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Midtsund AD, Henriksen L, Lukasse M, Valla L. Detecting and preventing child maltreatment in primary care and PHNs' role-a cross-sectional study. BMC PRIMARY CARE 2024; 25:218. [PMID: 38879472 PMCID: PMC11179210 DOI: 10.1186/s12875-024-02445-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 05/22/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Child maltreatment is a global problem that puts children at risk of mental illness, substance abuse, and premature death. Interdisciplinary collaboration is important in preventing and detecting child maltreatment. In Norway, children undergo universal preventive health assessments and receive complimentary follow-up care from specialized public health nurses in child and family health clinics. These nurses conduct regular check-ups and home visits to monitor children for signs of maltreatment. OBJECTIVE The objective of this study is to describe how public health nurses at child and family health clinics follow the National Clinical Guidelines to prevent and detect child maltreatment, with a particular focus on clinical procedures and interdisciplinary collaboration. Furthermore, we aim to determine factors that are associated with identification of child maltreatment. DESIGN A cross-sectional online survey was conducted among public health nurses working in primary care between October 24th and December 31st, 2022. Public health nurses who worked with children aged 0-5 years and had consultations with families were eligible to participate, resulting in 554 responses. The study employed descriptive analysis, including frequency, percentage and mean, as well as a two-step logistic regression analysis. The study was approved by the relevant authority, and informed consent was obtained through questionnaire completion. RESULTS The public health nurses in this study displayed strong adherence to the guidelines and utilized various comprehensive assessment procedures to monitor child well-being, growth, and development. However, there was limited and infrequent collaboration with other professionals, such as child protection services, general practitioners, and hospitals. Most public health nurses reported occasional suspicion of child maltreatment, with age and years of experience in child and family clinics influencing these suspicions. Older public health nurses were more likely to suspect physical violence, while those with less than two years of experience reported less experience in suspecting maltreatment. Additional education increased the probability of suspecting sexual violence. CONCLUSIONS This study provides insights into the practices of public health nurses in Norway regarding the detection and prevention of child maltreatment in child and family clinics. While adherence to guidelines is strong, suspicion of maltreatment is relatively rare. Collaboration across agencies is crucial in addressing child maltreatment. Age and experience may influence the detection of maltreatment. Improved collaboration, targeted guidelines, and ongoing professional development are needed to enhance child protection.
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Affiliation(s)
- Astrid Durdei Midtsund
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.
- Oslo Municipality, Grünerløkka Child and Family Health Clinic, Oslo, Norway.
| | - Lena Henriksen
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
- Division of General Gynaecology and Obstetrics, Oslo University Hospital, Oslo, Norway
| | - Mirjam Lukasse
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
- Department of Nursing and Social Sciences, Institute of Nursing and Health Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Lisbeth Valla
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
- Regional Centre for Child and Adolescent Mental Health, Eastern and Southern Norway (RBUP), Oslo, Norway
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Engström M, Randell E, Lucas S. Child health nurses' experiences of using the Safe Environment for Every Kid (SEEK) model or current standard practice in the Swedish child health services to address psychosocial risk factors in families with young children - A mixed-methods study. CHILD ABUSE & NEGLECT 2022; 132:105820. [PMID: 35932659 DOI: 10.1016/j.chiabu.2022.105820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 06/27/2022] [Accepted: 07/24/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Child maltreatment (CM) is often hidden, and the youngest children are often those most exposed. CM can be prevented through programs that address risk factors, but few primary prevention strategies have been evaluated. OBJECTIVE To examine the experiences of nurses using the Safe Environment for Every Kid (SEEK) model compared to nurses using current standard practice in the Swedish child health services (CHS) to address psychosocial risk factors in the family environment. PARTICIPANTS AND SETTING Nurses at 27 child health centers in the CHS in the county of Dalarna, Sweden participated in the study. A survey was answered by 55 nurses and 18 nurses participated in focus-group interviews. METHODS A convergent mixed methods research design with focus-group interviews and survey data was used. Qualitative Content Analysis was used to analyze the interview data and Mann Whitney U test was used to analyze the survey data. RESULTS The qualitative analysis identified four categories - "Framing the prerequisites for successful practice"; "Managing the mission of the CHS"; "Meeting the family as a professional"; and "Working with psychosocial risk factors can be emotional" - under the overarching theme "Universal application of a structured method adds value to experience-based knowledge when addressing psychosocial risk factors". Survey data showed that SEEK nurses rated to a greater degree that they possessed adequate knowledge, competence and sense of security to address psychosocial risk factors in their work. CONCLUSIONS This study indicates that using SEEK can strengthen the nurses in identifying and responding to families in need of psychosocial support.
