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Zusman N, Koton S, Tabak N, Kienski Woloski Wruble AC. The mediating role of nurses' attitude towards reporting child abuse and neglect. J Pediatr Nurs 2024; 78:106-111. [PMID: 38908341 DOI: 10.1016/j.pedn.2024.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 06/06/2024] [Accepted: 06/10/2024] [Indexed: 06/24/2024]
Abstract
PURPOSE Attitudes towards reporting child abuse and neglect play a significant role in determining the tendency to report abuse and neglect. In addition, Cognitive Response Theory (Shen, 2020) suggests that individuals actively process messages by producing pro and/or counter arguments referred to as "Gain - loss thoughts". However, literature positioning the variable, attitudes towards reporting, as a mediator, as well as its importance, are limited. The purpose of the study was to investigate the mediating effect of pediatric nurses' attitudes between "gain-loss thoughts" and the tendency to report child abuse and neglect. DESIGN AND METHODS A cross-sectional study examined 124 pediatric nurses working in central Israel's hospital departments concerning nurses' tendency to report (tendency to report = TTR), attitudes towards reporting, and "gain-loss thoughts" (positive and negative consequences for the child). RESULTS Most of the nurses had professional experience of 11 years or more (n = 75; 62.5%). According to the findings, nurses' attitudes towards reporting mediate the effect of gain-loss on the TTR child abuse and neglect. CONCLUSIONS Findings from this study contributed to our understanding of the importance of pediatric nurses' attitudes in determining the TTR abuse and neglect. Only nurses' positive attitudes towards reporting child abuse had a mediating effect on TTR. PRACTICE IMPLICATIONS Understanding the importance of attitudes and gain-loss thoughts can serve as a strategy for training programs and in the assimilation of reporting obligations by health professionals in general and nurses in particular.
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Affiliation(s)
- Nurit Zusman
- Head of Henrietta Szold School of Nursing of Hadassah and The Hebrew University Faculty of Medicine, Jerusalem, Israel.
| | - Silvia Koton
- Head of the Herczeg Institute on Aging, Tel Aviv University; Head of PhD Program, Department of Nursing, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv 6997801, Israel
| | - Nili Tabak
- Nursing Department, Tel Aviv University, Israel
| | - Anna C Kienski Woloski Wruble
- Senior Lecturer- Research HUJI, Henrietta Szold Hadassah Hebrew University, School of Nursing in the Faculty of Medicine, Jerusalem, Israel
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2
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Ackers SM, Colbert AM, Fraley HE, Schreiber JB. Exploring Screening Practices for Child Sexual Abuse in School Settings: An Integrative Review. J Sch Nurs 2024; 40:8-25. [PMID: 35833349 DOI: 10.1177/10598405221112662] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Child sexual abuse (CSA) is a pervasive public health problem. If left undetected, CSA can result in immediate and long-term health problems, which can be mitigated through early identification. Schools are an ideal environment to implement screening measures, and school nurses (SN) are uniquely poised to intervene and respond early. The aim of this review was to systematically examine and synthesize the international evidence related to screening for early identification of CSA in schools. Themes emerging from the analysis were SN behaviors relative to screening, potential instruments or approaches for screening, and SN and school professionals' beliefs about CSA screening practices. This review found little evidence that CSA screening is occurring in schools. However, SNs are aware that screening falls within their scope of practice and many SNs feel they should be screening for it. A constant proactive approach by SNs is necessary to improve early identification and subsequent intervention.
