Definition and identification of child abuse by Finnish public health nurses

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.

Child Temperament as a Predictor of Parents' Potential for Emotional Abuse

ABSTRACT

Children who are constantly criticized and humiliated by their parents and whose needs for affection and attention are not sufficiently addressed are defined as people with personality traits, low self-confidence, and antisocial behaviors. These personality traits have a significant influence on the shaping of the child's temperament. Therefore, emotional abuse negatively affects both the personality and success of the child. In line with this, child temperament was analyzed as a predictor of the emotional abuse potential of parents who have children between the ages of 4 and 6. The experimental group of the study consisted of 237 parents. Data were collected using The Scale for Emotional Abuse Potential of Parents with Children Aged 3 to 6 and Temperament Assessment Battery for Children-Revised: Parent Form. In the data analysis, the intervariable relationship was determined by the Pearson correlation coefficient, and the predictors of emotional abuse potentials were determined by multiple regression analysis. As a result of the analysis, a significant negative correlation was found between shyness and parents' emotionally abusive behaviors, a significant positive correlation between those behaviors and surgency, and negative affectivity. A positive correlation was found between persistence and the parents' emotional abuse preventive behaviors. In terms of predictive variables, it was found that the causality subdimension of the emotional abuse potentials of parents was significantly predicted by the negative affectivity subdimension of temperament, and emotional abuse preventive potentials of parents were significantly predicted by the persistence subdimension of temperament.

[Preventing child abuse risk factors: A study of the ease of French professionals working in early prevention]

Research on child abuse prevention has been limited for the last forty years to the experimental field. While we know how home visiting interventions can help limit situations of child abuse, we do not know how these results can be replicated in routine care situations. The objective of this study was to identify, in French public services, how prevention professionals approach child abuse risk factors with families, and with what degree of ease. The results show that, beyond a form of versatility that allows them to discuss a wide range of topics with families, prevention workers are very uncomfortable dealing with topics of family intimacy, psychopathology, or child abuse. The political implications are discussed.

The role of the school nurse in protecting children and young people from maltreatment: An integrative review of the literature

OBJECTIVES

This review aims to describe the role of the school nurse in protecting children and young people from maltreatment by examining the international literature. Child maltreatment is a prevalent issue in global society today and includes physical, emotional and sexual abuse, neglect and exploitation. School nurses are ideally placed to identify and work with children and young people who are at risk of maltreatment through their regular contact with the school community.

DESIGN

Integrative literature review incorporating thematic analysis.

DATA SOURCES

Electronic databases British Nursing Database, Cumulative Index of Nursing and Allied Health Literature, Medline, PsycInfo, Cochrane Library Database for Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL).

SEARCH TERMS

Role, School Nurse, Child Maltreatment.

REVIEW METHODS

Initial title and abstract review of 444 studies resulted in 78 studies for full text review. Additional search strategies identified one relevant study. Inclusion and exclusion criteria were employed as follows; (1) study published in the English language, (2) peer-reviewed, (3) primary research, (4) inclusion of school nurses (or equivalent role internationally) in the study sample, and (5) a focus on the role of school nurses in preventing child maltreatment. Studies were appraised using the Critical Appraisal Skills Programme tool for qualitative studies and the Strengthening the Reporting of Observational Studies in Epidemiology checklist for mixed-methods and quantitative studies. Findings from the studies were identified, summarised and organised into a summary table, before being analysed thematically.

RESULTS

21 studies met inclusion and quality criteria and were included in the review. Key themes that emerged from the analysis were; supporting the child and family, detective work, working with other professionals, training and supervision, barriers to protecting children and young people from maltreatment and trust.

CONCLUSION

International literature highlights the variety of activities that school nurses may undertake in daily practice to protect children and young people from maltreatment. Several challenges to this role are identified, including time management and building relationships with children and young people. Recommendations for practice and further research are made.

Mediating effect of emotional/behavioral problems and academic competence between parental abuse/neglect and school adjustment

The current study examined the mediating effects of emotional/behavioral problems and academic competence between parental abuse/neglect and a child's school adjustment by investigating 2070 student surveys from the Korean Child Youth Panel Study (KCYPS). A path analysis yielded the following key findings. Firstly, childhood abuse and neglect showed a significant negative and direct effect on school adjustment. It is particularly important to note that the effect of neglect was bigger than that of abuse in this study. Secondly, emotional/behavioral problems were found to partially mediate between abuse/neglect and school adjustment. Thirdly, academic competence partially mediated the effect of neglect on school adjustment, while it did not mediate the effect of abuse on school adjustment. The indirect effect of parental neglect via emotional/behavioral problems and academic competence was stronger than that of parental abuse. The influence of parental abuse and neglect on children's school adjustments was discussed in terms of emotional/behavioral problems and academic competence considering unique Korean cultural context.

The School Nurse's Ability to Detect and Support Abused Children: A Trust-Creating Process

Child abuse has negative health consequences. Early detection and preventive measures lead to avoidance of prolonged and more complex problems. School nurses have a child protection role and should pay attention to vulnerable children. Through health dialogues and other interactions with pupils, school nurses have the opportunity to detect child abuse. The aim of the study was to explore how school nurses detect child abuse and initiate support measures. Focus group interviews were conducted with 23 school nurses. The data were analyzed using a grounded theory approach. Results showed that the main concern of the school nurses was support and assistance to children who are abused which was preceded by a trust-creating and trust-strengthening process. Trust contains self-confidence and confidence in the system and trust can be strengthened or undermined. Building trustful relations is time consuming and is facilitated by networking, refined assessment instruments, and collaboration.