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Affiliation(s)
- Maria Engström
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
| | - Eva Randell
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Steven Lucas
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Assessment of the knowledge, awareness, and attitudes of family physicians in Adana regarding child abuse and neglect. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-020-01220-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Salami S, Alhalal E. Nurses' intention to report child abuse in Saudi Arabia: A cross-sectional study. CHILD ABUSE & NEGLECT 2020; 106:104514. [PMID: 32402818 DOI: 10.1016/j.chiabu.2020.104514] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 04/14/2020] [Accepted: 04/22/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Child abuse is a prevalent problem with short and long-term consequences. While most countries have enacted child abuse reporting laws, the Saudi healthcare system has not paid sufficient attention to nurses' role in the reporting of child abuse. OBJECTIVE This study aimed to 1) identify the factors associated with nurses' intention to report child abuse by testing a hypothetical model; 2) examine the patterns underlying their intention to report child abuse; and 3) investigate the differences in reporting based on clinical practice areas. PARTICIPANTS AND SETTING A convenience sample of 248 nurses recruited from emergency and pediatric inpatient units and primary healthcare centers in Riyadh, Saudi Arabia was used. METHODS In this cross-sectional study, data were collected using the Child Abuse Report Intention Scale and another self-report measure in February 2019. RESULTS Most nurses had not reported even one case of child abuse during their clinical practice. Knowledge about child abuse (β = .210, P = 0.000), subjective norms (β = .218, P = 0.001), and organizational support in guideline implementation (β = .138 P = 0.038) were significantly associated with the intention to report child abuse. Nurses reported a stronger intention to report child sexual abuse than other types of abuse. Clinical practice areas were significantly associated with nurses' intention to report child abuse. CONCLUSIONS Nurses' professional preparation for child abuse reporting is inadequate. The findings underscore the importance of enhancing their knowledge about child abuse and reporting laws, promoting social support, and creating an empowering clinical environment.
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Affiliation(s)
- Salma Salami
- Ministry of Health, Jizan 86518 - 3067, Saudi Arabia.
| | - Eman Alhalal
- Community and Mental Health Nursing Department, College of Nursing, King Saud University, Riyadh 11451, Saudi Arabia.
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Alsaleem SA, Alsaleem MA, Asiri AM, Alkhidhran SS, Alqahtani WSS, Alzahrani MS, Assiri HA, Alshahrany KM, Alsamghan AS. Knowledge and attitude regarding child abuse among primary health care physician in Abha, Saudi Arabia, 2018. J Family Med Prim Care 2019; 8:706-710. [PMID: 30984699 PMCID: PMC6436322 DOI: 10.4103/jfmpc.jfmpc_442_18] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Backgrounds Child abuse or child maltreatment is physical, sexual, or psychological maltreatment or neglect of a child or children, especially by a parent or other caregiver. Child abuse may include any act or failure to act by a parent or other caregiver that results in actual or potential harm to a child, and can occur in a child's home or in the organizations, schools, or communities the child interacts with. This study was conducted to assess the primary health care (PHC) centers' physicians' knowledge and attitude toward child abuse including its types, and child neglect with their behavior regarding reporting of abuse cases. Methods A cross-sectional study was conducted in Abha which is the capital of Aseer Province, including all PHC physicians (about 475) working in PHC centers. Data regarding physicians' demographic characteristics, perception, and awareness regarding child abuse and neglect were collected by self-administrative questionnaire in the PHC center during their time between patients' consultation. Results The study included 300 PHC physicians whose ages ranged from 25 to 50 years old with mean age of 28 years. About 65% of the physicians were males and 69% of them were married with about 73% having at least one child. Overall, 96.3% of the physicians recorded good awareness level regarding types of child abuse and 97.3% recorded good awareness level regarding child neglect patterns. Underreporting of child abuse cases was recorded by about 64% of physicians. Conclusion Regarding child abuse and neglect, PHC physicians have good knowledge, optimal attitude, and positive perception. There was also the problem of underreporting of suspected child abuse cases among PHC physicians in Saudi Arabia, with many barriers to report, such as community traditions; unclear reporting strategy was identified.