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Affiliation(s)
| | | | - Hannah E Fraley
- California State University at Fullerton School of Nursing, Fullerton, CA, USA
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3
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Al-Yateem N, Rossiter R, Slewa-Younan S, Azizur Rahman S, Subu MA, Dias JM, Saifan AR. Experiences of a mental health promotion, prevention, and early-intervention training program targeted to school nurses in the United Arab Emirates. Int Nurs Rev 2023; 70:372-382. [PMID: 36528889 DOI: 10.1111/inr.12817] [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: 12/15/2021] [Accepted: 11/24/2022] [Indexed: 12/23/2022]
Abstract
AIM To report participants' and facilitators' experiences of mental health promotion, prevention, and early-intervention training program targeted at school nurses in the United Arab Emirates (UAE). BACKGROUND The UAE school healthcare service is staffed by full-time nurses and part-time doctors and linked to primary healthcare centers. This service supports children's physical and mental well-being. However, school nurses' capacity to realize the potential of this service, particularly regarding mental health, has not yet been explored. METHODS We used an exploratory qualitative approach with data triangulation. Data were drawn from school nurses that participated in a targeted mental health promotion, prevention, and early-intervention training program. Data were gathered through focus group interviews with participating school nurses, written reflections, and notes recorded by the program designers and trainers. All school nurses who participated in the training program (N = 15) were included in this study. This study adhered to the consolidated criteria for reporting qualitative research. RESULTS Nurses' narratives encompassed three main themes, which indicated the program was an enjoyable professional and personal journey that allowed professional discovery/development and personal growth. Program organizers/facilitators indicated the training program was important, but challenging to implement. Four themes emerged from their reflections that covered the structure of school nursing services, participants' competency and education, the UAE context, and teaching style. CONCLUSION A well-structured professional development program can contribute to improving mental healthcare in schools. Improved service structure and regulations to support this goal are essential. IMPLICATIONS FOR NURSING PRACTICE, RESEARCH, AND POLICY School nurses benefit professionally and personally from targeted mental health training, which also improves the care students receive. School healthcare service managers should consider increasing such training opportunities for nurses and focus on measuring service outcomes and evaluating effectiveness. It is also necessary to reassess the minimum qualification requirement for school nurses. Specific professional development programs for school nurses will improve their clinical practice and support the recruitment of competent and prepared staff.
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Affiliation(s)
- Nabeel Al-Yateem
- Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Adjunct Associate Professor, School of Nursing, Paramedicine and Healthcare Sciences, Faculty of Science and Health, Charles Sturt University, Orange Campus, NSW, Australia
| | - Rachel Rossiter
- Associate Professor, School of Nursing, Paramedicine and Healthcare Sciences, Faculty of Science and Health, Charles Sturt University, Orange Campus, NSW, Australia
| | - Shameran Slewa-Younan
- Associate Professor, School of Medicine, Western Sydney University, Penrith, NSW, Australia
| | - Syed Azizur Rahman
- Assistant Professor, Department of Health Service Administration, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Muhammad Arsyad Subu
- Assistant Professor, Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Jacqueline Maria Dias
- Associate Professor, Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Ahmad Rajeh Saifan
- Associate Professor, Faculty of Nursing, Applied Sciences Private University, Amman, Jordan
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4
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Rolovic JS, Bokonjic D, Masic S, Stevanovic N. Pediatricians' Attitudes Toward Child Sexual Abuse in the Republic of Srpska. JOURNAL OF CHILD SEXUAL ABUSE 2022; 31:707-725. [PMID: 36004396 DOI: 10.1080/10538712.2022.2112641] [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: 09/10/2021] [Revised: 05/30/2022] [Accepted: 06/30/2022] [Indexed: 06/15/2023]
Abstract
Child sexual abuse (CSA) affects all cultures and sociodemographic sections. As health professionals, pediatricians are often the first line of defense when it comes to CSA identification and reporting. Our previous study examined encounters, competence, beliefs, and reporting regarding CSA among pediatricians in countries of the former Yugoslavia, Serbia, and Montenegro. Following up on this work, we expanded our research to another neighboring country, the Republic of Srpska (RS). Sixty pediatricians were surveyed in 2020, comprising 30% of all practicing pediatricians in the Republic of Srpska. Compared to their colleagues from Serbia and Montenegro, RS pediatricians revealed an increased perception that children are often abused by someone they do know well, were more confident in their abilities to detect CSA, reported a higher number of CSA cases, and were more interested in further trainings on the subject of CSA. Despite this, the level of underreporting remained high (40%). To our knowledge, this is the first study to both assess and compare CSA-related attitudes in this part of the world. Key differences between RS, other two neighboring countries as well as from other countries worldwide are likely to stem from the level of pediatricians' training and education, as well as from the socio-cultural and legislation context. Although encouraging, our data indicate a need for further research in the countries of the former Yugoslavia.
