How Do Nurses Keep Children Safe From Abuse and Neglect, and Does it Make a Difference? A Scoping Review

Strategies to Prevent Violence Against Children in the Home: A Systematic Review of Reviews

Violence against children (VAC) in the home, or by household members, is a human rights and social problem with long-lasting consequences for individuals and society. Global policy instruments like the INSPIRE package have proposed strategies to prevent VAC, including Implementation and enforcement of laws, Norms and values, Safe environments, Parent and caregiver support, Income and economic strengthening, Response and support services, and Education and life skills. This systematic review of reviews aimed to synthesize the recent evidence base (i.e., published since 2000) for each INSPIRE strategy to reduce VAC in the home or by household members. We searched four databases using controlled vocabularies and keywords and searched for additional records in prior reviews of reviews. A total of 67 studies were included in this review, including literature reviews, meta-analyses, systematic reviews, and other types of reviews. We found extensive evidence supporting the effectiveness of parent and caregiver support interventions. However, reviews on other INSPIRE strategies were scarce. We also found a vast underrepresentation of samples from low- and- middle-income countries, children with disabilities, and families affected by forced displacement and conflict. In sum, this systematic review suggests that there are several promising strategies to prevent VAC (e.g., home visiting and parent education), but further research is necessary to strengthen the current body of evidence and effectively inform the implementation and scale-up of evidence-based interventions to protect children from violence globally.

Nurses' and midwives' contributions to a public health response to keeping children safe from abuse and neglect - a Delphi study

Nurses and midwives can be instrumental to global efforts to address child abuse and neglect through a public health approach of prevention and early intervention. However, there is limited understanding of nurses' and midwives' roles, and no international or local guidelines to inform and evaluate their safeguarding practices. The aim of this modified Delphi study was to build consensus on the nature and scope of nursing and midwifery practice in safeguarding children in Australia. Sixty-four statements located within seven clusters were developed from a literature review and nursing and midwifery practice standards. Participants (N = 102) were nurses and midwives working with children in diverse contexts. They were asked to indicate the importance of each statement to their practice setting. Consensus (80%) was achieved on all statements in Round Two. Findings highlight that participating nurses and midwives agreed safeguarding children is a core component of their practice in diverse child-focussed settings. Findings can inform ongoing discussions about development of nursing and midwifery practice standards and guide effective workforce preparation, education, support and resourcing. Further research about ongoing development of nursing and midwifery roles in safeguarding children is essential to explore how to most effectively mobilise these professions to prevent child abuse and neglect.

'We aren't valued for who we are': Australian nurses' and midwives' perceptions of challenges and barriers to safeguarding children

PURPOSE

Professionals working with children, including nurses and midwives, are foundational to effectively safeguarding children from maltreatment. However, little is known about the full nature and scope of nurses' and midwives' roles in safeguarding children in Australia presenting barriers to effective workforce preparation and support.

DESIGN AND METHODS

This study reports an inductive analysis of qualitative responses (n = 51 Round 1, n = 17 Round 2) from a two-round Delphi study. The Delphi study aimed to build consensus on the nature and scope of nursing and midwifery practice in safeguarding children, and this manuscript presents findings of an inductive analysis of qualitative responses beyond the scope of the Delphi study. Participants were Australian nurses and midwives (n = 51, n = 17) from diverse child-focussed settings.

RESULTS

Nurses and midwives experienced many factors outside of their control that restricted their capacity to safeguard children. Influences included high workloads, burnout, lack of support, poor collaboration, structural barriers and inaccessible services for children.

CONCLUSIONS

Nurses and midwives are advocates for children but experienced many factors preventing them from effectively safeguarding children. Future approaches to reducing child maltreatment must be underpinned by support for frontline professionals to promote workforce capacity and sustainability.

PRACTICE IMPLICATIONS

Despite nurses' and midwives' best intentions, their attempts to prevent and respond to child maltreatment were hampered by systemic factors beyond their control. This study highlighted the need to address broader influences on nursing and midwifery practice to reduce the impacts of child maltreatment and support children to thrive.

