Recognizing and reporting child physical abuse: a survey of primary healthcare professionals

Awareness and knowledge of child abuse amongst physicians - a descriptive study by a sample of rural Austria

This study with a selected sample of physicians was conducted to assess their awareness and knowledge of child abuse. Two thirds (66.7%) of all participants confirmed contact with obviously abused children in the course of their professional life, whereas 87.3% did not report any prior education or training in that field. In relation to general practitioners, pediatricians had significantly more contacts with abused children (p = 0.021) and more prior education (p = 0.012). Results indicate that physicians in rural regions of Austria possess basic knowledge. Better training and further specialization is needed to facilitate diagnosing, enhance reporting, strengthen cooperation with experts and reduce fears when handling abuse victims. Austria is a rich country with excellent health care and competitive research structures. However, child abuse research in Austria still has to fill gaps in order to keep up with international developments.

Attitudes and child abuse reporting behaviours among Hong Kong GPs

BACKGROUND

GPs are often the first contact for injured children and hence play a crucial role in early identification and intervention of child abuse cases in the community.

OBJECTIVES

To investigate Hong Kong GPs' attitudes and behaviours towards child abuse reporting and their opinions on the introduction of a mandatory reporting system.

METHODS

A cross-sectional survey was conducted in 2006 among GPs who were attending or had attended a local postgraduate family medicine course.

RESULTS

One hundred and seventy-one GPs participated in this study, among which only 8.9% received formal child abuse training. Only 35.8% of those GPs who had encountered suspected cases reported every case. GPs who considered reporting could produce more harm than good to the family or child, who concerned about maintaining anonymity and who were reluctant to get involved with legal system were less likely to make a report [odds ratio (OR) 0.21-0.27; 95% confidence interval (CI) 0.06-0.11, 0.67-0.86]. 'Concern on own anonymity' was the only significant independent predictor for reporting (OR 3.47; 95% CI 1.11-10.87). Despite the low satisfaction with the present reporting system, 67.3% would not support the introduction of a mandatory reporting system. Logistic regression showed previous training could predict supportive attitude towards mandatory reporting (OR 4.84, 95% CI 1.01-23.27).

CONCLUSIONS

This study shows low reporting behaviour among Hong Kong GPs. The major barriers to report are identified and can only be addressed by education and a carefully designed support system for GPs. Further research engaging a multidisciplinary approach is required to work towards an optimally beneficial system for the children.

Am I sure I want to go down this road? Hesitations in the reporting of child maltreatment by nurses

PURPOSE

The purpose of this study was to explore the process of mandated reporting of child maltreatment by pediatric nurses.

DESIGN & METHODS

Qualitative description using a grounded theory lens was used with a cross-section of pediatric nurses.

RESULTS

A point of divergence in the reporting process appears to occur at the first of three moderating points. When nurses hesitate at this first point, decision-making becomes complex and delays the reporting process, giving rise to two themes: "It's the law" and "The ones that haunt you."

PRACTICE IMPLICATIONS

Increasing educational efforts focused on the recognition of child maltreatment may impact nurses' low rate of reporting.

Safeguarding children and public health: midwives' responsibilities

AIM

Using a healthy settings framework, this study aims to compare and contrast how midwives working in either hospital or community settings are currently responding to the co-occurrence of domestic and child abuse; their perceived role and willingness to identify abuse; record keeping; reporting of suspected or definite cases of child abuse; and training received.

METHODS

A survey questionnaire was sent to 861 hospital and community midwives throughout Northern Ireland, which resulted in 488 midwives completing the questionnaire, a 57% response rate. Comparisons were made using descriptive statistics and cross-tabulation and the questionnaire was validated using exploratory factor analysis.

RESULTS

Community midwives reported receiving more training on domestic and child abuse. Although a high percentage of both hospital and community midwives acknowledged a link between domestic and child abuse, it was the community midwives who encountered more suspected and definite (p < 0.001) cases of child abuse. More community midwives reported being aware of the mechanisms for reporting child abuse. However, an important finding is that although 12% of community midwives encountered a 'definite' case of child abuse, only 2% reported the abuse, leaving a 10% gap between reporting and identifying definite cases of child abuse. Findings suggest that lack of education and training was a problem as only a quarter of hospital midwives reported to have received training on domestic violence and 40% on child abuse. This was significantly less than that received by community midwives, where the figures were 57% and 62%, respectively.

CONCLUSION

Midwives need training on how to interact with abused mothers using non-coercive, supportive and empowering mechanisms. Many women may not spontaneously disclose the issues of child or domestic abuse in their lives, but often respond honestly to a sensitively asked question. This issue is important as only 13% of the sample actually asked a woman a direct question about domestic violence.

