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Abstract Juvenile delinquency is defined as any crime committed by children and adolescents under statutory age. A juvenile delinquent is one who is a minor with major problems. Generally, any person between the ages of 7 to 18, who violates the law, is considered as delinquent and persons above this age are considered as criminals (Siegel and Brandon, 2011). The most greatest risk of falling into juvenile delinquency are rapid population growth, the unavailability of family support services, unemployment, the decline in the authority of local communities, ineffective educational systems and discrimination against minority groups (Aaron and Dallaire, 2010). The number of children in especially difficult circumstances is estimated to have increased from 80 million to 150 million between 1992 and 2000 and from 150 million to more than 200 million between 2000 and 2010 all over the world (Harnsberger, 2011). In Egypt more than 25,202 juvenile delinquents involved 24,648 males and 554 females in custody, social care institutions, social offices and observation offices all over the country. There are only 3,570 juvenile delinquents in custody and social care institutions, 3,105 males and 465 females (Egyptian Ministry of Society Solidarity, 2012). In accordance to (World Health Organization, 2010) juvenile delinquents face several problems in their dealings with others inside the social institution for punishing and rehabilitation. Problems that face juvenile delinquents are divided into physical, psychological and social problems. Physical problems are such as acute illness, chronic physical conditions and communicable diseases. Psychological and mental problems as stress, transitory life style, poor relationships with others, child abuse, withdrawal and lying escape from the institution. Social problems as illiteracy, violent environment, neglect, smoking, discrimination, lack of accessible resources, physical and sexual assault. Aim of the Study: This study aims to assess the health status of institutionalized juvenile delinquents through: - Assessing the socio-demographic characteristics of juvenile delinquents. - Assessing the health status of juvenile delinquents (physical, psychological and social). - Identifying the factors related to juvenile delinquency. - Assessing the environment of the social care institutions of juvenile delinquency regarding punishment and rehabilitation activities. Research questions: 1. What is the health status of the juvenile delinquents? 2. What are the factors related to juvenile delinquency? 3. Is the social care institutions’ environment appropriate for the juvenile delinquents’ rehabilitation? Research setting: This purposive study was conducted at the 5 selected Egyptian social care institutions (El Marg institution for males and El Agouza, Ain Shams, Dar El Aman in Embaba and Kobri el Kobba institutions for females). Those institutions are the most crowding ones in Egypt and serve big numbers of juvenile delinquents coming from all over the country. Sampling: A purposive sample consists of 318 participants (248 males, and 70 females) from the juvenile delinquents inside the 5 selected social care institutions: 248 boys from El Marg Custodial and Social Care Institution for males, 32 girls from El Agoza Social Care Institution for females, 22 girls from Ain Shams Social Care Institution for females, 10 girls from Kobry El Kobba Social Care Institution for females and 6 girls from Dar El Aman Social Care Institution for females in Embaba. Tools for data collection: The data will be collected through the following tools: First tool: Juvenile delinquents’ record analysis for assessing sociodemographic characteristics as regards name, age, sex, educational stage, crime committed type, family type and scholastic achievement. Second tool: Questionnaire for assessing the following parts: A- Past and current health history related to acute and chronic health problems, surgery, hospitalization, drugs used continuously, injuries, accident and communicable diseases. B- Child health habits and life style as regards sleep pattern, sporting, smoking and nutrition/drinking preferences. Third tool: Questionnaire for assessing the following parts: A- Physical examination of the child from head to toe including weight, height and signs of somatic abuse (Wong, 2007). B- Psychological assessment of children self esteem using self esteem scale for children developed by (Eldosoki and Mosa, 1987). C- Assessment of children social status using antisocial behavioral scale adopted by (Abdel Daiem, 2009). Fourth tool: An observational checklist for assessing the social care institutions’ environmental condition related to buildings, cleanliness, ventilation, sewage disposal, lighting, garbage, crowding index of rooms, classes, canteen, health care clinic and water supply. Ethical consideration: All ethical considerations were considered for ensuring the juveniles’ privacy and