92/522)較非親密伴侶組7.4% (14/189)高(P=0.001)。男性親密伴侶暴力受害者右上臂有傷佔16.0%(4/25)，高於男性非親密伴侶暴力的1.9%(2/103)且達統計學上顯著差異(P=0.013)。男、女性親密伴侶暴力最常見的傷害為挫傷各佔64%(16/25)、76.1% (397/522)，與擦傷各佔60.0%(15/25)、27.4%(143/522)。男、女非親密伴侶暴力最常見傷害為挫傷各佔52.4%(54/103)、54.5%(103/189)，與擦傷各佔44.7% (46/103)、31.8%(60/189)。總傷痕數在女性親密伴侶組平均每人4.42個傷害，而女性非親密伴侶組每人平均3.67個傷害，兩組呈現顯著差異(P=0.039)。 依據本研究結果得知，無論男女，臉部與上肢是親密伴侶暴力與非親密伴侶暴力最常見的傷害分布。女性親密伴侶暴力在臀部、下肢、左右上臂的傷害比女性非親密伴侶暴力多，男性親密伴侶暴力在右上臂傷害比男性非親密伴侶暴力多。挫傷與擦傷是親密伴侶暴力與非親密伴侶暴力最常見的傷害型態。本研究比較親密伴侶暴力與非親密伴侶暴力的受傷型態，可以提供臨床法醫及醫療人員實務工作參考。
並列摘要
Intimate partner violence is a worldwide problem. There are many researches about injuries of intimate partner violence in other countries; nevertheless, that was deficient in our country. The purpose of this study is to investigate injury patterns in intimate partner violence in our country. We reviewed the medical records of intimate partner violence survivors who were evaluated or treated at National Taiwan University Hospital between 2001 and 2011. All patients were interviewed and were identified as intimate partner violence survivors by social workers. The non-intimate partner violence victims who were evaluated or treated at National Taiwan University Hospital between 2001 and 2011 were recruited as control group. Information including age, gender, relationship between victim and offender, types of injuries, and sites of injuries was collected. There were 547 cases of intimate partner violence recruited. Almost ninety five percent (95.4%, 522/547) victims were female with an average age of 38.5, whereas 4.6% (25/547) victims of intimate partner violence were male with an average age of 43.2. There were 189 female and 103 male victims of non-intimate partner violence recruited, with an average age of 35.4 and 38.1, respectively. The most common site of injuries in both female intimate partner violence survivors and non-intimate partner violence victims was facial region (55.4%, 289/522 and 52.4%, 99/189), followed by upper limbs (52.7%, 275/522 and 46%, 87/189). The most common site of injuries in male intimate partner violence survivors was upper limbs (68%, 17/25), followed by facial region (40%, 10/25). The most common site of injuries in male non-intimate partner violence victims was facial region (59.2%, 61/103), followed by upper limbs (44.7%, 46/103). In female, injuries at buttock (4.6%, 24/522) were more likely to present in intimate partner violence survivors, compared with non-intimate partner violence victims (0.5%, 1/189)(P=0.009). Injuries at lower limbs (28.4%, 148/522) were more likely to present in intimate partner violence survivors, compared with non-intimate partner violence victims ( 17.5% , 33/189)(P=0.003). Injuries at left upper arm (20.3%, 106/522) were more likely to present in intimate partner violence survivors, compared with victims of non-intimate partner violence victims (6.9%,13/189)(P<0.001). Injuries at right upper arm (17.6%, 92/522) were more likely to present in intimate partner violence survivors, compared with non-intimate partner violence victims (7.4%, 14/189)(P=0.001). In male, injuries at right upper arm (16%,4/25) were more likely to present in intimate partner violence survivors, compared with non-intimate partner violence victims (1.9%,2/103)(P=0.013). Bruise was the most common type of injuries in all groups, followed by abrasion. The prevalence of bruises were 76.1% (397/522) in female intimate partner violence survivors, 54.5% (103/189) in female non-intimate partner violence victims, 64% (16/25) in male intimate partner violence survivors, 52.4% (54/103) in male non-intimate partner violence victims. The average of numbers of injuries was 4.42 in female intimate partner violence survivors, and 3.67 in female non-intimate partner violence victims, with significant difference (P=0.039). In conclusion, facial region and upper limbs were the most common sites of injuries both in intimate partner violence survivors and non-intimate partner violence victims. In female, injuries at buttock region, lower limbs, and bilateral upper arms were more common in intimate partner violence survivors, compared with non-intimate partner violence victims. In male, injuries at right upper arms were more common in intimate partner violence survivors, compared with non-intimate partner violence victims. Besides, bruises and abrasions were the most common injuries in all four groups of victims. We present the patterns of injuries of intimate partner violence and non-intimate partner violence with comparison in both gender. This data will be helpful for clinical forensic examiners and healthcare providers in casework.