Croatian dentists' knowledge, experience, and attitudes in regard to child abuse and neglect

Attitudes and Knowledge of Dental Students in Bosnia and Herzegovina Towards Child Abuse and Neglect

INTRODUCTION

Child abuse and neglect (CAN) are social and public health problems. Access to oral health care for abused and neglected children is a challenge. The aim of this study was to assess the attitudes and knowledge of dental students from Bosnia and Herzegovina towards CAN.

MATERIALS AND METHODS

A cross-sectional survey was conducted among 263 dental students from two public universities in Bosnia and Herzegovina. The students answered 31 questions about the topic of CAN. The study population was categorised by year of study into six groups. Pearson's chi-squared test was used to analyse differences among participants regarding the year of study. The level of significance was set at p < 0.05.

RESULTS

The results show that 10.26% of total participants had experienced some knowledge about the topic of CAN during their studies, 17.87% had read about it in professional dental literature and 8.74% had some form of education and training on the topic. Over 50% of participants answered all of the questions about social indicators of CAN correctly. The knowledge of the study participants was found to be deficient concerning some physical signs of CAN found in the orofacial region. For a significant number of questions 'I don't know' was a frequent answer.

CONCLUSION

The level of knowledge of dental students from Bosnia and Herzegovina regarding the challenge of CAN is insufficient. An important strategy this to improve this is to increase the education and training of child abuse and neglect in dental curriculums.

Prevalence of reported violence in children and adolescents in the clinical work of health professionals: a systematic review and meta-analysis

This article aims to analyze the prevalence of reporting and notification of violence in children and adolescents in the work of clinical health professionals. The search was performed in six electronic databases and the gray literature for studies published until June 1, 2022. Estimates of interest were calculated using random effects meta-analyses. Two reviewers independently evaluated the potentially eligible studies according to the following criteria: cross-sectional studies carried out with health professionals who provided clinical care for children and adolescents and dealt with violence cases. Two reviewers extracted data on included trial characteristics, methods, and outcomes. Expectations of interest were transformed using random effects meta-analyses. The meta-analysis of the prevalence of reports of violence performed with 42 articles was 41%. The notification meta-analysis occurred with 39 articles and was 30%. About one in two health professionals face situations of violence against children and adolescents in their clinical practice (41%), and approximately one in three health professionals report the cases (30%).

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.

Association of child abuse and neglect training with filing reports of concern to child welfare services: a cross-sectional study

BACKGROUND

The aptitude, knowledge, and competence of dental health personnel on child abuse and neglect (CAN) is not optimal for deciding when to file a report of concern to child welfare services (CWS).

OBJECTIVES

The aim of this study was, firstly, to assess the association of the public dental health personnel 's (PDHP) training on CAN received in the last three work years, i.e., in 2016 through 2018 with filing reports to the CWS in the same period and secondly to assess the association of expressed need of training on CAN with filing reports to the CWS.

METHODS

This cross-sectional study uses data from an electronic survey census of PDHP from Norway (n = 1791) conducted in 2019. The Pearson chi-square test, non-parametric tests, logistic, and negative binomial regression were used for unadjusted and adjusted analysis. Data was reported with proportions, odds ratios (OR), incidence rate ratios and 95% confidence intervals (CIs).

RESULTS

From 2016 to 2018, the prevalence estimate of filing reports to CWS was 50%, with a mean (standard deviation) of 1.39 (2.11) reports sent. The logistic regression analysis showed an association between filing reports of concern and CAN training in the last three years. Compared to those that had not received CAN training during the three previous years, the ORs (95% CI) for filing reports to the CWS during the same period was 2.5 (1.6-4.0) for one day CAN work training, 3.2 (2.0-5.1) for 2-4 days CAN training and 4.9 (2.6-9.4) for five or more days CAN training. Compared to workers who did not need training in reporting (routines of CAN), those who expressed the need for a little more and more training were less likely to file a report. The corresponding OR were 0.6 (0.4-0.9) and 0.6 (0.3-0.9), respectively.

CONCLUSION

CAN training during the last three years is associated with filing reports of concern to CWS in the same period among PDHP in Norway. The likelihood of filing CAN reports increased with the number of days of CAN training received. Secondly, the PDHP with an expressed need for training on CAN routines were less likely to report suspicions to CWS.