How do public child healthcare professionals and primary school teachers identify and handle child abuse cases? A qualitative study

Background

Public child healthcare doctors and nurses, and primary school teachers play a pivotal role in the detection and reporting of child abuse, because they encounter almost all children in the population during their daily work. However, they report relatively few cases of suspected child abuse to child protective agencies. The aim of this qualitative study was to investigate Dutch frontline workers’ child abuse detection and reporting behaviors.

Methods

Focus group interviews were held among 16 primary school teachers and 17 public health nurses and physicians. The interviews were audio recorded, transcribed, and thematically analyzed according to factors of the Integrated Change model, such as knowledge, attitude, self-efficacy, skills, social influences and barriers influencing detection and reporting of child abuse.

Results

Findings showed that although both groups of professionals are aware of child abuse signs and risks, they are also lacking specific knowledge. The most salient differences between the two professional groups are related to attitude and (communication) skills.

Conclusion

The results suggest that frontline workers are in need of supportive tools in the child abuse detection and reporting process. On the basis of our findings, directions for improvement of child abuse detection and reporting are discussed.

Paediatric nurses' identification of violence against children

AIM

This paper is a report of an evaluation of paediatric nurses' assessment and diagnostic skills and interventions used for child maltreatment.

BACKGROUND

The use of violence against children occurs in all environments worldwide. Therefore, broader theoretical and practical knowledge related to this issue is needed in health care to facilitate more accurate identification of child maltreatment in order to instigate implementation of appropriate care for these children.

METHODS

The study was based on cross-sectional data obtained with a convenience sample of 160 Registered Nurses employed at paediatric wards at two large cities in Poland (response rate 80%). Data collection took place between December 2005 and March 2006. The research tool was a questionnaire form designed on the basis of international literature concerning battered child syndrome.

RESULTS

Battered child syndrome seems to be a relatively common phenomenon, as a great majority of participants (86·25%) had encountered it in their practice. The form of child maltreatment which was most often mentioned (by 30·00% of participants) was neglect. Almost three-quarters of the nurses (61·25%; n = 98) said that they had been involved in providing care for a maltreated child.

CONCLUSION

Nurses should work with maltreated children on an individualized basis, combined with interdisciplinary cooperation with specialists from related disciplines concerned with the issue. There appears to be a need for specialized training for nurses to increase their competence in working with maltreated children and their families.

Health visitors’ assessments of parent–child relationships: A focus group study

BACKGROUND

Health visitors (HVs), also known as public health nurses, in the UK provide a universal community-based service to preschool children and their parents. Since they have ongoing supportive contact with almost all mothers and young children they have opportunities to identify problems in the parent-infant relationship: for example during developmental screening, home visits and immunisation clinics. Research into the role of screening for problems in the parent-child relationship in early childhood is sparse and little is known about how such problems are currently identified in the community.

OBJECTIVE

To explore the approaches taken by health visitors (HVs) to identifying problems in the parent-child relationship.

DESIGN

Focus group study.

SETTING

Glasgow, Scotland.

PARTICIPANTS

24 health visitors sampled purposively.

RESULTS

Multiple sources of information were used by health visitors in assessing parent-child relationships. These include use of known risk factors, knowledge of local norms, direct observations of behaviour, reflection on the relationship between the parent and health visitor, as well as more intuitive reactions. In many cases understanding difficulties in parent-child relationships involved piecing together a jigsaw over a considerable time span. Continuity of relationships appeared to be crucial in this task. Home visits were described as the most informative setting in which to develop an understanding of the parent-child relationship. PARTICIPANTS reported a lack of formal training in the assessment of parent-child relationships and were keen to obtain more training.

CONCLUSIONS

Health visitors use complex strategies to integrate information about parent-child relationships. These strategies are acquired in a variety of ways, but receive little emphasis during basic professional training.

Nurse Reporting of Known and Suspected Child Abuse and Neglect Cases in Taiwan

Despite the frontline role of taking care of children, nurses in Taiwan have been reluctant to report known and suspected cases of child abuse and neglect (CAN). This problem threatens the success of legislation aimed at reducing CAN cases in Taiwan. The purpose of this study was to examine the influence of nurses' perceptions, attitudes, and knowledge on suspecting and reporting CAN cases in health care settings in Taiwan. Two hundred and thirty-eight nurses were surveyed using structured questionnaires with a return rate of 79.3%. Health care settings surveyed in this study included emergency units, pediatric units, and community centers from eight hospitals in southern Taiwan. Almost 3/4 (70%) of the sample of nurses thought they needed more training courses on CAN. Correlation analysis showed a significant relationship between suspecting and reporting CAN with perception, attitude, and knowledge. Stepwise multiple regression analysis revealed that perception (beta = 0.475), knowledge (beta = 0.265), and attitude (beta = 0.246) accounted for 60% of the variance in suspecting and reporting CAN. The focus and scope of training programs for nurses in Taiwan should take these findings into consideration.