1
|
Åstrøm AN, Berge KG, Birungi N, Brattabø IV. Information sharing between the dental healthcare and child welfare services regarding child maltreatment-A repeated cross-sectional study in Norway. Int J Paediatr Dent 2024; 34:494-504. [PMID: 38173186 DOI: 10.1111/ipd.13150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 11/30/2023] [Accepted: 12/06/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Little is known about dental healthcare workers reported suspected child maltreatment to and received inquiry from the child welfare services (CWS). AIM Assess time lag differences in public dental healthcare workers' information sharing with CWS and identify sociodemographic and attitudinal covariates of information sharing with CWS in 2014 and 2019. DESIGN In 2014 and 2019, a national census of 1542 and 1791 Norwegian dental health care workers, respectively, were invited to participate in an electronic survey. Of them, 1200 (77.8%) and 1270 (70.9%) replied to the questionnaires. Time trends of reported child maltreatment and received inquiries were estimated and adjusted for sociodemographics, attitudes, trust, and collaborative routines in logistic regression analyses. RESULTS The likelihood of reported child maltreatment to and received inquiry from CWS was higher in 2019 than in 2014 (OR 1.4 [95% CI 1.2-1.7] and OR 1.1 [95% CI 0.9-1.4]). Significant associations occurred with sociodemographic characteristics, attitudes, and collaborative routines. The likelihood of receiving inquiry about whether being employed long versus short term was higher in 2019 than in 2014. CONCLUSION Information sharing between dental healthcare workers and CWS improved across time and might promote beneficial outcomes.
Collapse
Affiliation(s)
- Anne Nordrehaug Åstrøm
- Oral Health Center of Expertise in Western Norway, Bergen, Norway
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | | | - Nancy Birungi
- Oral Health Center of Expertise in Western Norway, Bergen, Norway
| | | |
Collapse
|
2
|
Jampersa L, Paisca AB, Taveira KVM, Araújo CMD, Massi GADA. Prevalence of reported violence in children and adolescents in the clinical work of health professionals: a systematic review and meta-analysis. CIENCIA & SAUDE COLETIVA 2024; 29:e19192022. [PMID: 39140551 DOI: 10.1590/1413-81232024298.19192022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 08/21/2023] [Indexed: 08/15/2024] Open
Abstract
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%).
Collapse
Affiliation(s)
- Lucas Jampersa
- Universidade Tuiuti do Paraná. R. Luiz Gurgel do Amaral Valente 104. 81925-230 Curitiba PR Brasil.
| | - Adriele Barbosa Paisca
- Universidade Tuiuti do Paraná. R. Luiz Gurgel do Amaral Valente 104. 81925-230 Curitiba PR Brasil.
| | | | | | | |
Collapse
|
3
|
Birungi N, Berge KG, Åstrøm AN, Brattabø IV. Association of child abuse and neglect training with filing reports of concern to child welfare services: a cross-sectional study. BMC Oral Health 2024; 24:427. [PMID: 38582849 PMCID: PMC10999089 DOI: 10.1186/s12903-024-04222-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 04/02/2024] [Indexed: 04/08/2024] Open
Abstract
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.
Collapse
Affiliation(s)
- Nancy Birungi
- Oral Health Centre of Expertise in Vestland County, Bergen, Norway.
| | | | - Anne Nordrehaug Åstrøm
- Oral Health Centre of Expertise in Vestland County, Bergen, Norway
- Institute of Clinical Dentistry, University of Bergen, Bergen, Norway
| | | |
Collapse
|
4
|
Meyer LM, Lehmann T, Schüler IM. Child abuse and neglect: A comparative study between dental and medical students' competencies in Germany. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2024; 28:302-312. [PMID: 37661599 DOI: 10.1111/eje.12950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/02/2023] [Accepted: 07/30/2023] [Indexed: 09/05/2023]
Abstract
INTRODUCTION Despite children's right to a non-violent upbringing, they become daily victims of violence. Physical violence concerns mostly the head-especially the orofacial area. Therefore, dentists and paediatricians should be able to suspect possible abuse and to initiate child protection. This study aimed to record and compare the training situation and competencies of dental and medical students at Jena University Hospital regarding child abuse and neglect (CAN). MATERIALS AND METHODS Using a three-part questionnaire about CAN, 123 medical and 77 dental students were surveyed anonymously after completing all courses on the topic. The question sets included as follows: (1) educational experiences, training content and satisfaction; (2) current knowledge regarding diagnostic, management and legal concerns; (3) self-evaluation, needs of further education and wishes. Reliability of the questionnaire was tested with kappa-statistics and assessed as good. RESULTS Dental and medical students' overall satisfaction with CAN-related training is low. Although medical students had more knowledge on CAN, all participants showed large deficits. Better diagnostic than management skills were reported in both groups. Only 1.3% dental and 16.3% medical students felt adequately prepared to deal with CAN. 7% of all study participants stated that they can report CAN without any help. 87.0% of medical and 79.2% of dental students expressed a desire for further education. To improve their knowledge, both courses prefer seminars, followed by expert talks, lectures and simulation-based training (SkillsLab). CONCLUSION Dental and medical students are inadequately prepared to suspect possible abuse and to deal with possible signs of CAN. Mandatory interdisciplinary courses and lectures addressing CAN are recommendable for both medical and dental curricula.
Collapse
Affiliation(s)
- Lisa-Marie Meyer
- Department of Orthodontics, Section of Preventive and Pediatric Dentistry, Jena University Hospital, Jena, Germany
| | - Thomas Lehmann
- Institute of Medical Statistics, Computer Sciences and Documentation, Jena University Hospital, Jena, Germany
| | - Ina Manuela Schüler
- Department of Orthodontics, Section of Preventive and Pediatric Dentistry, Jena University Hospital, Jena, Germany
| |
Collapse
|
5
|
Alapulli H, Blomqvist M, Tupola S, Valkama E, Nikkola E. The experiences of Finnish dental professionals in handling child abuse and neglect issues in their daily work. Acta Odontol Scand 2023; 81:534-540. [PMID: 37155363 DOI: 10.1080/00016357.2023.2209641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 04/28/2023] [Indexed: 05/10/2023]
Abstract
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.
