Reporting of child physical abuse by a group of Brazilian primary care health professionals and associated factors

Child physical abuse: changes over ten years in the perceptions of Finnish dental professionals

OBJECTIVE

This study aimed to assess perceptions and actions taken by Finnish dental professionals in suspected cases of child physical abuse (CPA) and to describe changes over 10 years.

MATERIAL AND METHODS

Data collected from two child abuse and neglect (CAN) surveys among Finnish dental professionals, working in public health care, covering suspicions of CPA and actions taken as well as training on CPA issues, were compared. The chi-squared (χ2) test was used to analyze associations.

RESULTS

In total, 625 (2008) and 1,025 (2019) questionnaires were completed. Respondents reported that they suspected CPA more frequently in 2008 than in 2019 (21.0% vs. 8.7%, p < 0.001). Out of all respondents, 1.1% had reported their concern to the police in 2019. Worries about the report's negative consequences to the child at home (44.5% vs. 56.4%, p < 0.001) and to the informer (30.2% vs. 36.3%, p = 0.016) increased between the surveys. The proportion of respondents with previous training on CPA issues increased between the surveys (5.9% vs. 36.4%, p < 0.001).

CONCLUSIONS

Recognition of CPA was low and decreased over the years. Furthermore, mandatory reporting to the police was low. Additional education on issues related to CPA is needed.

Early identification and awareness of child abuse and neglect among physicians and teachers

BACKGROUND

Child abuse and neglect (CAN) causes enormous suffering for those affected.

OBJECTIVE

The study investigated the current state of knowledge concerning the recognition of CAN and protocols for suspected cases amongst physicians and teachers.

METHODS

In a pilot study conducted in Mecklenburg-Western Pomerania from May 2020 to June 2021, we invited teachers and physicians working with children to complete an online questionnaire containing mainly multiple-choice-questions.

RESULTS

In total, 45 physicians and 57 teachers responded. Altogether, 84% of physicians and 44% of teachers were aware of cases in which CAN had occurred in the context of their professional activity. Further, 31% of physicians and 23% of teachers stated that specific instructions on CAN did not exist in their professional institution or that they were not aware of them. All physicians and 98% of teachers were in favor of mandatory training on CAN for pediatric residents and trainee teachers. Although 13% of physicians and 49% of teachers considered a discussion of a suspected case of CAN to constitute a breach of confidentiality, 87% of physicians and 60% of teachers stated that they would discuss a suspected case with colleagues.

CONCLUSION

Despite the fact that a large proportion of respondents had already been confronted with suspected cases of CAN, further guidelines for reporting procedures and training seem necessary. There is still uncertainty in both professions on dealing with cases of suspected CAN.

Ophthalmologists' Attitudes, Knowledge, and Willingness to Report Child Abuse

The aim of the present study was to explore ophthalmologists' attitudes, knowledge, and willingness to report child abuse. One-hundred-and-seven ophthalmologists employed in various hospitals in Israel completed an online questionnaire. Less than half the ophthalmologists (44.9%) reported that they had treated children whom they identified or suspected as being victims of child abuse, while only 43.9% of these reported child abuse. Despite generally positive attitudes towards reporting of child abuse among the ophthalmologists, their average level of knowledge was low. Ophthalmologists who had received training on child abuse and residents displayed a higher level of knowledge. In addition, female ophthalmologists tended to agree more that ophthalmologists are obligated to screen for and report child abuse. Moreover, female ophthalmologists expressed higher willingness to report child abuse. The present study reveals that underreporting of child abuse, and more precisely the discrepancy between identification and reporting, is present among ophthalmologists. It seems that lack of knowledge regarding identification and reporting of child abuse is the main barrier to reporting, especially among medical specialists. These findings underscore the importance of training programs on child abuse, both during formal education in medical school, and post-qualification, for all ophthalmologists, irrespective of seniority.

Health Professionals: Identifying and Reporting Child Physical Abuse-a Scoping Review

Health professionals play a significant role in identifying and reporting child physical abuse (CPA). However, several studies have pointed out non-reporting behavior among these professionals, evidencing difficulties identifying and reporting suspected cases. This review aimed to explore the frequency and possible barriers in identifying and reporting CPA by health professionals worldwide and to identify associated factors. This scoping review was conducted in the Pubmed, Web Of Science, Scopus, and SciELO databases between July 2019 and December 2020. Analytical and qualitative observational epidemiological studies were selected and published in English, Portuguese, and Spanish, with data on the identification and/or reporting of CPA by health professionals. Twenty studies fulfilled the criteria of this review. The studies were conducted with dentists, nurses, pediatricians, and general practitioners. The frequency of identification of CPA ranged from 50% to 89%, while the frequency of reporting ranged from 8% to 47%. This review revealed that health professionals had a low frequency of reporting of CPA, especially for dentists. In addition, several associated factors and barriers in the identification and reporting of CPA were identified in the studies. These were discussed in five main themes: training and continuing education in CPA, impact on professional practice, experiences and perceptions about child protection services, the threshold for suspicion of the professional, and the professional category.