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Affiliation(s)
- Safar A Alsaleem
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Mohammed A Alsaleem
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Ahmed M Asiri
- Medical Intern, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Saif S Alkhidhran
- Medical Intern, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | | | | | - Huda A Assiri
- Medical Intern, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | | | - Awad S Alsamghan
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia
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Runhaar J, Rozendaal RM, van Middelkoop M, Bijlsma HJW, Doherty M, Dziedzic KS, Lohmander LS, McAlindon T, Zhang W, Bierma Zeinstra S. Subgroup analyses of the effectiveness of oral glucosamine for knee and hip osteoarthritis: a systematic review and individual patient data meta-analysis from the OA trial bank. Ann Rheum Dis 2017; 76:1862-1869. [DOI: 10.1136/annrheumdis-2017-211149] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 06/22/2017] [Accepted: 06/26/2017] [Indexed: 01/01/2023]
Abstract
ObjectiveTo evaluate the effectiveness of oral glucosamine in subgroups of people with hip or knee osteoarthritis (OA) based on baseline pain severity, body mass index (BMI), sex, structural abnormalities and presence of inflammation using individual patient data.MethodsAfter a systematic search of the literature and clinical trial registries, all randomised controlled trials (RCTs) evaluating the effect of any oral glucosamine substance in patients with clinically or radiographically defined hip or knee OA were contacted. As a minimum, pain, age, sex and BMI at baseline and pain as an outcome measure needed to be assessed.ResultsOf 21 eligible studies, six (n=1663) shared their trial data with the OA Trial Bank. Five trials (all independent of industry, n=1625) compared glucosamine with placebo, representing 55% of the total number of participants in all published placebo-controlled RCTs. Glucosamine was no better than placebo for pain or function at short (3 months) and long-term (24 months) follow-up. Glucosamine was also no better than placebo among the predefined subgroups. Stratification for knee OA and type of glucosamine did not alter these results.ConclusionsAlthough proposed and debated for several years, open trial data are not widely made available for studies of glucosamine for OA, especially those sponsored by industry. Currently, there is no good evidence to support the use of glucosamine for hip or knee OA and an absence of evidence to support specific consideration of glucosamine for any clinically relevant OA subgroup according to baseline pain severity, BMI, sex, structural abnormalities or presence of inflammation.
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Sahebihagh MH, Hosseini SZ, Hosseinzadeh M, Shamshirgaran SM. Knowledge, Attitude and Practice of Community Health Workers Regarding Child Abuse in Tabriz Health Centers in 2015-2016. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2017; 5:264-274. [PMID: 28670588 PMCID: PMC5478747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
BACKGROUND Child abuse is a widespread social phenomenon with serious life-time consequences. Since parents bring their children to healthcare centers for growth screening and vaccinations, Community Health Workers play an important role in identifying and reporting child abuse cases. Thus, the current study aimed to investigate knowledge, attitude and performance of Community Health Workers regarding child abuse in Tabriz. METHODS This is a descriptive (cross-sectional) study; census method was used for sampling. Study population consists of 265 people, employed at units of family health and vaccination in Tabriz healthcare centers in 2015-2016. A questionnaire was used to collect the data. Data analysis was carried out using SPSS, version 23 through descriptive (mean and standard deviation) and analytical (Two Independent Samples T-test and analysis of variance) statistics. RESULTS Findings indicate that 58.5 percent of Community Health Workers had good knowledge about causes of child abuse and 45 percent had good knowledge of the signs, symptoms and complications of child abuse. Their total knowledge was good (57%). The mean score of awareness (knowledge) was significant according to the variable of training participation (P=0.04). The participants had a favorable attitude toward dealing with child abuse (91.3 %); the mean score of attitude was significant according to the educational field (P<0.001) and their performance in dealing with child abuse was moderate and lower (94.3 %). CONCLUSION Community Health Workers had good knowledge regarding child abuse, favorable attitude toward dealing with child abuse, and poor performance in dealing with child abuse. This may be due to fear of side issues to deal with child abuse, or lack of clear legal guidelines regarding this.