Collapse
Affiliation(s)
- Heikki Alapulli
- Department of Oral and Maxillofacial Diseases, Children's Hospital, Helsinki University and Helsinki University Hospital, Helsinki, Finland
| | - My Blomqvist
- Department of Oral and Maxillofacial Diseases, Children's Hospital, Helsinki University and Helsinki University Hospital, Helsinki, Finland
| | - Sarimari Tupola
- Department of Children and Adolescents, Children's Hospital, Helsinki University and Helsinki University Hospital, Helsinki, Finland
| | - Elisa Valkama
- Department of Children and Adolescents, Children's Hospital, Helsinki University and Helsinki University Hospital, Helsinki, Finland
| | - Eeva Nikkola
- Department of Children and Adolescents, Children's Hospital, Helsinki University and Helsinki University Hospital, Helsinki, Finland
| |
Collapse
|
6
|
Harris JC, Baker SR, Elcock C. Paediatric dentists' role in child protection practice: Progress over time? Int J Paediatr Dent 2022; 32:714-723. [PMID: 34919298 DOI: 10.1111/ipd.12950] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 12/03/2021] [Accepted: 12/09/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Child maltreatment (abuse and neglect) is a global public health problem. Healthcare professionals must contribute to safeguarding and promoting the welfare of children at risk. AIM To determine whether paediatric dentists' rates of child protection training, experience and practice have changed and to identify factors currently associated with maltreatment recognition and referral. DESIGN A pre-piloted anonymous questionnaire was mailed to the UK-based British Society of Paediatric Dentistry members in 2005 (n = 789) and 2016 (n = 575). Analysis was conducted for practising dentists. RESULTS Response rates were 66.3% in 2005 and 62.4% in 2016. Increases were observed in respondents' postgraduate child protection training (87.2% vs. 99.7%), multi-agency training (27.9% vs. 49.2%), ever suspected (67.9% vs. 82.3%) and ever referred child maltreatment (30.7% vs. 61.0%). The proportion who had suspected maltreatment but never referred a child reduced from 37.2% to 21.3%. Having referred more than five times in the preceding five years rose from 0.4% to 14.6% of respondents, yet those seeing children with neglected dentitions daily or more frequently remained unchanged. CONCLUSION This repeated cross-sectional survey demonstrates a substantial improvement in UK paediatric dentists' training and practice, but a gap remains between suspecting and referring maltreatment concerns such that some children remain at risk.
Collapse
Affiliation(s)
- Jenny C Harris
- Community & Special Care Dentistry, Charles Clifford Dental Services, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.,Unit of Oral Health, Dentistry & Society, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Sarah R Baker
- Unit of Oral Health, Dentistry & Society, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Claire Elcock
- Unit of Oral Health, Dentistry & Society, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| |
Collapse
|
7
|
Collins H, Forbes G, Roebuck EM. A dentist's dilemma: sharing wellbeing concerns to safeguard Scotland's children. Br Dent J 2022:10.1038/s41415-022-4088-y. [PMID: 35304590 DOI: 10.1038/s41415-022-4088-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 07/21/2021] [Indexed: 11/09/2022]
Abstract
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.
Collapse
Affiliation(s)
- Hannah Collins
- Speciality Registrar in Paediatric Dentistry, Edinburgh Dental Institute, Edinburgh, UK.
| | - Gillian Forbes
- Research Fellow in Implementation Science, University College London, UK
| | - Elizabeth M Roebuck
- Consultant in Paediatric Dentistry, Edinburgh Dental Institute, Edinburgh, UK
| |
Collapse
|
8
|
BULDUR B, BÜYÜKKÖK Ç, CAVALCANTI AL. Knowledge, attitudes, and perceptions regarding child abuse and neglect among dentists in Turkey. Braz Oral Res 2022; 36:e001. [PMID: 35081219 DOI: 10.1590/1807-3107bor-2022.vol36.0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 04/05/2021] [Indexed: 11/22/2022] Open
|
9
|
Bradbury-Jones C, Isham L, Morris AJ, Taylor J. The "Neglected" Relationship Between Child Maltreatment and Oral Health? An International Scoping Review of Research. TRAUMA, VIOLENCE & ABUSE 2021; 22:265-276. [PMID: 31043121 DOI: 10.1177/1524838019841598] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
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.
Collapse
Affiliation(s)
| | - Louise Isham
- 1724University of Birmingham, Birmingham, United Kingdom
| | | | - Julie Taylor
- 1724University of Birmingham, Birmingham, United Kingdom
- Birmingham Children's Hospital, NHS Foundation Trust, Birmingham, United Kingdom
| |
Collapse
|
10
|
Mahmoud S, Abd Al Gawad R. Knowledge, attitude, and experience of master degree dental students toward child physical abuse in Egypt: A cross-sectional study. J Int Oral Health 2021. [DOI: 10.4103/jioh.jioh_138_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
11
|
Saleem MN, Raja HZ, Shakoor A, Rashid H, Nasir H, Yusuf E. Knowledge, Attitude, and Practices of Dental Practitioners Regarding Domestic Violence in Pakistan. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2021; 58:469580211060799. [PMID: 34915749 PMCID: PMC8725044 DOI: 10.1177/00469580211060799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Domestic violence is a complex social issue worldwide that includes a wide range of physical, sexual, psychological, economic, or emotional trauma to a child or adult. A large proportion of domestic violence cases remain unreported or undocumented. Dentists can play an important role in identifying and reporting these cases, but no such local study is available assessing the dental practitioners' attitudes and knowledge of evaluating physical abuse in Pakistan. The objective of this study was to assess the knowledge and practices of dental practitioners of Pakistan about domestic violence. This cross-sectional study was carried out over 2 months, among 330 dentists across Pakistan, selected by convenience sampling technique. Data was collected via a pre-validated online questionnaire, filled anonymously after taking informed consent. The survey questionnaire collected data about dentists' demographics, awareness, and experiences about domestic violence cases via close-ended questions. Only 10.6% of participating dentists received formal training in the management of domestic violence cases. Approximately 55% of participants knew that physical abuse should be reported in all circumstances; however, half of them could not accurately identify the legal authorities where suspected cases should be reported. Only 20% of the participating dentists had ever suspected a case of physical abuse and 30% of those actually reported it to legal authorities. Participants characterized fear of anger from relatives as the most significant barrier toward reporting suspected cases. The analysis revealed that Pakistan's dentists lack adequate knowledge regarding domestic violence in terms of identification, relevant physical signs/symptoms, and social indicators. Dentists of Pakistan had insufficient knowledge about the identification, management, and reporting of domestic violence cases. However, formal training and dentists' qualification were positively associated with overall awareness and practices regarding domestic violence case management.