Effectiveness of the training provided to healthcare professionals in Turkey to recognise the symptoms and risks of child abuse and neglect

Healthcare professionals have a significant role to play in the early diagnosis of child abuse and neglect (CAN), which is important in terms of protecting children's health. The study aimed to measure the change in the participants' level of diagnosing the risks and symptoms of CAN before and after the training by providing a training program to healthcare professionals including the signs of CAN, symptoms and procedures to be followed in this case. All healthcare professionals working in a State Hospital and Family Health Centers in Tunceli, Turkey, and who volunteered to participate in the study were included in the study (n = 125). The data were collected before and after the training by using the Personal Information Form and The Diagnosis Scale of the Risks and Symptoms of Child Abuse and Neglect (DSRSCAN). 39 participants (31.2%) reported that they had previously suspected CAN, and 35 (28%) stated that they had encountered CAN before. The mean DSRSCAN score of the healthcare professionals included in the study before the training was 3.38 (lowest =2.37, highest =3.55), while after the training, it went up to 3.60 (lowest =2.76, highest =5.00), and the difference between the pre-training and post-training DSRSCAN scores was determined to be statistically significant (p < 0.001). It was determined that when healthcare professionals were trained on CAN, their awareness could be further strengthened. Hence, training programs for healthcare professionals on diagnosing and reporting CAN should be updated and increased.

Capability, Opportunity, Motivation, and Behaviour (COM-B) model association with Egyptian dentists' reporting of suspected abuse

Background and objectives

This study assessed the frequency of reporting suspected abuse by Egyptian dentists who have examined patients with manifestations of abuse and factors associated with this reporting within the framework of the Capability, Opportunity, Motivation, and Behaviour (COM-B) model.

Methods

A cross-sectional study included dentists practicing in Egypt in 2019. A questionnaire collected information about personal and professional background, and whether: participants received training to manage abuse, reported suspected abuse, were aware of the presence of hotlines for reporting and agencies supporting abuse victims, and eight items assessing attitude towards reporting suspected abuse. Principal Component Analysis (PCA) was used to assess the structure of attitude items. Logistic regression assessed the relationship between the dependent variable (reporting suspected abuse) and independent factors: receiving training (capability), attitude components (motivation), and awareness of the presence of hotlines and support agencies (opportunity).

Results

The response rate was 68.2% (821/ 1203), mean age (SD) = 29.7 (10.0) years, 43.1% had examined patients with suspected abuse last year and 4.3% reported their suspicions. PCA identified two attitude components scored out of 10: professional attitude towards reporting (mean (SD) = 6.7 (2.2)) and negative perception of workplace commitment to reporting (mean (SD) = 7.2 (2.1)). Higher odds of reporting suspected abuse were associated with better professional attitude towards reporting (AOR = 1.87, P = 0.003) and less negative perception of workplace commitment to reporting (AOR = 0.77, P = 0.04), but not with previous training (P = 0.74), awareness of the presence of victims’ support agencies (P = 0.68) or a hotline (P = 0.88).

Conclusions

Only a minority of dentists reported suspected abuse. Dentists who reported their suspicions had better professional attitude towards reporting and better perception of their workplace commitment to reporting. Thus, the motivation component of the COM-B framework was significantly associated with reporting suspected abuse. The present training methods to manage abuse, and dentists’ unawareness of national efforts to manage the problem do not seem to encourage reporting.

Organizational factors affecting nurses' tendency to report child abuse and neglect

OBJECTIVE

To examine the factors that affect the tendency of nurses working in mother and child health clinics (MCHC) to report child abuse to the authorities.

DESIGN

Cross-sectional survey.

SAMPLE

Three hundred and forty-one female nurses working in MCHC across Israel.

MEASUREMENTS

(1) Social and organizational variables; (2) the tendency to report child abuse and neglect; (3) attitudes toward reporting child abuse and neglect.

RESULTS

On average, the participants perceived that they have good collaboration with other staff members and with welfare services. They showed a favorable attitude toward reporting child abuse, but less than half (44.8%) would report child abuse suspicion to the authorities. None of the organizational variables (MCHC type, collaboration among staff, collaboration with welfare services) were correlated with the tendency to report child abuse and neglect, yet all three variables were significantly correlated with attitudes toward reporting child abuse. Nurses' attitudes toward reporting were mediated by the organizational variables.

CONCLUSIONS

The effect of the organizational factors on the actual tendency to report child abuse is mediated by nurses' attitude toward reporting. Organizational constraints probably encourage MCHC nurses to be cautious before reporting child abuse and neglect to the authorities, restricting adherence to the law, which requires direct reporting.