Adaptation of the Child sexual abuse myth scale to Turkish culture: A reliability and validity study

This study aims to analyze the reliability and validity of the Child Sexual Abuse Myth Scale (CSAMS) in Turkish society. This methodological and cross-sectional study was conducted with 334 individuals between the ages 19 to 65. Data were collected through the Personal Information Form and the Child Sexual Abuse Myth Scale. Content Validity Ratio values of the scale items in the study ranged between 0.500 and 1.00, and the Content Validity Index was found to be 0.68. Exploratory Factor Analysis was appropriate based on Kaiser-Meyer-Olkin Measure of Sampling Adequacy (KMO = 0.809) and Barlett's Test of Sphericity (X2 = 1269, p < 0.001). Factor Analysis resulted in 4 sub-scales (Accusation, Causality, Normalization, and Sexist Approach). Item factor loads of the scale were found to range between 0.501 and 0.839, and the total explained variance was 59.4 %. Pearson correlation coefficients of all the items ranged between 0.32 and 0.60, and Cronbach's alpha coefficient was 0.81. Accusation, Normalization, and Sexist Approach sub-scale scores were found to increase with age. Sub-scale scores were found to demonstrate significant differences by gender, marital status, education level, working or not, income level, family type, number of siblings, and number of children (p < 0.05). The findings of this study show that the CSAMS is valid and reliable for Turkish culture in its 14-item and 4 sub-scale form.

Development and psychometric evaluation of the reporting suspected child abuse and neglect (RSCAN) scale for United States registered nurses

PURPOSE

In the United States (US), nurses have a mandated duty to report child abuse and neglect (CAN). Despite comprising the highest proportion of the US healthcare workforce, limited research has explored the institutional barriers they face in reporting suspected CAN. Furthermore, there is no existing valid and reliable measure of reporting relevant to US. The purpose of this research is to develop and psychometrically evaluate a scale to measure nurse knowledge and self-efficacy as CAN mandated reporters.

DESIGN AND METHODS

The Reporting Suspected Child Abuse and Neglect (RSCAN) tool was developed from two existing international tools to examine institutional barriers and facilitators to US nurses' professional knowledge and reporting of CAN. A convenience sample of one hundred and sixty-six US nurses primarily from the Pacific Northwest responded to an online survey. An exploratory factor analysis (EFA) and Cronbach's α were used to examine validity and internal consistency, respectively, of an initial 16-item scale.

RESULTS

A two-factor model consisting of eight items indicated good model fit (CFI = 0.986, RMSEA = 0.049, and SRMR = 0.028) and was internally consistent (Cronbach's α = 0.822).

CONCLUSION

RSCAN is the first US instrument to reliably measure nurses' professional knowledge and self-efficacy of reporting suspected CAN.

PRACTICE IMPLICATIONS

Future research can build upon these findings to recognize and support nurses in their mandated role to report CAN.

Investigation of fathers' metaphors regarding child sexual abuse in Turkey: A metaphor study

BACKGROUND AND PURPOSE

This study was designed to determine the perceptions of fathers about child sexual abuse in Turkey using metaphors to facilitate understanding of child sexual abuse.

METHODS

The study was conducted as a qualitative study based on metaphor analysis. The data were collected from 164 Turkish fathers in Turkey between August 2022 and September 2022 using a descriptive information form for fathers and a semi-structured interview form exploring fathers' perceptions of child sexual abuse. The semi-structured interview form included metaphor statements like "Child sexual abuse is like....... because .......", and "Child sexual abuse reminds me of the color....... because .......". The data were analyzed using the content analysis technique. The study was reported based on Standards for Reporting Qualitative Research (SRQR).