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Affiliation(s)
| | - Dejan Bokonjic
- University of East Sarajevo, Republic of Srpska, Bosnia and Herzegovina, Banja Luka, Bosnia and Herzegovina
| | - Srdjan Masic
- University of East Sarajevo, Republic of Srpska, Bosnia and Herzegovina, Banja Luka, Bosnia and Herzegovina
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5
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Making Sense of Mandatory Reporting: A Qualitative Study of Reporting Practices from the Perspectives of Schools and Child Welfare Services in Sweden. SOCIAL SCIENCES-BASEL 2022. [DOI: 10.3390/socsci11070273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Schools play an important role in ensuring the well-being of children, although the process of mandatory reporting of concern for children is not widely understood. This qualitative focus group study investigated the process from the perspectives of school and child welfare service professionals. Using theories of human service organizations and professional discretion, we analyzed viewpoints on an individual duty being handled by an organization. We investigated the expectations that a report be simultaneously simple and value-free, while providing depth and clear examples of concerns. Finally, we investigated the views of the supportive and protective functions supposedly underlying the duty to report. The results indicated problems associated with a collective reporting process. Ambiguity in how information in a report is communicated may also contribute to a more problematic reporting process from schools and then in interpretations and the follow up reports made by social workers.
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6
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Garmy P, Clausson EK, Janlöv AC, Einberg EL. A Philosophical Review of School Nursing Framed by the Holistic Nursing Theory of Barbara Dossey. J Holist Nurs 2021; 39:216-224. [PMID: 33856238 PMCID: PMC8427807 DOI: 10.1177/08980101211006615] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 02/26/2021] [Accepted: 03/04/2021] [Indexed: 11/15/2022]
Abstract
This article is a philosophical review of school nursing and its constructs framed by Barbara Dossey's holistic nursing theory. The author describes the application of holistic nursing theory within the school nurse's area of activity. The review suggests that holistic nursing theory can be applied in several areas of school nursing. School nurses have a multifaceted occupation that includes meetings with students, parents, and school staff. Barbara Dossey's holistic nursing theory offers the school nurse tools to deal with people's varied experiences, feelings, and needs.
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Affiliation(s)
- Pernilla Garmy
- Kristianstad University
Clinical Health Promotion Center, Lund University
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7
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Wilson IA, Lee J. Barriers and Facilitators Associated With Child Abuse and Neglect Reporting Among Child Care Professionals: A Systematic Review. J Psychosoc Nurs Ment Health Serv 2021; 59:14-22. [PMID: 34060955 DOI: 10.3928/02793695-20210324-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Hundreds of children die every year due to child abuse and/or neglect (CAN). Despite CAN reporting laws, approximately one fifth of child care professionals fail to report CAN. The current systematic review examines 37 studies on factors associated with CAN reporting and synthesizes their findings to provide in-depth insights on CAN reporting strategies. A systematic search on peer-reviewed original studies published from 2010 to 2020 was conducted with various databases. Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols guidelines were used to screen 266 studies retrieved from the initial search; of those, 37 were retained for review. Barriers to and facilitators of CAN reporting were categorized by the following common characteristics: system and structure (e.g., reporting system infrastructure), resources and support (e.g., funding, time), sociocultural context (e.g., CAN as a family matter), reporter traits (e.g., gender), and psychological attributes (e.g., knowledge, beliefs, mistrust). Intervention strategies tailored to the needs of professionals that can maximize their CAN reporting behaviors must be developed. [Journal of Psychosocial Nursing and Mental Health Services, 59(6), 14-22.].