confidentiality of the collected data during the study. The purpose and nature of the study were explained for the participants and oral agreement was taken to gain their participation after being informed that each study subject is free to withdrawal at any time through the study. All selected study sample agreed to participate in the study and they were assured that the study would posed no risks or hazards on their social, psychological or physical health. Pilot Study: A pilot study was conducted at the beginning of the study. It carried out on 32 cases or 10% of the total sample to investigate the feasibility of data collection tools for their content validity, clarity and simplicity. Some questions were added (e.g. child health habits and child health history). It took about one month from July to August (2013). Subjects included in the pilot study were excluded from the actual study sample. Statistical design: Data was analyzed using the Statistical Package for Social Science (SPSS) version 16. Qualitative data was presented as number and percent. Relations between different qualitative variables were tested using Chi-square test (X2). Probability (pvalue) < 0.05 was considered significant and < 0.001 was considered highly significant. Results: The results of the present study could be summarized as following: 39.6% of the JDs ’ family residence were in rural or slumareas. 78.2% of males compared with 84.3% of females left school before admission; 32.4% from the total sample left schools because they were hating it. 51.9% of JDs had illiterate fathers and 64.1% had illiterate mothers. 83.3% of JDs were smoking and 54% of them were sometimes using drugs. 14.3% were sometimes practicing homosexual activities and 38.6% were sometimes practicing masturbation with a statistical significant difference between males and females. chronic diseases especially different types of allergy were common among 74.3% of females and 39.3 % of all children. 95% of JDs suffered acute diseases and 14.5% of juveniles complains backache with a statistical significant difference between males and females. Physical examination results revealed that 61.6% of the JDs suffered skin problems and 55% suffered mouth problems. Injuries and signs of somatic abuse were common among all JDs, wounds were common among 51.3% children, fractures were 50.6% and burns were 34.9%. 37.7% from the total sample had average self-esteem and 42.8% of JDs had high general antisocial behaviors. Institutional rooms’ crowding index was 40% crowded and classes were 20% crowded but, institutional cleanliness levels and environmental sanitation were 100% suitable and sanitary. Medical and paramedical staff in the institutions’ health clinic were 100% insufficient and the medical services were 60% incompletely applied. There was a highly statistical significant relation between the JDs’ crimes and the general antisocial behaviors, where X2= 18.136 respectively of P <0.001. There was a statistical significant relation between the JDs’ institutional crowding index and their acute diseases, where X2= 6.769 respectively of P <0.05. Conclusion: Based on the findings of the present study, the conclusion included: The male rate was 78% which showed that the highest rate among JDs were males. The main factor of JD which was observed obviously in this study was the family problems which most of the studied sample of the JDs were living with low family support, unsuitable parents’ occupation status, low socioeconomic status with a minimum level of coping to deal with all life’s stresses, inadequate parental supervision pattern in addition to low educational level. Average self-esteem level was the common psychological status indicator among the institutionalized JDs. High general antisocial behaviors were most common among them. Study sample was affected by many main physical health problems as skin, mouth and eye problems and injuries and signs of somatic abuse were observed in all the institutionalized JDs as wounds, fractures and burns. The environment of the social care institutions of JD regarding punishment and rehabilitation activities was unsuitable to meet the rehabilitative needs of the JDs. Recommendations: The findings of this study projected the needs for: Community health nurse, medical and paramedical staff to conduct 24 hours health services for juvenile delinquents inside the institutions. Periodic physical examination and screening for early identification and detection of health problems and prompt intervention. Providing the juvenile delinquents with health education about good life style. Providing adequate nursing care for juvenile delinquents with chronic illnesses as diabetes mellitus, bronchial asthma, skin allergy and parasitic infestation. Establishing referral system to the resources of assistance in physical, psychological and emergency services. Ensuring safe and secured environment with appropriate safety measures, crowding, living furniture and free from waste products. |