Current approaches addressing oral health practitioners' responsiveness to child abuse and neglect: A scoping review protocol

INTRODUCTION

Child abuse and neglect (CAN) poses significant risks, causing severe and long-lasting effects on a child's well-being, including physical and mental health and learning and socializing capabilities. Oral health practitioners (OHPs) uniquely position themselves to identify signs of maltreatment in the orofacial area, offer appropriate support, and collaborate with a multidisciplinary team. The literature has shown that OHPs under-report child protection concerns to a statutory child protection agency. Responding to CAN is often hindered by various factors, such as the fear of making false accusations and insufficient knowledge to detect and report potential cases. However, the literature lacks a comprehensive understanding of the strategies and interventions that can address the responsiveness of OHPs and other professionals to child protection issues. This scoping review aims to provide a broad overview and map the literature on the existing approaches to enhance the responsiveness of OHPs in child protection.

MATERIALS AND METHODS

The proposed scoping review will be conducted following the JBI methodology for scoping reviews guideline and reported using the PRISMA-ScR guideline. The first exploratory search is conducted to refine the search strategy and inclusion and exclusion criteria. The second search will include MEDLINE (EBSCO), CINAHL (EBSCO), Dentistry & Oral Science Source (EBSCO), Cochrane Library, and Scopus, with a date range from January 2000 to March 2023. The third search will involve reference list searching and gray literature searching in Google and Google Scholar. Government and international health organizations' websites will be searched for policies and guidelines. The review will consider studies that report the current approaches to address OHPs' responsiveness to CAN in any setting. Two reviewers will independently select sources and extract data. Any disagreements will be resolved by consensus of the research team. The extracted data will be presented in a tabulated chart with a narrative summary.

The experiences of Finnish dental professionals in handling child abuse and neglect issues in their daily work

OBJECTIVE

This study aimed to assess the experiences, attitudes and knowledge of child abuse and neglect (CAN) among dentists, dental hygienists and dental nurses in Finland.

MATERIAL AND METHODS

A web-based CAN survey was sent to 8500 Finnish dental professionals, covering demographic characteristics, dental education, suspicion of CAN, actions taken and reasons for inaction as well as training on CAN issues. The chi-squared (χ2) test was used to analyse associations.

RESULTS

In total, 1586 questionnaires with valid data were completed. Among respondents, 25.8% had received at least some undergraduate training and 36.3% had received postgraduate training on child maltreatment issues. In addition, 43% of respondents had at least one suspicion of CAN at some point during their career. Of those, 64.3% did not refer to social services. Training positively associated with the identification of CAN and referral frequencies. Uncertainty about an observation (80.1%) and a lack of knowledge regarding procedures (43.9%) were the most frequently reported barriers.

CONCLUSIONS

Finnish dental professionals need more education on child abuse and neglect issues. Competence related to CAN is fundamental to their skills given that all dental professionals regularly work with children and are obligated to report their concerns to proper authorities.

Knowledge and Information Resources about Child Abuse among Government and Private Dental Practitioner in Uttar Pradesh, India

Background and Aim

To evaluate knowledge, attitude, and information sources about child abuse and neglect (CAN) among dentists in Varanasi district of Uttar Pradesh state, India.

Subjects and Methods

A cross-sectional online survey was carried out of dentist working in government and private hospitals in the Varanasi district, Uttar Pradesh State, India (n = 674). The structured questionnaire was sent through electronic mail that contained the consent form, instructions for filling, and returning the questionnaire. The data obtained were systematically compiled and the Chi-square test was applied to test the association. The significance level of P ≤ 0.05 was applied.

Results

A maximum number of dental practitioners from the government (81.97%) and private sector (85.98%) were aware of the child protection law. A significant number of government and private dental practitioners were satisfied with their knowledge (p = 0.0092); however, 83.79% suggested that the continuing education programs/courses were important tool to update their knowledge. The girl child was maximum sufferer (p = 0.0056) of CAN. Only 14.08% of practitioners acted on the suspected cases, and a statistical significant relation was observed between the government and private dental practitioners for not taking any action on child abuse and neglect (p = 0.0010).

Conclusions

Data from this study may provide a useful contribution to the current limited knowledge about the familiarity of dental practitioners with child maltreatment and their skills to recognize and manage CAN cases in their practice. The majority of dental practitioners knew about the child protection law in India, but they were reluctant to report such cases due to the fear of anger from the parents and family of the child. Continuing education programs/courses were the most preferred method for increasing the knowledge regarding CAN. They should report the CAN cases to local legislators and health authorities so to prevent child abuse and neglect from ever occurring.