Safeguarding children in dentistry: 1. Child protection training, experience and practice of dental professionals with an interest in paediatric dentistry

Following several highly publicised inquiries into the deaths of children from abuse and neglect, there has been much recent interest in the role and responsibility of all health professionals to protect children at risk of maltreatment. The findings of a postal questionnaire, sent in March 2005 to 789 dentists and dental care professionals with an interest in paediatric dentistry working in varied settings in the UK, are presented in a two-part report and discussed in the context of current multi-agency good practice in safeguarding and promoting the welfare of children. This first part explores reported child protection training, experience and practice. There was a significant gap between recognising signs of abuse and responding effectively: 67% of respondents had suspected abuse or neglect of a child patient at some time in their career but only 29% had ever made a child protection referral. The dental profession is alerted to the need to ensure necessary appropriate action to safeguard children is always taken when child abuse or neglect are suspected.

Recognizing the co-occurrence of domestic and child abuse: a comparison of community- and hospital-based midwives

This study aimed to compare and contrast how midwives working in either hospital or community settings are currently responding to the co-occurrence of domestic and child abuse (CA), their perceived role and willingness to identify abuse, record keeping, reporting of suspected or definite cases of CA and training received. A survey questionnaire was sent to 861 hospital and community midwives throughout Northern Ireland which resulted in 488 midwives completing the questionnaire, leading to a 57% response rate. Comparisons were made using descriptive statistics and cross-tabulation, and the questionnaire was validated using exploratory factor analysis. Community midwives reported receiving more training on domestic and CA. Although a high percent of both hospital and community midwives acknowledged a link between domestic violence (DV) and CA, it was the community midwives who encountered more suspected and definite (P < 0.001) cases of CA. More community midwives reported to be aware of the mechanisms for reporting CA. However, an important finding is that although 12% of community midwives encountered a definite case of CA, only 2% reported the abuse, leaving a 10% gap between reporting and identifying definite cases of CA. Findings suggest that lack of education and training was a problem as only a quarter of hospital-based midwives reported to have received training on DV and 40% on CA. This was significantly less than that received by community midwives, as 57% received training on DV, and 62% on CA. The study suggests that midwives need training on how to interact with abused mothers using non-coercive, supportive and empowering mechanisms. Many women may not spontaneously disclose the issues of child or domestic abuse in their lives, but often respond honestly to a sensitively asked question. This issue is important as only 13% of the sample actually asked a woman a direct question about DV.

Dentists' involvement in identification and reporting of child physical abuse: Jordan as a case study

OBJECTIVES

The objectives of this study were to assess the knowledge, attitude, and experience among Jordanian dentists regarding child abuse, and to explore the factors that affect their hesitation to report any suspected cases.

MATERIALS AND METHODS

A self-administered structured questionnaire was sent randomly to 500 Jordanian dentists. It investigated dentists' knowledge, attitude, and experience in recognizing and reporting child abuse cases. It also investigated several factors associated with dentists' hesitation to report suspected cases of child physical abuse.

RESULTS

The response rate was 68%. More dentists were aware of their ethical obligations (80%) than their legal responsibilities (71%) to report child abuse cases. One-third of the dentists knew where to report suspected cases. Although 42% of dentists suspected cases of child abuse, only 20% of them reported these cases. The most frequently cited reasons for hesitation to report such cases were lack of history (76%), uncertainty about diagnosis (73%), and possible consequences on the child (66%). Reporting was significantly associated with suspicion of child abuse cases, as well as the belief of legal responsibilities.

CONCLUSION

There was a low reporting rate of child abuse among Jordanian dentists. They lack the adequate knowledge about recognition and reporting issues of suspected cases.

To report or not report? Attitudes held by Norwegian nursing home staff on reporting inadequate care carried out by colleagues

Aims: The aims of this study are, first, to describe attitudes held by nursing home staff on reporting acts of inadequate care committed by their colleagues, and second, to investigate whether nursing staff have different attitudes depending on age, education, and length of experience of working in the healthcare services. Methods: A questionnaire survey was conducted among nursing staff in 16 nursing homes in the central part of Norway. The response rate was 79% (n=616). Results: A positive attitude towards reporting acts of inadequate care committed by their colleagues was held by the participants in this study. Compared with younger staff, the older staff seemed to be more reluctant to report colleagues, to feel less brave, to be more afraid of what would happen to them if they reported, and to agree that it is best to deal with such matters internally. Regarding education, it seemed that a higher educational level was related with a more positive attitude towards a willingness to report and less fear of negative sanctions. Conclusions: Staff who observe acts of inadequate care committed by colleagues agree that it is their intention to report such incidents. Institutions need to develop and implement mechanisms for understanding and evaluating acts of inadequate care, and staff must be encouraged to speak out on behalf of residents rather than be punished for doing so.

Safeguarding children is everyone's responsibility: UK government statement on the duties of doctors

The first duty of the paediatrician is to the child or young person