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Affiliation(s)
- Mohammad Hasan Sahebihagh
- Tabriz Health Sciences Management Research, Department of Community Health Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seyedeh Zahra Hosseini
- Member of Student Research Committee, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mina Hosseinzadeh
- Department of Community Health Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seyed Morteza Shamshirgaran
- Department of Statistical and Epidemiology, School of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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Yoshioka-Maeda K, Kuroda M. Characteristics and related factors of Japanese mothers who have faced difficulties with childrearing. Public Health Nurs 2017; 34:422-429. [PMID: 28419536 DOI: 10.1111/phn.12328] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To identify characteristics of mothers who face difficulties with childrearing. DESIGN AND SAMPLE Cross-sectional study. During 2014, 221 mothers and 248 children living in City A within the Tokyo metropolis were registered as requiring help with childrearing. Nursing records of 205 mothers (92.8%) and their 227 children (91.5%) were available. We excluded 29 mothers and children owing to incomplete data for a final sample of 176 mothers (79.6%) and 198 children (79.8%). MEASURES Difficulties with childrearing were assessed by self-reported questionnaires at the newborn child's 4-month health checkups. Data on maternal and child variables were collected from nursing records. RESULTS The "Difficulties group" included 59 mothers (35.4%) and their 70 children. Logistic regression analysis showed that mothers who were aged 40 years or older, who had a total score on the Edinburgh Postnatal Depression Scale of 9 or greater, who used more child-care support services, and who were monitored more frequently by public health nurses had a high risk of facing difficulties with childrearing. CONCLUSIONS Periodic monitoring by PHNs is a key strategy to improve the impact of the difficulties of childrearing for mothers of yoshien jido and their children.
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Affiliation(s)
- Kyoko Yoshioka-Maeda
- Department of Community Health Nursing, School of Nursing, Tokyo Medical University, Tokyo, Japan
| | - Mariko Kuroda
- Department of Community Health Nursing, School of Nursing, Tokyo Medical University, Tokyo, Japan
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Identifying and Intervening in Child Maltreatment and Implementing Related National Guidelines by Public Health Nurses in Finland and Japan. Nurs Res Pract 2017; 2017:5936781. [PMID: 28265469 PMCID: PMC5317151 DOI: 10.1155/2017/5936781] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 12/28/2016] [Indexed: 11/18/2022] Open
Abstract
Aim. This study aimed to investigate how public health nurses identify, intervene in, and implement the guidelines on child maltreatment in Finland and Japan and to compare the data between the two countries. Method. This study employed a cross-sectional design. Public health nurses' knowledge and skills with respect to child maltreatment prevention were assessed using a questionnaire consisting of three categories: identification, intervention, and implementation of guidelines. Public health nurses working in the area of maternal and child health care in Finland (n = 193) and Japan (n = 440) were the participants. Results. A significantly higher percentage of Japanese public health nurses identified child maltreatment compared to Finnish public health nurses, while Finnish nurses intervened in child maltreatment better than their Japanese counterparts. In both countries, public health nurses who had read and used the guidelines dealt with child maltreatment better than those who did not. Conclusion. The results suggest that effective training on child maltreatment and the use of guidelines are important to increase public health nurses' knowledge and skills for identifying and intervening in child maltreatment.
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