A dentist's dilemma: sharing wellbeing concerns to safeguard Scotland's children

Introduction Over a decade ago, Getting it right for every child (GIRFEC) introduced the 'Named Person' as a central contact with whom professionals could share 'wellbeing' concerns in Scotland, aiming to promote inter-agency working to avoid potential child protection issues. The mandatory 'Named Person' scheme has since been repealed but the professional's responsibility to share concerns at wellbeing level remains.Aims To explore general dental practitioners' (GDPs') understanding of a child's 'wellbeing', along with the investigation of influencing factors on behaviour when sharing concerns at wellbeing level.Methods Qualitative one-to-one semi-structured telephone interviews with GDPs. Themes arising from transcriptions were organised into the Theoretical Domains Framework.Results In total, 11 dentists (five men and six women) participated. Risks to wellbeing included only attending in pain and dental neglect. There was good awareness of the 'Named Person' and triggers to sharing suspicions were identified, which were concern severity, multiple concerns and own intuition. Multiple barriers (eg poor knowledge, fear of consequences, environment) and enablers (eg professional responsibility and influences, positive consequences) influenced decisions to refer. GDPs struggled to differentiate between wellbeing and child protection.Conclusion Barriers and facilitators to sharing wellbeing suspicions are similar to child protection. GDPs may benefit from further training when safeguarding at a wellbeing level.

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.

The "Neglected" Relationship Between Child Maltreatment and Oral Health? An International Scoping Review of Research

Globally, the oral health needs of children who have, or are suspected of having, experienced abuse or neglect has become a focus of concern. It is thus valuable and timely to map the contemporary nature of the research landscape in this expanding field. This review reports the findings of a scoping review of the international empirical literature. The aim was to explore the relationship between child maltreatment and oral health and how this complex issue is addressed in contemporary dental, health, and social work practice. The review identified 68 papers, analysis of which identified three themes: (1) There is a relationship between poor oral health and child maltreatment that is well evidenced but conceptually underdeveloped. (2) There are discrepancies between the knowledge of members of the dental team about child maltreatment and their confidence and aptitude to identify and report child protection concerns. (3) There are areas of local-level policy and practice development that seek to improve working relationships between dentists and health and social work practitioners; however, there is widespread evidence that the oral health needs of this group of vulnerable children are not consistently met. To orientate critical discussion and planning for future research and practice, we present the Patterns, Advances, Gaps, Evidence for practice and Research recommendations (PAGER) framework. The review's findings are likely to be of interest to researchers, practitioners, and policy makers working across dentistry, health and social work.

Knowledge, experiences and attitudes of dental health professionals towards reporting child abuse in Western Australia

BACKGROUND

Up to 50% of child abuse (CA) victims exhibit evidence of traumatic facial or intraoral injuries. Dental health professionals (DHPs) are therefore well-positioned to detect and report incidences of CA. This study aimed to assess the knowledge and attitudes of Western Australian DHPs towards identifying and reporting CA.

METHODS

General dentists, specialists, hygienists and oral health therapists completed an online questionnaire which assessed their knowledge and experience in identifying and reporting CA.

RESULTS

A total of 228 participants completed the questionnaire (representing 7% of DHPs, 60% of paediatric dentists and 11% of all dental hygienists and therapists in Western Australia). The majority of participants (66.2%, P < 0.05) felt that they were unlikely to recognize a patient with physical abuse, or detect signs of sexual abuse (90.8%, P < 0.001). Uncertainty around diagnosing abuse was a barrier towards reporting cases (86.4%, P < 0.05) and most participants (78.0%, P < 0.05) felt that they did not have adequate safeguarding training to report CA.

CONCLUSIONS

Self-reported confidence in identifying and reporting CA cases was low; with the majority of the dental professionals participating in this study unlikely to recognize signs of CA. Inadequate training and knowledge around correct reporting protocols were identified as barriers, which warrants an appropriate change to improve child safeguarding.

Child maltreatment in Dubai and the Northern United Arab Emirates: dental hygienists and assistants' knowledge

PURPOSE

Dental assistants (DAs) and hygienists (DHs) should play an active role in the detection and reporting of child abuse and neglect (CAN). We aimed to investigate CAN knowledge of DAs and DHs in the United Arab Emirates (UAE) and some of the inhibiting factors to the process of CAN reporting.

