الفهرس 
Evaluation of Cases of Family ViolenceOnly 14 pages are availabe for public view
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Abstract
The current study were done on cases of family violence arrived at Menoufia University Hospital in the period from the first of June 2009 to the
last of May 2011and they were 472 cases ( 465 cases of physical and 7 cases
of sexual family violence).
As regards:
Socio-Demographic pattern.
Injuries pattern.
Possible risk factors.
Relation between family violence and substance abuse.
Outcome.
A clinical sheet was designed for cases of family violence and data were
taken from the victims and /or their guardians including data about
sciodemographic data of victims and assailants, then clinical examination and
required investigations were performed.
The results of this study showed that:-
characteristics of the violence:
It was noticed that the majority of cases were of physical type (98.5%)
while of sexual type represented only1.5%. Most violence occurred indoor.
Majority of violence (80.7%) occurred in repeated attacks. Causes of violence
were mainly social causes of violence (50%) and economic causes (28.2%).
characteristics of the victims in the study:
As regards gender it was noted that females represented 56.4% of the cases
while males represented 43.6%. They were mainly from rural areas constituted
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68.2%. As regards age groups, children represented 13.8% of cases; middle age
group represented 78.4% while elders represented 7.8%.
Considering educational level below secondary represented 31.9%,
followed by secondary, uneducated, high education (30.9%, 22.9%, and 10.3%
respectively) and the least was preschool 4% of the cases. As regards
occupation, manual workers constituted 35.2% of the cases, followed by house
wives, employers, students, and skilled labors, preschool and retired (27.5%,
17.6%, 8.9%, 5.7%, 4% and 1.1% respectively). As regards socio- economic
standard it was noticed that about half of the cases were of low standard
(50.8%) followed by middle standard (43%) and the lowest were of high
standard (6.2%). There was no history of tobacco smoking in most of cases
(85.2%) while positive history was found in 14.8% of the cases and there was
no history of other substances of abuse.
characteristics of the assailants in the study:
As regards gender, males constituting the majority of assailants (89.2%).
Considering residence, they were most commonly from rural areas (71.8%).
The most represented age groups were 30-<40 and 21- <30 constituting 40%
and 25.4% of the assailants respectively. Husbands were the most common
assailants followed by brothers represented by 23%, and 16%, the least were
mothers in 0.4% of the cases.
Distribution of the family violence cases in relation to causes of violence in
different age categories and gender:
Sexual causes of violence were significantly concentrated in children rather
than other age groups while social, economic and inheritance causes was
significantly concentrated in middle age group. Significant difference between
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gender and causes of violence, where the inheritance causes were more
common in male victims while sexual and social causes more common in
female victims.
Types of injurious agents to the cases of the physical family violence
Shows that the most common injurious agent was blunt instrument
(87.5%) followed by sharp instrument, thermal or chemical injury, represented
by 9.8% and 1.5% respectively, the least was firearm weapons and poisons
represented by 0.6% for each. Blunt and sharp instruments were significantly
more commonly used in middle age group whereas poisons, thermal or
chemical agents were significantly more commonly used in children compared
to victims of other ages. There was significant difference between gender and
type of injurious agents as sharp instrument and poison were more common in
males versus females.
Local examination of the of the physical family violence cases as regard site
and of the wounds:
Injuries to head and face (54%) and upper limbs (50.4%) were the most
common sites of trauma followed by lower limbs (13%), back of the trunk
(11.2%), chest (11%), neck (6.8%), where the abdomen was the least (3.6%).
As regards the types of the wounds:
The most common type of wounds was contused wound represented 32.3%
followed by contusions, combination of abrasions and contusions, incised
wounds, stab wounds, thermal or chemical burns and firearm wounds which
represented 24.2%, 21.9%, 7%, 2.8%, 1.5%, and 0.6% respectively. The least
common was the punctured wound represented by 0.2% of the cases. Chemical
or thermal burns were mainly affect children and incised and stab wounds were
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180
mainly in middle aged victims. Cut and stab wounds were more common in
males (9.4% &4.5% respectively) than females (5% &1.5% respectively).
Fractures evident by radiology in victims:
Fractures of bones occurred in 64 cases (13.6%) in which the most
common type was the fracture of hand bones (25%), long bones of upper limbs
(21.9%) and fracture nose (20.3%), and fracture skull 12.5%.
Sexual violence
Sexual cases represented 1.5% of all cases of family violence. Males
represented 28.6% below 7 years (cases of sodomy). While the female cases
represented 71.4% (cases of buggery), three of them were under 7 years and the
other two cases were in the age category between 21 and 30 years old. Sexual
violence was significantly associated with lower age of assailants and lower age
of victims. The positive local findings were dilated anal opening these findings
were present in four children cases below 7 years. Severe findings were present
in one female child below 7 years where there was stool incontinence, conical
anus, and loss of anal corrugations. The other positive local findings were
dilatation of the anus and loss of corrugations in the adult two females in the
age category between 21-30years.
Violence against children
Children represented 13.8% of the victims. Parental status in violence
against children was that they were divorced in 41.5%, death of the father in
36.9% and they were together in 21.5%. The most common assailant was the
father in 30.8%, uncle 27.7%, stepfather 18.5%, stepmother 7.7%, Cousin
6.2%, uncle’s wife 4.6%, mother 3.2% and mother inlaw1.5%.
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Violence against females:
Most of the violence against married females was carried out by their
husbands represented 60%. Husband assailants from rural areas outnumbered
those from urban areas (69.4% versus 30.5%). More than half of husband
assailants were below secondary or uneducated. The lowest percentage was
highly educated represented by 7.5%. Considering occupation, majority of
assailants were manual workers constituting 73.1% followed by employers and
skilled laborers represented by 16.7% and 10.2%respectively.
Females abused by their husband had significantly lower age (Mean ± SD=
28.27 ± 6.61) than other married females abused by non husband assailants
(Mean ± SD= 37.43 ± 10.81). It also shows that husband assailants had
significantly lower age (Mean ± SD= 32.59 ± 6.24) than other assailants
(Mean± SD=36.55±11.68). It was noted that 17.7 % of the married females in
the child bearing period were pregnant during the assault and resulted in loss of
the fetuses in 10.3% of cases and necessitated emergency cesarean section and
delivery of the fetus in one case.
Violence against elders:
Elders represented 7.8% of the victims. Males represented 51.4% which
females represented 48.6%. The most common type of wounds was
combination of abrasions and contusions in 48.6%, followed by contused
wound and abrasions represented 13.5% for each. The least were firearm
wounds and burns represented 2.7% for each of them. Cure without
disfigurement or permanent infirmity was the outcome of all cases of elder
abuse.
Outcome of the violence on cases (N = 472)
The majority of the cases were cured without disfigurement or permanent
infirmity (97.2%), cure with disfigurement or permanent infirmity was found in
2% of cases, the mortality rate was 0.6% (3 cases) and one case (0.2%) had
unknown outcome as she did not complete follow up. Outcome of violence
resulted in significant difference where cases cured with disfigurement or
permanent infirmity were more represented in middle age group and more cases
of deaths in children.