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Forsner M, Elvhage G, Ewalds-Kvist BM, Lützén K. Moral Challenges When Suspecting Abuse and Neglect in School Children: A Mixed Method Study. CHILD & ADOLESCENT SOCIAL WORK JOURNAL : C & A 2020; 38:599-610. [PMID: 32836722 PMCID: PMC7298689 DOI: 10.1007/s10560-020-00680-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The World Health Organization (WHO), concludes that child maltreatment is a global concern calling for a multi sectoral interdisciplinary approach. School professionals, such as social workers, teachers, and health care professionals are in positions to discover and report maltreatment enabling social workers to intervene. However, a variety of reports reveal an evident gap between incidences and frequency of number of cases reported. A review of relevant research indicates that the problem of "not reporting" suggests that moral conflicts are activated in the process of decision-making. The aim was to gain a deeper understanding of school professionals' experiences of reporting suspected neglect and abuse to the Social Welfare Board. In a mixed method approach 32 school professionals, such as teachers, social workers, nurses and psychologists participated in interviews and responded to questionnaires. Findings from the qualitative content analysis were compared to the quantitative analysis in a meta-analysis. Moral conflicts occur when faced with making decisions about how to best deal with a child's situation. Thoughts about the child's best interest and relationship with his/her parents as well as the informants´ own safety, were central. The comparative meta- analysis of both data sets revealed these conflicts commence with a moral sensitivity of possible negative consequences for the child. Moral sensitivity can be viewed as a "good" personal attribute, it paradoxically might lead to moral stress despite an open ethical climate. Based on the results of this study, further research on the interpersonal aspects of dealing with moral conflicts involved in reporting suspected child abuse is indicated.
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Affiliation(s)
- M. Forsner
- Department of Nursing Sciences, Umeå University, 90187 Umeå, Sweden
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - G. Elvhage
- Department of Social Work, Södertörns Högskola, Stockholm, Sweden
| | - B. M. Ewalds-Kvist
- Department of Psychology, Stockholm University, Stockholm, Sweden
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| | - K. Lützén
- The Swedish Association of Health Professionals, Stockholm, Sweden
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9
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Lines LE, Hutton A, Grant JM. Navigating and negotiating meanings of child abuse and neglect: Sociocultural contexts shaping Australian nurses' perceptions. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:941-949. [PMID: 31833159 DOI: 10.1111/hsc.12925] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 11/08/2019] [Accepted: 11/28/2019] [Indexed: 06/10/2023]
Abstract
Nurses who work with children have the opportunity to make a difference by identifying and responding to child abuse and neglect. Little is known about the ways that nurses define, assess and respond to child abuse and neglect and how this subsequently affects children. This paper reports one of four themes identified through inductive analysis of a qualitative study exploring nurses' perceptions and experiences of keeping children safe from abuse and neglect. The aim of this paper was to report on how nurses understand and interpret child abuse, is found to be shaped by their own sociocultural contexts. A qualitative research design underpinned by social constructionism framed the study. Data were collected in 2016 and 2017 through 21 in-depth, semi-structured interviews with nurses who work with children in Australia. Key findings showed that nurses working with children had difficulty defining child abuse and drew upon multiple sources to construct a working definition. In addition to drawing from official legislation and guidelines, nurses compared and contrasted the level of abuse with their own personal and professional experiences of parenting. Nurses described the challenges of making assessments when faced with cultural practices different from their own. Nurses' descriptions of how they defined abuse showed that their assessments of child abuse and neglect were inextricably linked to their personal values and beliefs. As such, nurses were often working from their own value systems rather than consistently taking a child-focussed approach. There was an absence of consistent and explicit critical reflection on ways that values and beliefs might shape practice at individual and system levels. We propose this is a missing aspect of child safe practice. Reflection on how personal and professional values and beliefs interact with the implementation of evidence-informed approaches will increase nurses' capacity to maintain a child-focus.