Self-reported knowledge, attitudes, and practice of final-year dental students in relation to child abuse: A multi-centre study

BACKGROUND

The number of child abuse cases is increasing worldwide; therefore, it is important to educate individuals having contact with children about it. This includes dentists who play a pivotal role in detecting and reporting child abuse.

AIM

To identify and compare the final- year dental student's knowledge, attitudes, and practice in relation to child abuse.

DESIGN

A 38- item and four- part online questionnaire was distributed to students of 11 dental schools in 10 countries. SPSS and GraphPad Prism were used for data analysis. The levels of statistical significance were determined using a chi- square test. P ≤ .05 was considered to be statistically significant.

RESULTS

A total of 660 students completed the survey. Fifty- six percent of the students received formal training on child abuse, and 86% wanted additional training. The knowledge of child abuse was significantly higher in Australia, the United States, and Jordan compared with other countries. Internet (60.3%) was commonly used as an information source for child abuse.

CONCLUSIONS

The study showed that dental students lack knowledge and experience in recognizing and reporting child abuse. Most respondents indicated a desire for additional training; therefore, dental schools should review what they are currently teaching and make changes as appropriate.

Understanding factors associated with barefoot social workers' decision making in assessing and reporting child physical abuse in China

BACKGROUND

Mandatory reporting is new in China, and barefoot social workers are responsible for detecting and reporting child maltreatment.

OBJECTIVE

Guided by the decision-making ecology, this study examined factors associated with barefoot social workers' decision making in assessing and reporting child physical abuse in China.

PARTICIPANTS AND SETTINGS

Cross-sectional data were collected from barefoot social workers (N = 1489) in a metropolitan city in Southern China.

METHODS

Descriptive, bivariate, and binary logistic regression analyses were conducted. Dependent variables were barefoot social workers' assessments of and intention to report child physical abuse in two cases.

RESULTS

For a less severe physical abuse case, case severity (OR = 2.78, p < .001), receiving a social worker license (OR = 1.64, p = .03), and having a reporting history (OR = 23.55, p = .03) were associated with higher odds of assessments, whereas being younger (OR = 0.97, p = .04) was associated with lower odds. For a more severe physical abuse case, case severity (OR = 3.64, p < .001) and child welfare training (OR = 2.27, p = .03) were associated with higher odds of assessments. Across two cases, case severity (Case 1: OR = 1.44, p < .001; Case 2: OR = 1.34, p < .001), assessment of whether it is abuse (Case 1: OR = 11.48, p < .001; Case 2: OR = 15.98, p < .001), impacts of reporting on the family (Case 1: OR = 1.21, p < .001; Case 2: OR = 1.25, p < .001), and perceived behavior control (Case 1: OR = 1.06, p = .01; Case 2: OR = 1.10, p = .01) were associated with higher odds of reporting. Impacts of reporting on the child (OR = 1.27, p < .001) were associated with higher odds of reporting the less severe case. Attitudes regarding punishment of offenders or victims of child abuse (OR = 1.09, p = .01) and subjective norms of reporting (OR = 1.09, p = .01) were associated with higher odds of reporting the more severe case.

CONCLUSIONS

This study identified factors associated with barefoot social workers' decision making in assessing and reporting child physical abuse in China. Results of this study indicate the importance of providing training to barefoot social workers on recognizing, detecting, and reporting child physical abuse. It is also important to encourage them to receive continued social work training and obtain a social work license, which may increase their confidence in decision making. Furthermore, increasing the effectiveness of mandatory reporting is needed.

Brazilian Child Protection Professionals' Resilient Behavior during the COVID-19 Pandemic

BACKGROUND

The COVID-19 pandemic deeply affected child protection professionals. One potential area of concern is whether and how the pandemic has dampened these individuals' ability to engage in the resilient practices that are so vital to their wellbeing.

OBJECTIVE

Within the unique and understudied context of a developing economy facing the strain of an international pandemic, this study sought to expand our theoretical understanding of the individual and socio-ecological predictors of whether child protective services professionals engage in resilient behaviors.

PARTICIPANTS AND SETTING

Three hundred and nine professionals working in child protection related fields (e.g., psychologists, social workers, professors, pediatricians, nurses, and other clinicians).

METHODS

Participants were surveyed as to their demographics, current work conditions, their engagement in resilient behaviors, and potential individual and socio-ecological predictors of those behaviors.

RESULTS

Both job support for and individuals' beliefs of the importance of resilient behaviors predicted their engagement in such behaviors.

CONCLUSIONS

Child protection professionals' resilience must be fostered by socio-ecological contexts, such as their workplace and employers, and additional supports are needed during the trying times of the COVID-19 pandemic.