RESULTS

According to the results, 77.4% of the fathers had knowledge about protecting their children from sexual abuse, 40.9% got this information from the internet, and only 11.1% educated their children about sexual abuse. Seventy three percent of the fathers were afraid of confusing their children while educating them. The fathers involved in the study used 20 metaphors related to "child sexual abuse" and "the color evoked by child sexual abuse". The metaphors created by the fathers were analyzed under six categories: "emotions, feeling inadequate, punishment method, abuser, child concept, and uncertainty".

CONCLUSION

Based on the results of the study, fathers had common feelings and emphasize the same concepts about child sexual abuse.

PRACTICE IMPLICATIONS

Metaphors provide a unique approach to identifying fathers' conceptual images of child sexual abuse.

Engagement and Retention of Families in Universal Australian Nurse-Home-Visiting Services: A Mixed-Methods Study

Family support is offered to Australian parents of young children using a mix of targeted and universal child and family health services including nurse-home-visiting programmes. These rely on the voluntary engagement of families. In this study, the capacity to engage and retain families, including those at risk of becoming involved with child protection services, was examined. The broad objective was to identify nursing practices used at the interface of health and child protection services and to articulate those practices. Child and Family Health Nurses (CFHN) (n = 129) participated in a pragmatic, multilevel mixed-methods study. A questionnaire was used to identify nursing practices in the first phase of this study followed by focus groups in the second phase to describe these practices in more detail. Three practice themes were identified and described: enrolment, retention and conclusion of the nurse-family relationship. Universal child and family health services feature flexible, advanced, and multidimensional family support services including child protection practices. This paper focuses on practices employed by nurses to engage and retain families where child protection concerns are identified.

Perceptions of third and fourth year nursing students enrolled in a pediatric nursing course regarding the concept of child abuse: A metaphorical study

BACKGROUND

Child abuse is an important public health problem as it negatively affects the child's development as well as the child's family and therefore society. Nurses are one of the most important members of the team caring for child abuse victims and are indispensable in terms of child and family education.

OBJECTIVES

The research was carried out to determine the perceptions of third and fourth year nursing students, who took the Child Health and Diseases Nursing course, about child abuse through metaphor.

DESIGN

The research was carried out with the metaphor analysis technique based on the phenomenological method. "Metaphor analysis" is a technique based on the phenomenological research method within the qualitative research methods.

SETTINGS

The study was conducted at a state university in Turkey.

PARTICIPANTS

While the population of the research consisted of nursing department students in a facility, the sample consisted of third and fourth year nursing students who took the Child Health and Diseases Nursing Course. In the study in which 186 nursing students volunteered to participate, the study was completed with 174 students, since the answers of 12 students did not contain metaphors. 174 students who took the course participated in the research.

METHODS

The data were collected using the Student Information Form and the metaphor sentence "Child abuse is like … because…" questioning the perceptions of child abuse from June to August 2021.

RESULTS

At the time of the research, it was determined that all third and fourth year nursing students who took the Child Health and Diseases Nursing course in the institution had negative metaphors about "child abuse". The harm caused by child abuse to the child and the future has often been compared to natural disasters and catastrophes. Metaphors produced for the perception of "Child Abuse"; it is grouped under a total of five categories: Disaster, Damage, Never Beginning, Never Been Like Before, and Hunting.

CONCLUSIONS

Child abuse is a medical, pediatric and public health problem that must be reported. Nursing students' perceptions of the subject are very important, as it is among the duties, responsibilities and roles of nurses. The fact that child abuse is perceived by student nurses as the strong hurting the weak, the irreversible harm, or the fact that something good ends before it begins, reveals the importance of the situation. It clearly reflects the necessity of a course on child abuse in the nursing curriculum.

TWEETABLE ABSTRACT

It is important to evaluate the perceptions of child abuse of nursing undergraduate students. @dilek_fatos.