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Affiliation(s)
| | - Alison Hutton
- College of Nursing and Health Sciences, Flinders University, Adelaide, South, Australia
- School of Nursing and Midwifery, University of Newcastle, Callaghan, Australia
| | - Julian Maree Grant
- College of Nursing and Health Sciences, Flinders University, Adelaide, South, Australia
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10
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Wilkinson Y. Poor communication hinders the role of the school nurse as a key professional in protecting children and young people from maltreatment. Evid Based Nurs 2020; 23:22. [PMID: 31003970 DOI: 10.1136/ebnurs-2019-103079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2019] [Indexed: 06/09/2023]
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11
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Sundler AJ, Whilson M, Darcy L, Larsson M. Swedish School Nurses' Experiences of Child Abuse. J Sch Nurs 2019; 37:176-184. [PMID: 31311406 DOI: 10.1177/1059840519863843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Child abuse recognition and the protection of children is a global concern. In Sweden, the role of the school nurse (SN) is to promote schoolchildren's health and development and to identify and prevent harm. The aim of this study was to describe Swedish SN experiences of suspecting, identifying, and reporting child abuse and to compare them with respect to (a) years of experience as SN, (b) age of SN, and (c) pupil population size. A descriptive design was used. Two-hundred and thirty-three SNs completed a survey detailing their experiences. Most SNs (96%) reported having suspected a child suffering from physical or psychological abuse. Approximately half of them reported occurrences of honor-related violence (54%) and of child sexual abuse (57%). SNs with less nursing experience reported significantly less recognition and reporting of child abuse. The findings indicate that experiences of child abuse are common. Thus, it is vital that SNs have the necessary competency and support to identify and report suspected child abuse.
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Affiliation(s)
- Annelie J Sundler
- Faculty of Caring Science, Work Life and Social Welfare, 1802University of Borås, Borås, Sweden
| | - Marie Whilson
- Institution of Health and Learning, 7359University of Skövde, Skövde, Sweden
| | - Laura Darcy
- Faculty of Caring Science, Work Life and Social Welfare, 1802University of Borås, Borås, Sweden
| | - Margaretha Larsson
- Institution of Health and Learning, 7359University of Skövde, Skövde, Sweden
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Hena M, Leung C, Clausson EK, Garmy P. Association of Depressive Symptoms with Consumption of Analgesics among Adolescents. J Pediatr Nurs 2019; 45:e19-e23. [PMID: 30585152 DOI: 10.1016/j.pedn.2018.12.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 12/11/2018] [Accepted: 12/12/2018] [Indexed: 12/14/2022]
Abstract
PURPOSE To investigate the prevalence of depressive symptoms, pain (headaches and stomachaches), and analgesic consumption in addition to the association between depressive symptoms and analgesic consumption among adolescents. DESIGN AND METHODS This cross-sectional study was conducted in southern Sweden. The survey was distributed among students in grade 8 (aged 13-15 years, n = 878). RESULTS The prevalence of depressive symptoms (Center for Epidemiological Studies Depression Scale ≥16) was 37% among girls and 13% among boys. The prevalence rate of analgesic consumption to ease headaches and/or stomachaches during the last several weeks was 57% among girls and 29% among boys. Depressive symptoms are significantly associated with analgesic consumption among adolescents even after controlling for pain. CONCLUSION The knowledge that there is a higher use of analgesics in adolescents with depressive symptoms implies that healthcare professionals should focus on complex psychosocial problems, not only physiological pain, in adolescents. PRACTICE IMPLICATIONS Over the counter analgesics are frequently used by adolescents. Head and stomachaches are common reasons for students to visit the school nurse and primary healthcare facility. School nurses and pediatric nurses have to be aware of the link between depressive symptoms and pain in addition to the higher use of analgesics in adolescents with depressive symptoms. It is important to reduce the cause of the pain in order to prevent depressive symptoms and also analgesic overuse.
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Affiliation(s)
- Momota Hena
- Clinical Health Promotion Centre, Medical Faculty, Lund University, Lund, Sweden
| | - Cherry Leung
- Department of Community Health Systems, University of California, San Francisco, United States of America
| | - Eva K Clausson
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
| | - Pernilla Garmy
- Clinical Health Promotion Centre, Medical Faculty, Lund University, Lund, Sweden; Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden.