METHODS

A cross-sectional study design was utilized. We surveyed 186 DAs and DHs using a previously validated self-administered anonymous CAN knowledge questionnaire. Statistical analysis was performed using χ²-square, Fisher's exact test, t test/Mann-Whitney, and a ROC curve (p < 0.05).

RESULTS

Among 186 DAs and DHs surveyed, satisfactory knowledge of CAN was demonstrated by 50.5%. DAs scored a significantly higher score of knowledge compared to DHs (p = 0.03). The most reported CAN referral inhibiting factor was "being afraid to get in trouble with parents". The recognition of a child with special needs and parents missing multiple appointments as risk factors for CAN was significantly higher in the DAs compared to DHs (p = 0.04, p = 0.024, respectively). Awareness of local laws was related to CAN knowledge in DAs (p = 0.012) and DHs (p = 0.008).

CONCLUSION

The lack of appropriate knowledge regarding CAN necessitates a clear reporting process and better education for DAs and DHs in the UAE.

Perspectives towards child abuse and neglect among dental practitioners in Belagavi city: A cross-sectional study

BACKGROUND

Child abuse (CA) is prevalent in every segment of society and is witnessed in all social, ethnic, religious, and professional strata. In this situation, dentists are in an ideal position to help detect signs of CA and should be able to recognize those signs.

AIM

To assess the perspectives toward CA and neglect among dental practitioners of Belagavi city.

MATERIALS AND METHODS

A cross-sectional survey was conducted among 102 dental practitioners. The data were collected by self-administered structured questionnaire. Data were analyzed using descriptive analyses for responses to each question, and Chi-square test was applied to test the association.

RESULTS

59.8% had learned the topic of CA and neglect as a student. Overall, 16 participants have recognized suspicious case of CA and neglect in their dental office. Only 34.3% had knowledge regarding the findings pointing to CA and neglect, and 96% had reported that there are barriers regarding reporting the same. 93% are of opinion that the topic is of utmost importance and more training is required in this aspect.

CONCLUSION

Training and continuing dental education programs should be tailored to the specific needs of all professionals to diagnose, report, and prevent CA.

Barriers and factors influencing communication between dental professionals and Child Welfare Services in their everyday work

BACKGROUND

Among various health professionals, general dental professionals (GDPs) screen children frequently, giving them a unique opportunity to act upon suspicion of child maltreatment. The dental team has received considerable attention regarding safeguarding children.

AIM

The aims of this study were to explore whether GDPs have mutual collaboration and communication with the Child Welfare Services (CWS), and potential barriers for reporting child maltreatment.

DESIGN

An electronically pre-coded questionnaire was sent to all GDPs (n = 131) in the Public Dental Health Service (PDHS) in Oslo. Frequency distributions and statistical analysis were carried out by chi-squared statistics and multivariate logistic regression analysis.

RESULTS

The response rate was 75%. Ninety per cent of GDPs had received requests from CWS to provide a child's dental chart. General dental professionals reported child maltreatment frequently (71%), but CWS only gave feedback in 55% of the cases. Uncertainty was the most common reason for not reporting and 33% of the GDPs had chosen not to send a report despite suspicion. Using guidelines increased frequency of reporting (OR 3.6).

CONCLUSIONS

Mutual collaboration and communication should be improved in the task of safeguarding children. Uncertainty and lack of guidelines may act as barriers for not reporting to the CWS.

Dental professionals' experience with and handling of suspicion of child maltreatment in a small-scale society, the Faroe Islands

The aims of the present study were to describe how frequently dental professionals in a small-scale society like the Faroese Islands, experience suspicion on child maltreatment, and how they handle their suspicion. Furthermore, we wanted to investigate the hypothesis that the special interpersonal characteristics of small-scale societies like the Faroese, influence how dental professionals handle suspicion of child maltreatment compared to how their colleagues in larger societies handled such suspicion. The design of our study was cross-sectional using a non-probability purposive sampling method. A translated and slightly modified version of the Danish questionnaire regarding suspicion on child maltreatment was sent to all 71 dental professionals (44 dentists and 27 dental hygienists) in the Faroe Islands. 51 (72%) returned a valid questionnaire. Of these, 61% experienced suspicion of child maltreatment at some point in their career, 33% within the last 6 months, and 10% percent were certain of child maltreatment during the last six months. Of those respondents who had experienced suspicion at some point of their career, 39% had reported their suspicion. The main reasons for withholding a suspicion were: uncertainty as to whether the suspicion was reliable, fear of the consequences for the child, and lack of procedural knowledge. Faroese dental professionals suspected child maltreatment much more frequently (61%) than their Danish (38%), Scottish (29%), and Croatian colleagues (26%) did. Child maltreatment raises concern among the Faroese dental professionals more frequently than among their colleagues in larger societies. They also seem to report their concern more frequently than their Scottish colleagues do. Thus, the present study indicates that the social structure in small-scale societies may affect dental professionals' suspicions, and handling of child maltreatment.