Collapse
Affiliation(s)
- Muhammad Nasir Saleem
- Professor of Operative Dentistry, 462516Institute of Dentistry CMH Lahore Medical College, NUMS, Lahore, Pakistan
| | - Hina Zafar Raja
- Professor Prosthodontics, 462516Institute of Dentistry CMH Lahore Medical College, NUMS, Lahore, Pakistan
| | - Asma Shakoor
- Associate Professor, 462516Institute of Dentistry CMH Lahore Medical College, NUMS, Lahore, Pakistan
| | - Haroon Rashid
- Vice President and Dy Chief Executive, 462516CMH Lahore Medical College, NUMS, Lahore, Pakistan
| | - Haiqa Nasir
- 462516Institute of Dentistry CMH Lahore Medical College, Lahore, Pakistan
| | - Elyon Yusuf
- Deceased, Former student 462516Institute of Dentistry CMH Lahore Medical College, Lahore, Pakistan
| |
Collapse
|
12
|
Abstract
Objectives: This study assessed the level of knowledge, attitudes, and awareness of child abuse and neglect (CAN) among dentists. Study design: The sample, consisted of 20,298 Turkish Dental Association (TDA) members, which comprise about two thirds of all dentists, specialists, academics and dental PhD students in Turkey. Among the 20,298 emails sent, 1,020 responses were obtained Descriptive analysis was performed and correlations were tested using the Chi-square and Fischer's Exact tests. A p value of <0.05 was considered statistically significant. Results: Of the participating dentists, 32.7% were able to identify cases of CAN cases, while 17.1% had suspected cases of child abuse and only 1% of them, reported these, to the authorities. The most frequently cited reasons for hesitation to report CAN cases were lack of adequate history (45%), lack of knowledge about the healthcare worker's role in reporting CAN (18.3%), and considerations of the possible consequences against the child (18.8%). Only 11.6% of the participants had received undergraduate level training on the topic of CAN; The majority (86.5%) expressed the need for further education on this issue, and, also, 84.3% believed that it should be a part of postgraduate education. Conclusions: Improvements in CAN education and continuing education courses are necessary to equip dentistry professionals with adequate knowledge about the physical and behavioral indicators of possible abuse, the current legislation regarding mandated reporting and the procedures for reporting suspected cases.
Collapse
|
13
|
Özgür N, Ballıkaya E, Güngör HC, Ataç AS. Turkish paediatric dentists’ knowledge, experiences and attitudes regarding child physical abuse. Int Dent J 2020; 70:145-151. [DOI: 10.1111/idj.12532] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
14
|
Can child safeguarding training be improved?: findings of a multidisciplinary audit. Eur Arch Paediatr Dent 2020; 21:679-685. [PMID: 32062852 DOI: 10.1007/s40368-020-00513-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 01/30/2020] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Child protection has become a very poignant subject in the UK. The Laming report into the death of Victoria Climbié led to the implementation of multidisciplinary safeguarding policies and training for healthcare professionals, social services staff and police. However, many dental practitioners, as well as other healthcare professionals, have little confidence when reporting their concerns and reducing the 'gap' between suspicion and reporting (Laming in The victoria climbie inquiry: report of an inquiry by Lord Laming, 2003. https://www.gov.uk/government/publications/the-victoria-climbie-inquiry-report-of-an-inquiry-by-lord-laming ). Our audit aimed to identify and address the barriers of reporting safeguarding concerns amongst the hospital team. MATERIALS AND METHODS Questionnaires were distributed to staff at Surrey and Sussex Healthcare National Health Service Trust with a valid Safeguarding Children Level 3 certificate in order to assess their knowledge of safeguarding children. Changes to traditional safeguarding training (Group 1) were implemented to include a broader range of speakers, each speaking for shorter times with more personal and focused presentations (Groups 2 and 3). Three cohorts of participants were assessed including healthcare assistants, nurses, dentists, and doctors. RESULTS Group 1 (n = 100) reported 64% experience of reporting compared with group 2 (n = 100) 43% and group 3 (n = 76) 51%. Confidence was higher in those with more experience in child protection. The most common barrier was the uncertainty of diagnosis. More barriers to reporting existed in the new style of training in groups 2 and 3. The scenarios were answered with appropriate concern and reporting by groups 1 and 2, however, less for group 3. DISCUSSION Experienced and trained practitioners are more likely to refer children to child protection teams when they have concerns of abuse or neglect. Personalising training was shown to be less effective and the focus should be more on diagnosis and local protocols. Early training from undergraduate level was a unanimous request. CONCLUSION Focused training on diagnosis and local protocols, accompanied by bespoke teaching for specific specialties would be the most constructive tool for safeguarding children. Exploring modern methods such as simulation-based training could be effective. Structured forms and local policies that are familiar to clinicians prevent omissions and encourage professional awareness.
Collapse
|
15
|
Rønneberg A, Nordgarden H, Skaare AB, Willumsen T. Barriers and factors influencing communication between dental professionals and Child Welfare Services in their everyday work. Int J Paediatr Dent 2019; 29:684-691. [PMID: 31077635 DOI: 10.1111/ipd.12507] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 05/03/2019] [Accepted: 05/06/2019] [Indexed: 12/22/2022]
Abstract
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.
Collapse
Affiliation(s)
- Anne Rønneberg
- Department of Paediatric Dentistry and Behavioural Science, Faculty of Dentistry, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Hilde Nordgarden
- TAKO-centre (National Resource Centre for Oral health in Rare Disorders), Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Anne B Skaare
- Department of Paediatric Dentistry and Behavioural Science, Faculty of Dentistry, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Tiril Willumsen
- Department of Paediatric Dentistry and Behavioural Science, Faculty of Dentistry, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| |
Collapse
|
16
|
Melo M, Ata-Ali F, Cobo T, Diago J, Chofré-Lorente MT, Bagán L, Sanchez-Recio C, Ata-Ali J. Role of a Dentist in the Diagnosis of Child Abuse and Neglect: A Literature and Narrative Review. Open Dent J 2019. [DOI: 10.2174/1874210601913010301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Child Abuse (CA) is defined as any physical or psychological harm inflicted upon children. The most commonly affected anatomical region in these cases is the orofacial complex, thereby placing dentists in a dominant position for detecting CA. The statistical figures referred to CA are high, and many cases go unreported.