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Harding L, Davison-Fischer J, Bekaert S, Appleton JV. The role of the school nurse in protecting children and young people from maltreatment: An integrative review of the literature. Int J Nurs Stud 2019; 92:60-72. [PMID: 30711872 DOI: 10.1016/j.ijnurstu.2018.12.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 10/29/2018] [Accepted: 12/08/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVES This review aims to describe the role of the school nurse in protecting children and young people from maltreatment by examining the international literature. Child maltreatment is a prevalent issue in global society today and includes physical, emotional and sexual abuse, neglect and exploitation. School nurses are ideally placed to identify and work with children and young people who are at risk of maltreatment through their regular contact with the school community. DESIGN Integrative literature review incorporating thematic analysis. DATA SOURCES Electronic databases British Nursing Database, Cumulative Index of Nursing and Allied Health Literature, Medline, PsycInfo, Cochrane Library Database for Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL). SEARCH TERMS Role, School Nurse, Child Maltreatment. REVIEW METHODS Initial title and abstract review of 444 studies resulted in 78 studies for full text review. Additional search strategies identified one relevant study. Inclusion and exclusion criteria were employed as follows; (1) study published in the English language, (2) peer-reviewed, (3) primary research, (4) inclusion of school nurses (or equivalent role internationally) in the study sample, and (5) a focus on the role of school nurses in preventing child maltreatment. Studies were appraised using the Critical Appraisal Skills Programme tool for qualitative studies and the Strengthening the Reporting of Observational Studies in Epidemiology checklist for mixed-methods and quantitative studies. Findings from the studies were identified, summarised and organised into a summary table, before being analysed thematically. RESULTS 21 studies met inclusion and quality criteria and were included in the review. Key themes that emerged from the analysis were; supporting the child and family, detective work, working with other professionals, training and supervision, barriers to protecting children and young people from maltreatment and trust. CONCLUSION International literature highlights the variety of activities that school nurses may undertake in daily practice to protect children and young people from maltreatment. Several challenges to this role are identified, including time management and building relationships with children and young people. Recommendations for practice and further research are made.
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Affiliation(s)
- Lauren Harding
- Oxford Brookes University, Jack Straw's Lane, Oxford, OX3 0FL, United Kingdom.
| | - Jan Davison-Fischer
- Oxford Brookes University, Jack Straw's Lane, Oxford, OX3 0FL, United Kingdom.
| | - Sarah Bekaert
- Oxford Brookes University, Jack Straw's Lane, Oxford, OX3 0FL, United Kingdom.
| | - Jane V Appleton
- Oxford Brookes University, Jack Straw's Lane, Oxford, OX3 0FL, United Kingdom.
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Musliu E, Vasic S, Clausson EK, Garmy P. School Nurses' Experiences Working With Unaccompanied Refugee Children and Adolescents: A Qualitative Study. SAGE Open Nurs 2019; 5:2377960819843713. [PMID: 33415234 PMCID: PMC7774343 DOI: 10.1177/2377960819843713] [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] [Received: 11/06/2018] [Revised: 02/14/2019] [Accepted: 03/23/2019] [Indexed: 11/24/2022] Open
Abstract
School nurses are one of the first health-care professionals to meet unaccompanied refugee children and adolescents and therefore have an important impact on health outcomes. The aim of this study was to describe school nurses' experiences working with unaccompanied refugee children and adolescents. Semistructured interviews were conducted with school nurses (n = 14) who worked with unaccompanied refugee children and adolescents. The interviews were analyzed via qualitative content analysis. The results fell into three themes: (a) knowledge of trauma-informed care, (b) knowledge of intercultural nursing, and (c) importance of self-awareness. School nurses require the development of tailor-made skills that focus on crisis, trauma, and cultural awareness to meet the complex needs associated with working with unaccompanied refugee children and adolescents.