Nursing Care Challenges of Child Violence Victims: A Qualitative Study

BACKGROUND

Violence against children is a serious global phenomenon. The severity of the injuries caused due to violence toward a child is sometimes so great that it sends them to the hospital. Nurses have the first contact with Child Violence Victims (CVVs). These nurses experience different challenges. This study was aimed at exploring nurses' experiences of challenges in care provision to CVVs.

MATERIALS AND METHODS

This conventional content analysis and qualitative study was conducted in 2018-2019. Using a purposive sampling method, 17 nurses with experience in care delivery to CVVs were recruited from among those working in Children's Medical Center, Tehran, Iran, and Bu-Ali Subspecialty Hospital, Ardabil, Iran. In-depth semi-structured interviews were conducted to collect the required data. Data were analyzed through the conventional content analysis method.

RESULTS

During data analysis, the 3 main categories of role conflict, lack of continuity of care, and emotional resentment and 9 subcategories were identified. Nurses experience challenges in care provision to CVVs. They do not have enough knowledge about CVVs, are unable to maintain the continuity of care, and experience role conflicts and emotional resentment.

CONCLUSIONS

Nurses experience some difficulties and challenges in the process of care delivery to CVVs. They tried to overcome emotional resentment, different conflicts, and concerns about the lack of continuity of care without adequate support and resources. Thus, planning to support nurses in this regard seems essential.

Sexual Violence and the Coach-Athlete Relationship-a Scoping Review From Sport Sociological and Sport Psychological Perspectives

Sexual violence against athletes in elite and leisure sport has become of growing interest in recent years. In line with social media initiatives such as #SportToo and #CoachDontTouchMe and a rise in general media coverage, research in this field indicates an urgent need for action. These recent developments occasionally have led to no-touch policies, which may result in moral panic, uncertainty, and fear of unjustified suspicion among coaches. However, the role of closeness and distance in the development of sexual violence within the coach-athlete relationship has not yet been researched systematically. In this scoping review, the authors focus on the coach-athlete relationship, particularly its predispositions to sexual violence and how to prevent abusive relationships. Some characteristics typical of elite sport may predispose coaches to commit abuse, such as gender and power relations, the need for physical touch, hierarchical structures in sport, and trust and closeness between coaches and athletes. This scoping review follows an interdisciplinary approach combining sociological and psychological perspectives. It comprises 25 publications in English and German published from 2000 to 2019. The literature review highlights that closeness, power, blurred boundaries, and ambiguous roles are areas that seem to be crucial to the analysis of the coach-athlete relationship from both sociological and psychological perspectives.

Navigating and negotiating meanings of child abuse and neglect: Sociocultural contexts shaping Australian nurses' perceptions

Nurses who work with children have the opportunity to make a difference by identifying and responding to child abuse and neglect. Little is known about the ways that nurses define, assess and respond to child abuse and neglect and how this subsequently affects children. This paper reports one of four themes identified through inductive analysis of a qualitative study exploring nurses' perceptions and experiences of keeping children safe from abuse and neglect. The aim of this paper was to report on how nurses understand and interpret child abuse, is found to be shaped by their own sociocultural contexts. A qualitative research design underpinned by social constructionism framed the study. Data were collected in 2016 and 2017 through 21 in-depth, semi-structured interviews with nurses who work with children in Australia. Key findings showed that nurses working with children had difficulty defining child abuse and drew upon multiple sources to construct a working definition. In addition to drawing from official legislation and guidelines, nurses compared and contrasted the level of abuse with their own personal and professional experiences of parenting. Nurses described the challenges of making assessments when faced with cultural practices different from their own. Nurses' descriptions of how they defined abuse showed that their assessments of child abuse and neglect were inextricably linked to their personal values and beliefs. As such, nurses were often working from their own value systems rather than consistently taking a child-focussed approach. There was an absence of consistent and explicit critical reflection on ways that values and beliefs might shape practice at individual and system levels. We propose this is a missing aspect of child safe practice. Reflection on how personal and professional values and beliefs interact with the implementation of evidence-informed approaches will increase nurses' capacity to maintain a child-focus.