Objective:
To determine the level of knowledge, the aptitudes and capacity of dentists in reporting cases of CA; the barriers facing the reporting of cases; and the key clinical characteristics for the detection of CA.
Methodology:
A search was made of the PubMed (MEDLINE), ScienceDirect, LILACS and SciELO databases for articles published up until March 2019, involving analytical observational and descriptive studies relevant to the objectives of our study. All articles were independently reviewed by two authors.
Results:
Injuries caused by CA are largely located in the orofacial region – the most prevalent being caries, burns and fractures. The most frequently identified risk factor is behavioral alterations on the part of the parents or caregivers. The reviewed studies reflect a discrepancy between suspected and reported cases of CA.
Conclusion:
Although dentists are able to detect injuries, there is a great lack of knowledge about how to report cases of CA to the authorities. It is interesting to establish guidelines for the detection and reporting of suspicious cases. Improved training in forensic and legal dentistry is needed, together with the establishment of detection and reporting protocols. The clinical signs detected in the case of CA and neglect include untreated caries, poor oral hygiene, traumatisms, burns, lacerations and biting. The recognition of such signs and correct case history compilation are essential for the detection of CA.
Collapse
|
17
|
Brattabø IV, Bjørknes R, Breivik K, Åstrøm AN. Explaining the intention of dental health personnel to report suspected child maltreatment using a reasoned action approach. BMC Health Serv Res 2019; 19:507. [PMID: 31331329 PMCID: PMC6647276 DOI: 10.1186/s12913-019-4330-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 07/08/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study provides an empirical test of the reasoned action approach (RAA) socio-cognitive theory with the aim of 1) predicting the intention of public dental health personnel (PDHP) to report suspected child-maltreatment to child welfare services (CWS); 2) estimating the effects of the theoretical constructs of RAA, including experiential and instrumental attitudes, injunctive and descriptive norms, and perceived capacity and autonomy regarding PDHP's behavioural intentions; and 3) exploring whether the RAA operates equivalently (i.e., is invariant) in male and female providers. METHODS This national cross-sectional study was conducted in Norway. An electronic survey was distributed to 1542 dentists and dental hygienists working in the public dental health service. The survey included RAA items constructed in accordance with the recommendations for the RAA model. Structural equation modelling (SEM) was used to identify factors derived from the theory of RAA to predict PDHP reporting intentions. RESULTS A total of 77.8% (1200) of those surveyed responded to the survey. The present study provided support for the utility of the RAA across both male and female providers in predicting their intention to report suspected child-maltreatment to the CWS. The final modified SEM model revealed that instrumental attitudes and perceived behavioural control (based on merged capacity and autonomy parameters) were the strongest predictors of intention to report, followed by the reporting of descriptive norms, injunctive norms and experiential attitudes. These factors explained 63.6% of the observed variance in the reporting intention. CONCLUSIONS The large amount of explained variance suggests that RAA is a well-functioning theory that predicts PDHP's reporting intentions to CWS across gender, and gives an understanding of the socio-cognitive factors involved. To strengthen reporting intention among dental personnel, this study suggests educators should focus on the value and positive consequences of reporting, the resources available and how to overcome obstacles; attention to normative expectations and individuals' feelings about reporting may also be helpful.
Collapse
Affiliation(s)
- Ingfrid Vaksdal Brattabø
- Oral Health Centre of Expertise in Western Norway, Hordaland, Pb. 2354 Møllendal, 5867 Bergen, Norway
- Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Pb. 7807, 5020 Bergen, Norway
| | - Ragnhild Bjørknes
- Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Pb. 7807, 5020 Bergen, Norway
| | - Kyrre Breivik
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway, Pb 7810, 5020 Bergen, Norway
| | - Anne Nordrehaug Åstrøm
- Oral Health Centre of Expertise in Western Norway, Hordaland, Pb. 2354 Møllendal, 5867 Bergen, Norway
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Norway, Pb. 7804, 5020 Bergen, Norway
| |
Collapse
|
18
|
Bjørknes R, Iversen AC, Nordrehaug Åstrøm A, Vaksdal Brattabø I. Why are they reluctant to report? A study of the barriers to reporting to child welfare services among public dental healthcare personnel. HEALTH & SOCIAL CARE IN THE COMMUNITY 2019; 27:871-879. [PMID: 30565768 DOI: 10.1111/hsc.12703] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 11/14/2018] [Accepted: 11/23/2018] [Indexed: 06/09/2023]
Abstract
This study is a national cross-sectional survey, conducted in November 2014, of 366 dental hygienists and dentists who had suspected maltreatment but did not report it to Norwegian Child Welfare Services (CWS). The aims of the present paper are to identify the reasons why public dental healthcare professionals are reluctant to report suspected child maltreatment to CWS and to determine whether there are differences in the identified barriers according to socio-demographic variables. The questionnaire was based on earlier studies and was adapted to fit the Norwegian context. The most frequently chosen reason for not reporting was "unsure of own assessment" (90.4%). Thirteen items pertaining to not reporting were factorised into three factors of barriers. These factors were "insufficient knowledge of child maltreatment and reporting", "fear of the consequences for oneself and the dental clinic", and "fear of the consequences for the patient and their family". A t test revealed that public dental healthcare personnel who had not received training on maltreatment and reporting to CWS during their professional education scored significantly higher on the barrier "insufficient knowledge of child maltreatment and reporting" than did dental personnel who had received such training. Furthermore, dental personnel with more years of experience (11+) scored higher on this barrier than did dental personnel with less experience. No other significant differences in barriers were observed. Public dental healthcare personnel have a mandatory obligation to report to CWS if they suspect child maltreatment. Despite this obligation, the present study reveals that several barriers to reporting exist. This study underscores the importance of strengthening knowledge among dental hygienists and dentists about when and how to report, both during education and in clinical practice.