Assessment of knowledge and attitudes of dental students in regard to child abuse in Turkey

INTRODUCTION

Child abuse is a serious public problem. Signs of abuse are often present in the oro-facial region and dentists are in a strategic position to recognise and report suspected cases. The aim of this study was to investigate dental students' knowledge about and attitudes towards child abuse.

MATERIAL AND METHODS

This study was performed at the Faculty of Dentistry of the Ondokuz Mayis University. The data were collected through a self-report questionnaire administered to dental students (137 female/111 male) in three different dental classes (third, fourth and fifth study years) and grouped by considering those students who have been training in the school year of 2013. The definition of physical and social indicators of abuse, awareness regarding legal and ethical responsibilities, students' experience and requests made by students were evaluated by the students' response to questions put in the questionnaire. Descriptive statistics and chi-square tests were performed to analyse the questionnaire data.

RESULTS

The questionnaire completion rate was 100%. About 67.74% of the third year, 40.71% of the fourth year and 16.67% of the fifth year believed that they could detect child abuse cases. However, results indicated a major lack of knowledge of social indicators, signs of physical abuse and reporting procedure amongst all respondents. The assessment of the total correct answers exhibited significant differences amongst third-, fourth- and fifth-year students' answers. Fifth-year students had the highest rate of correct responses (P < 0.05). Most students wanted to receive more knowledge about this topic.

CONCLUSION

Dental students in Turkey are not sufficiently prepared for their role in diagnosing suspected cases of child abuse.

How Danish dentists and dental hygienists handle their role in child abuse and neglect matters

OBJECTIVE

The objective of this study was to identify how the dental team perceives its role in safeguarding children, to identify barriers to referral to social services, to compare data with data previously reported from Denmark, and to assess if increased focus on safeguarding children has had an effect on how the dental team handles its responsibility to refer to social services.

MATERIAL AND METHODS

The study is based on a Danish version of a questionnaire previously used in Scotland and Denmark. The questionnaire was sent to a random sample of the Danish dental team.

RESULTS

The number of returned questionnaires was 964 (67.0%) with valid data. Of these, 40.8% had had a suspicion of child abuse or neglect and 50.0% had referred their concern to social services. Frequently reported barriers to referral were uncertainty about observations, signs, and symptoms of abuse and neglect, and uncertainty about referral procedures. A total of 84 (8.9%) of the respondents had received both undergraduate and postgraduate training on the topic, and 64.4% of the respondents found that the dental staff could recognize signs and symptoms of abuse and neglect.

CONCLUSION

Findings suggest a continuous need for a focus on the awareness and training of the Danish dental staff on the important topic of child abuse and neglect.

Experience with suspecting child maltreatment in the Norwegian public dental health services, a national survey

OBJECTIVE

Detecting and responding to child-maltreatment is a serious challenge and public health concern. In Norway, public dental health personnel (PDHP) have a mandatory obligation to report to child welfare services (CWS) if they suspect child-maltreatment. This study aimed to assess PDHP's frequency of reporting and failing to report to CWS and whether the frequencies varied according to personal, organizational and external characteristics.

MATERIAL AND METHODS

An electronic questionnaire was sent to 1542 public dental hygienists and dentists in Norway, 1200 of who responded (77.8%).

RESULTS

The majority 60.0%, reported having sent reports of concern to CWS throughout their career, 32.6% had suspected child-maltreatment but failed to report it in their career and 42.5% had sent reports during the three-year period from 2012 to 2014. The reporting frequency to CWS was influenced by PDHP's personal, organizational and external characteristics, while failure to report was influenced by personal characteristics.

CONCLUSIONS

Compared to international studies, PDHP in Norway sends reports of concern and fails to report to CWS at relatively high rates. PDHP's likelihood of reporting was influenced by age, working experience, number of patients treated, size of the municipality and geographical region, while failure to report to CWS was influenced by working experience.