Collapse
Affiliation(s)
- Ragnhild Bjørknes
- Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Anette Christine Iversen
- Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Anne Nordrehaug Åstrøm
- Oral Health Centre of Expertise in Western Norway, Bergen, Norway
- Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Ingfrid Vaksdal Brattabø
- Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Bergen, Norway
- Oral Health Centre of Expertise in Western Norway, Bergen, Norway
| |
Collapse
|
19
|
Jakobsen U, Fjallheim AS, Gislason H, Gudmundsen E, Poulsen S, Haubek D. Dental professionals' experience with and handling of suspicion of child maltreatment in a small-scale society, the Faroe Islands. Clin Exp Dent Res 2019; 5:145-150. [PMID: 31049217 PMCID: PMC6483035 DOI: 10.1002/cre2.164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 12/12/2018] [Accepted: 12/13/2018] [Indexed: 11/23/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Unn Jakobsen
- Municipal Dental Service for Children and Adolescents, KlaksvíkFaroe Islands
| | - Anna Sofia Fjallheim
- University of the Faroe Islands, Faculty of Health Sciences, Centre of Health Science, SjólonVestara BryggjaTórshavnFaroe Islands
| | - Hannes Gislason
- University of the Faroe Islands, The Faculty of Science and Technology, SjólonVestara BryggjaTórshavnFaroe Islands
| | - Eina Gudmundsen
- Municipal Dental Service for Children and Adolescents, Department of Orthodontics, TórshavnFaroe Islands
| | - Sven Poulsen
- Section for Paediatric Dentistry, Department of Dentistry and Oral Health, HealthAarhus UniversityAarhusDenmark
| | - Dorte Haubek
- Section for Paediatric Dentistry, Department of Dentistry and Oral Health, HealthAarhus UniversityAarhusDenmark
| |
Collapse
|
20
|
Harris JC. The mouth and maltreatment: safeguarding issues in child dental health. Arch Dis Child 2018; 103:722-729. [PMID: 29472196 DOI: 10.1136/archdischild-2017-313173] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 01/23/2018] [Accepted: 01/24/2018] [Indexed: 11/03/2022]
Affiliation(s)
- Jenny C Harris
- Charles Clifford Dental Services, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.,School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| |
Collapse
|
21
|
El Tantawi M, Gaffar B, Arheiam A, AbdelAziz W, Al-Batayneh OB, Alhoti MF, Al-Maweri S, Dama MA, Zaghez M, Hassan KS, Al-Sane M, AbdelSalam M, Sabbah W, Owais AI, Abdelgawad F, Aldhelai TA, El Meligy OAES, AlHumaid J, Al-Harbi F. Dentists' intention to report suspected violence: a cross-sectional study in eight Arab countries. BMJ Open 2018; 8:e019786. [PMID: 29602845 PMCID: PMC5884375 DOI: 10.1136/bmjopen-2017-019786] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES This study assessed dentists' intention in eight Arab countries to report suspected exposure to violence among patients and factors associated with this intention based on the theory of planned behaviour. METHODS A cross-sectional study was conducted in 2016 including a convenience sample of dentists practising in public, private and academic sectors in Algeria, Egypt, Jordan, Kuwait, Libya, Palestine, Saudi Arabia and Yemen. Respondents answered a self-administered questionnaire collecting information about personal and professional background and perceived ability to identify victims of violence. The questionnaire assessed (on a scale from 1 to 10 using six negative statements) dentists' perception of healthcare system mandated reporting of suspected violence. Six statements were used to assess professional attitude towards reporting suspected violence. Logistic regression was used to assess the association between intention to report suspected violence and perceived ability, perception and attitude adjusting for confounders. RESULTS The response rate was 65.2% (n=2936/4506) from general practitioners (70.9%) of mean age=31 years with 56.7% women. Of those, 68.8% intended to report and 52.2% considered themselves able to identify violence victims. The mean (SD) negative perception score=5.3/10 (2.1) and the mean (SD) professional attitude score=7.5/10 (1.9). In multivariate regression, intention to report was associated with professional attitude (OR 1.08, 95% CI 1.03 to 1.14), ability to identify violence victims (OR 1.76, 95% CI 1.45 to 2.12) and negative perception that reporting is not mandated (OR 0.89, 95% CI 0.85 to 0.94). Significant differences existed among countries in intention to report. CONCLUSION Most dentists intended to report suspected violence and their intention could be explained by the theory of planned behaviour which offers a framework for professional development to support violence victims. Sharing of training resources, policies and guidelines is needed to ensure that practices similar to international guidelines are consistently adopted by dentists across Arab countries.
Collapse
Affiliation(s)
- Maha El Tantawi
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Balgis Gaffar
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Arheiam Arheiam
- Department of Community and Preventive Dentistry, Faculty of Dentistry, University of Benghazi, Benghazi, Libya
| | - Wafaa AbdelAziz
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Ola B Al-Batayneh
- Department of Preventive Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | | | | | - Mai A Dama
- Department of Paedodontics and Orthodontics, College of Dentistry, Arab American University of Jenin, Jenin, Palestine
| | - Mounir Zaghez
- Department of Oral Medicine, Faculty of Medicine, Annaba University (BADJI Mokhtar), Annaba, Algeria
| | - Khalid Saddiq Hassan
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, AlAzhar University, Assiut, Egypt
| | - Mona Al-Sane
- Department of Developmental and Preventive Sciences, Faculty of Dentistry, Kuwait University, Kuwait City, Kuwait
| | - Maha AbdelSalam
- Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Wael Sabbah
- Department of Population and Patient Health, King’s College Hospital, London, UK
| | - Arwa I Owais
- Department of Pediatric Dentistry, College of Dentistry, University of Iowa, Iowa City, Iowa, USA
| | - Fatma Abdelgawad
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt
| | | | - Omar Abd El Sadek El Meligy
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
- Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Jehan AlHumaid
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Fahad Al-Harbi
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| |
Collapse
|
22
|
Brattabø IV, Bjørknes R, Åstrøm AN. Reasons for reported suspicion of child maltreatment and responses from the child welfare - a cross-sectional study of Norwegian public dental health personnel. BMC Oral Health 2018; 18:29. [PMID: 29499677 PMCID: PMC5833052 DOI: 10.1186/s12903-018-0490-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 02/20/2018] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND To prevent child maltreatment, the identification of vulnerable children is essential. In Norway, public dental health personnel (PDHP) report suspicion of child maltreatment to child welfare services (CWS) at a relatively high rate. However, their reasons for reporting and the response from CWS have not been investigated. The objectives of this study were to (1) explore the reasons that PDHP send reports of concern, (2) examine how CWS responds to PDHP reports, and (3) assess whether different reasons for concern are associated with a given response from CWS. METHODS A national cross-sectional study was conducted by an electronic survey distributed to public dental hygienists and dentists in Norway. Descriptive statistics were calculated in terms of mean (SD) distributions and frequency, expressed as % (n). To account for clustering of responses among respondents, binomial generalized estimating equation analysis was used to estimate odds ratios (ORs) and confidence intervals (CIs) of CWS responses across number of reports with different reasons for concern. RESULTS Of a total of 1542 questionnaire recipients, 1200 (77.8%) responded to the survey. From 2012 to 2014, 42.5% of the respondents sent 1214 reports to CWS, with a mean number of 2.7 (SD = 2.0) reports per respondent. The PDHP sent the reports due to suspicion of neglect or physical, sexual and/or psychological abuse. Non-attendance at dental appointments and grave caries were reported most frequently. Among the reports, 24.5% resulted in measures being taken by CWS, 20.7% were dropped, and 29.4% lacked information from CWS on the outcome. Reports due to suspicion of sexual abuse, (OR 1.979, 95% CI (1.047-3.742), P = 0.036), grave caries (OR 1.628, 95% CI (1.148-2.309), P = 0.006), and suspicion of neglect (OR 1.649, 95% CI (1.190-2.285), P = 0.003) had the highest association with the implementation of measures. CONCLUSIONS PDHP report on several forms of child maltreatment and contributes in detection of victimized children. However, the relatively low number of measures being taken by CWS and the number of reports that lack a response to reporters reveal a need for a closer cooperation between the services, as this would benefit both the children at risk and the services.
Collapse
Affiliation(s)
- Ingfrid Vaksdal Brattabø
- Oral Health Centre of Expertise in Western Norway/Hordaland, Pb. 2354, Møllendal, 5867 Bergen, Norway
- Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Pb. 7807, 5020 Bergen, Norway
| | - Ragnhild Bjørknes
- Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Pb. 7807, 5020 Bergen, Norway
| | - Anne Nordrehaug Åstrøm
- Oral Health Centre of Expertise in Western Norway/Hordaland, Pb. 2354, Møllendal, 5867 Bergen, Norway
- Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Pb. 7804, 5020 Bergen, Norway
| |
Collapse
|
23
|
Hazar Bodrumlu E, Avşar A, Arslan S. Assessment of knowledge and attitudes of dental students in regard to child abuse in Turkey. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2018; 22:40-46. [PMID: 27735105 DOI: 10.1111/eje.12242] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/20/2016] [Indexed: 06/06/2023]
Abstract
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.
Collapse
Affiliation(s)
- E Hazar Bodrumlu
- Department of Pediatric Dentistry, Faculty of Dentistry, Bulent Ecevit University, Zonguldak, Turkey
| | - A Avşar
- Department of Pediatric Dentistry, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
| | - S Arslan
- Department of Biometry, Faculty of Veterinary Medicine, Ondokuz Mayıs University, Samsun, Turkey
| |
Collapse
|
24
|
Li X, Yue Q, Wang S, Wang H, Jiang J, Gong L, Liu W, Huang X, Xu T. Knowledge, attitudes, and behaviours of healthcare professionals regarding child maltreatment in China. Child Care Health Dev 2017; 43:869-875. [PMID: 28809059 DOI: 10.1111/cch.12503] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 07/16/2017] [Accepted: 07/22/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND A new, recently issued national law and regulation in China conferred the responsibility of healthcare professionals in child maltreatment intervention. However, few studies have reported on the recognition and reporting of child maltreatment by healthcare professionals in China. The aim of this study was to assess healthcare professionals' knowledge, attitudes, and self-perceived behaviour in terms of identifying, assessing, and reporting child maltreatment cases in China. METHODS A cross-sectional survey of 877 healthcare professionals from four provinces was conducted using a structured questionnaire. RESULTS The respondents demonstrated insufficient knowledge on identifying potential child maltreatment cases. Over 30% of them were less than confident in the medical examination, evaluation, and treatment of child maltreatment cases, especially with regard to cases involving sexual abuse. Only 3.19% of respondents had ever received training on child maltreatment intervention, and as a result, lack of knowledge with regard to dealing with child maltreatment cases, referral procedures, and regulations was indicated to be the main cause of underreporting. CONCLUSIONS Healthcare professionals in China have insufficient knowledge, skills, and confidence when it comes to dealing with all aspects of child maltreatment. Although participants reported a positive attitude towards their role in detecting and reporting child maltreatment cases, there are obstacles that hinder them from doing so. Appropriate training courses should be developed to empower professionals with knowledge and skills, as well as increase their confidence in dealing with suspected child maltreatment cases.
Collapse
Affiliation(s)
- X Li
- Child Health Care Department, National Center for Women and Children's Health, China CDC, Beijing, China
| | - Q Yue
- Child Health Care Department, National Center for Women and Children's Health, China CDC, Beijing, China
| | - S Wang
- Child Health Care Department, National Center for Women and Children's Health, China CDC, Beijing, China
| | - H Wang
- Child Health Care Department, National Center for Women and Children's Health, China CDC, Beijing, China
| | - J Jiang
- Child Health Care Department, National Center for Women and Children's Health, China CDC, Beijing, China
| | - L Gong
- Child Health Care Department, National Center for Women and Children's Health, China CDC, Beijing, China
| | - W Liu
- School of Brain and Cognitive Sciences, Beijing Normal University, Beijing, China
| | - X Huang
- Department of Social Work and Social Policy, Zhou Enlai School of Government, Nankai University, Tianjin, China
| | - T Xu
- Child Health Care Department, National Center for Women and Children's Health, China CDC, Beijing, China
| |
Collapse
|
25
|
Brattabø IV, Iversen AC, Åstrøm AN, Bjørknes R. Experience with suspecting child maltreatment in the Norwegian public dental health services, a national survey. Acta Odontol Scand 2016; 74:626-632. [PMID: 27648631 DOI: 10.1080/00016357.2016.1230228] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
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.
Collapse
|
26
|
Rodrigues JL, Lima AP, Nagata JY, Rigo L, Cericato GO, Franco A, Paranhos LR. Domestic violence against children detected and managed in the routine of dentistry – A systematic review. J Forensic Leg Med 2016; 43:34-41. [DOI: 10.1016/j.jflm.2016.07.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 06/24/2016] [Accepted: 07/10/2016] [Indexed: 10/21/2022]
|
27
|
Dental health care providers’ views on child physical abuse in Malaysia. Eur Arch Paediatr Dent 2016; 17:387-395. [DOI: 10.1007/s40368-016-0242-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2016] [Accepted: 05/26/2016] [Indexed: 10/21/2022]
|
28
|
Renato Paranhos L, Rodrigues JL, de Mello Rode S. The role of the dentist facing neglect and domestic violence. JOURNAL OF ORAL RESEARCH 2016. [DOI: 10.17126/joralres.2016.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
29
|
Mogaddam M, Kamal I, Merdad L, Alamoudi N. Knowledge, attitudes, and behaviors of dentists regarding child physical abuse in Jeddah, Saudi Arabia. CHILD ABUSE & NEGLECT 2016; 54:43-56. [PMID: 26990176 DOI: 10.1016/j.chiabu.2016.02.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Revised: 01/29/2016] [Accepted: 02/29/2016] [Indexed: 05/29/2023]
Abstract
A large proportion of child physical abuse cases go undocumented and unreported. Dentists can play an important role in identifying and reporting these cases, but little has been reported about this issue in Saudi Arabia. The aims of the study were to (1) assess dentists' knowledge of child physical abuse, (2) assess dentists' attitudes towards child physical abuse, and (3) assess the behaviors of dentists in identifying and reporting child physical abuse. A cross-sectional survey of pediatric dentists, pediatric dentistry residents, and dental interns practicing at all of the dental schools in Jeddah, Saudi Arabia was conducted using an anonymous, self-administered questionnaire. The participants in current study demonstrated insufficient knowledge of the signs and symptoms of child physical abuse, actions that should be taken in suspected cases, circumstances in which to report such cases, and the legal authorities to which they should be reported. The attitudes of participants towards detecting and reporting cases were generally positive. Only 11% of the participants had suspected a case of child abuse, and only 3% of them reported it. Lack of knowledge about referral procedures and fear of anger from family members were the main causes of underreporting. In conclusion, this study showed that dentists have insufficient knowledge about child physical abuse but positive attitudes towards their role in detecting and reporting it. This topic should be covered and emphasized in dental schools' curricula, and healthcare and academic institutes must have a clear protocol to be followed if a case of abuse is suspected.
Collapse
Affiliation(s)
- Meaad Mogaddam
- Faculty of Medicine, King Abdulaziz University, Saudi Arabia.
| | - Iman Kamal
- Faculty of Medicine, King Abdulaziz University, Saudi Arabia; Faculty of Medicine, AlAzhar University, Egypt
| | - Leena Merdad
- Faculty of Dentistry, King Abdulaziz University, Saudi Arabia
| | - Najlaa Alamoudi
- Faculty of Dentistry, King Abdulaziz University, Saudi Arabia
| |
Collapse
|
30
|
Al-Amad SH, Awad MA, Al-Farsi LH, Elkhaled RH. Reporting child abuse cases by dentists working in the United Arab Emirates (UAE). J Forensic Leg Med 2016; 40:12-5. [PMID: 26950173 DOI: 10.1016/j.jflm.2016.01.033] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Revised: 11/16/2015] [Accepted: 01/01/2016] [Indexed: 11/30/2022]
Abstract
Reporting of suspicious cases of child abuse is a sensitive issue that is often hindered by uncertainty of diagnosis. This cross sectional study aimed to assess the UAE dentists' experiences in child abuse recognition, the factors that prevent them from reporting suspicious cases to authorities and their perceived training needs. A closed-ended, self-administered questionnaire was distributed to 350 dentists working in the UAE. Chi Square test was used to determine association between training needs on child abuse and its reporting rate. Logistic regression was used to determine the association between perceived training needs and other covariates. One hundred and ninety three respondents satisfied the inclusion criteria. Forty seven (25%) dentists reported encountering a suspicious child abuse case at least once in their career, but only 15 (32%) of those reported their suspicion. Fear of making the wrong diagnosis was the most frequent challenge hindering reporting and dentists who demonstrated a need for specialized training were more likely to express this fear (OR = 5.88, 95% CI: 0.07, 0.45; P = 0.00). The majority of UAE dentists do not report their suspicion to authorities and specialized training should be offered to build dentists' capacity in diagnosing and appropriately reporting suspicious child abuse cases.
Collapse
Affiliation(s)
- Suhail H Al-Amad
- College of Dental Medicine, University of Sharjah, United Arab Emirates.
| | - Manal A Awad
- College of Dental Medicine, University of Sharjah, United Arab Emirates
| | | | | |
Collapse
|
31
|
Al-Dabaan R, Asimakopoulou K, Newton JT. Effectiveness of a web-based child protection training programme designed for dental practitioners in Saudi Arabia: a pre- and post-test study. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2016; 20:45-54. [PMID: 25655568 DOI: 10.1111/eje.12141] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/08/2015] [Indexed: 06/04/2023]
Abstract
AIM Safeguarding children is an integral part of dental training and practice. The purpose of this research was to evaluate a web-based training program in child protection on dental practitioners' knowledge and practice in Saudi Arabia. In addition, participants' views of the course were also assessed. METHOD Pre-, immediately post-training, and one month post-training knowledge and self reported behaviour were assessed following completion of an online training course in child protection by 82 dental practitioners working in Saudi Arabia. RESULTS Eighty-two participants completed the whole training package and 62 completed the one month post-training survey. A significant increase in knowledge was found immediately after taking part in the child protection training program in comparison to baseline knowledge (P < 0.001). The course was highly rated by those who completed it. At one month following the training program, 21% have or intend to adopt a child protection policy in their practice, 29% identified a staff member to lead on child protection since completing the program, almost all participants have been aware of child abuse and neglect (CAN) signs in their daily practice and 27.4% have made a report of a suspected case of CAN in the last month since the training. CONCLUSION The web-based training program in child protection was appraised positively and was effective in increasing knowledge and changing attitudes towards safeguarding children.
Collapse
Affiliation(s)
- R Al-Dabaan
- Paediatric Dentistry Division, Department of Paediatric Dentistry and Orthodontics, King Saud University College of Dentistry, Riyadh, Saudi Arabia
- Unit of Social & Behavioural Sciences, King's College London Dental Institute, London, UK
| | - K Asimakopoulou
- Unit of Social & Behavioural Sciences, King's College London Dental Institute, London, UK
| | - J T Newton
- Unit of Social & Behavioural Sciences, King's College London Dental Institute, London, UK
| |
Collapse
|
32
|
Cukovic-Bagic I, Dumancic J, Kujundzic Tiljak M, Drvaric I, Boric B, Kopic V, Krupic I, Bakarcic D, Budimir M, Welbury RR. Croatian dentists' knowledge, experience, and attitudes in regard to child abuse and neglect. Int J Paediatr Dent 2015; 25:444-50. [PMID: 25512027 DOI: 10.1111/ipd.12151] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Child abuse and neglect (CAN) is a widespread social phenomenon encompassing all forms of maltreatment with serious lifelong consequences. Dentists and dental team members are in the unique position to identify the symptoms of CAN often visible in craniofacial region. AIM To evaluate Croatian dentists' level of knowledge, experience, and attitude towards CAN issue. DESIGN Investigation was conducted in five major Croatian cities (Zagreb, Varaždin, Osijek, Rijeka, and Split). A previously used questionnaire regarding knowledge and experience in child protection was adopted to Croatian terminology and distributed to 544 dentists. RESULTS A total of 510 dentists who returned a questionnaire with valid data 26.27% reported to have had suspicion of CAN during professional career and 5.1% reported their suspicion within the last 6 months, mostly to social services and police. Fear of violence towards the child and uncertainty about observations were the most frequently reported barriers towards referring and only 11.4% knew the procedure. About 80% of respondents want further training in identifying and reporting of physical abuse. CONCLUSIONS Study showed a lack of knowledge and uncertainty in recognizing and reporting CAN cases in Croatian dentists. They expressed the need for undergraduate and post-graduate continuing education on this issue.
Collapse
Affiliation(s)
- Ivana Cukovic-Bagic
- Department of Pediatric and Preventive Dentistry, Department of Dental Medicine, School of Dental Medicine, University of Zagreb, University Hospital Center Zagreb, Zagreb, Croatia
| | - Jelena Dumancic
- Department of Dental Anthropology, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Mirjana Kujundzic Tiljak
- Department of Medical Statistics, Epidemiology and Medical Informatics, School of Public Health "Andrija Štampar", School of Medicine, University of Zagreb, Zagreb, Croatia
| | | | | | | | | | - Danko Bakarcic
- School of Medicine, University of Rijeka, Rijeka, Croatia
| | | | - Richard R Welbury
- Department of Paediatric Dentistry, University of Glasgow Dental School, Glasgow, UK
| |
Collapse
|
33
|
Ramazani N. Child dental neglect: a short review. INTERNATIONAL JOURNAL OF HIGH RISK BEHAVIORS & ADDICTION 2014; 3:e21861. [PMID: 25741483 PMCID: PMC4331660 DOI: 10.5812/ijhrba.21861] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 08/25/2014] [Accepted: 08/27/2014] [Indexed: 11/16/2022]
Abstract
Context: Child dental neglect is a terrible tragedy with a high prevalence. Dealing with this issue is important regarding psychological and physical health policies. The current review was conducted to provide health professionals insight into the different aspects of child dental neglect as reported in previous literature. Evidence Acquisition: Our review was prepared through an electronic search using Pub Med, Science Direct, Medline, Google, Cochran Library, Google Scholar and EMBASE databases. Relevant papers published since 2000 until now in English, discussing child dental neglect were retrieved. Both original and review papers were included. Eligible articles were fully read by the author. A data form was used to record useful findings. Results: Distinguishing the direct and indirect signs of dental neglect is the first step for improvement of this matter. The dental team are the main professionals who can improve parental knowledge about the consequences of child dental neglect. Victims suffer from short and long-term adverse outcomes. Collaborative attempts need to be made by different health professionals to deal with this problem. Conclusions: Child dental neglect has many long-term impacts. The main professionals who are responsible for identification, intervention and treatment of child dental neglect are dental practitioners. However, other professionals cannot ignore this task. Finally, child dental neglect, despite its derivative outcomes, may be a presentation of a broader maltreatment.
Collapse
Affiliation(s)
- Nahid Ramazani
- Children and Adolescent Health Research Center, Department of Pediatric Dentistry, School of Dentistry, Zahedan University of Medical Sciences, Zahedan, IR Iran
- Dental Research Center, School of Dentistry, Zahedan University of Medical Sciences, Zahedan, IR Iran
- Corresponding author: Nahid Ramazani, Children and Adolescent Health Research Center, Department of Pediatric Dentistry, School of Dentistry, Zahedan University of Medical Sciences, Zahedan, IR Iran. Tel: +98-5412423218, +98-9155009085, Fax: +98-5412414003, E-mail:
| |
Collapse
|
34
|
Tilvawala D, Murray C, Farah R, Broadbent JM. New Zealand dental therapists’ beliefs regarding child maltreatment. Aust N Z J Public Health 2014; 38:480-4. [DOI: 10.1111/1753-6405.12238] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 01/01/2014] [Accepted: 02/01/2014] [Indexed: 11/30/2022] Open
Affiliation(s)
- Dhara Tilvawala
- Sir John Walsh Research Institute, Department of Oral Rehabilitation; University of Otago; New Zealand
| | - Colleen Murray
- Sir John Walsh Research Institute, Department of Oral Rehabilitation; University of Otago; New Zealand
| | - Rami Farah
- Sir John Walsh Research Institute, Department of Oral Rehabilitation; University of Otago; New Zealand
| | - Jonathan M. Broadbent
- Sir John Walsh Research Institute, Department of Oral Rehabilitation; University of Otago; New Zealand
| |
Collapse
|
35
|
Borrie F, Bonetti D, Bearn D. What influences the implementation of interceptive orthodontics in primary care? Br Dent J 2014; 216:687-91. [DOI: 10.1038/sj.bdj.2014.525] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2014] [Indexed: 11/09/2022]
|
36
|
The Scottish dental practitioner's role in managing child abuse and neglect. Br Dent J 2013; 214:E24. [DOI: 10.1038/sj.bdj.2013.435] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2013] [Indexed: 11/08/2022]
|