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Affiliation(s)
- Ermira Musliu
- Faculty of Health Sciences, Kristianstad
University, Kristianstad, Sweden
| | - Snezana Vasic
- Faculty of Health Sciences, Kristianstad
University, Kristianstad, Sweden
| | - Eva K. Clausson
- Faculty of Health Sciences, Kristianstad
University, Kristianstad, Sweden
| | - Pernilla Garmy
- Faculty of Health Sciences, Kristianstad
University, Kristianstad, Sweden
- Department of Health Science, Clinical Health
Promotion Centre, Lund University, Lund, Sweden
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15
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Lines L, Grant J, Hutton A. How Do Nurses Keep Children Safe From Abuse and Neglect, and Does it Make a Difference? A Scoping Review. J Pediatr Nurs 2018; 43:e75-e84. [PMID: 30064706 DOI: 10.1016/j.pedn.2018.07.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 07/24/2018] [Accepted: 07/25/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To explore the extent of child protection work performed by nurses and identify which interventions hold the strongest evidence for future practice. DESIGN This scoping review was guided by Arksey and O'Malley's framework for scoping reviews. DATA SOURCES Electronic databases (CINAHL, Medline, Scopus, Web of Science) and grey literature were searched in August 2017. Further studies were identified through manual literature searching. RESULTS Forty-one studies from seven countries met the inclusion criteria. The studies showed nurses keep children safe primarily through the prevention of abuse (n = 32), but also through detection of abuse (n = 1) and interventions to mitigate the effects of abuse (n = 8). Nurses' specific interventions most frequently involved post-natal home visiting (n = 20), parent education (n = 10) and assessment and care of children or adolescents following sexual abuse (n = 4). The main findings showed that although nurses did have positive impacts upon some measures of abuse and neglect, results were not consistent across studies. In addition, some studies used indirect measures of abuse and neglect, which may not impact children's experiences of abuse. It is difficult to extrapolate these findings to the broader nursing profession as literature did not accurately represent the range of ways that nurses keep children safe from abuse and neglect. CONCLUSIONS This review demonstrated nurses prevent, detect and respond to abuse and neglect in many ways. However, given mixed evidence and absence of some nurse interventions in the literature, further research is needed to represent the range of ways that nurses keep children safe and determine their effectiveness.
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Affiliation(s)
- Lauren Lines
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia.
| | - Julian Grant
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia.
| | - Alison Hutton
- School of Nursing and Midwifery, University of Newcastle, New South Wales, Australia.
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Albaek AU, Kinn LG, Milde AM. Walking Children Through a Minefield: How Professionals Experience Exploring Adverse Childhood Experiences. QUALITATIVE HEALTH RESEARCH 2018; 28:231-244. [PMID: 29046119 PMCID: PMC5734381 DOI: 10.1177/1049732317734828] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Understanding the challenges of professionals in addressing child adversity is key to improving the detection, protection, and care of exposed children. We aimed to synthesize findings from qualitative studies of professionals' lived experience of addressing child adversity. Through a systematic search, we identified eight qualitative studies and synthesized them using metaethnography. We generated three themes, "feeling inadequate," "fear of making it worse," and "facing evil," and one overarching metaphor, "walking children through a minefield." The professionals felt that they lacked the means necessary to explore child adversity, that they were apprehensive of worsening the child's situation, and that their work with child adversity induced emotional discomfort. This metasynthesis indicated that the professionals' efficiency in exploring abuse relied upon their ability to manage emotional and moral distress and complexity. To support children at risk, we propose developing professionals' ability to build relationships, skills in emotion regulation, and proficiency in reflective practice.
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Affiliation(s)
- Ane U. Albaek
- Southern Norway Resource Center for Psychological Trauma, Kristiansand, Norway
- University of Bergen, Bergen, Norway
- University of Agder, Kristiansand, Norway
| | - Liv G. Kinn
- Western Norway University of Applied Sciences, Bergen, Norway
| | - Anne M. Milde
- University of Bergen, Bergen, Norway
- Uni Research Health, Bergen, Norway
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Lee HM, Kim JS. Predictors of Intention of Reporting Child Abuse among Emergency Nurses. J Pediatr Nurs 2018; 38:e47-e52. [PMID: 29137839 DOI: 10.1016/j.pedn.2017.10.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 10/12/2017] [Accepted: 10/13/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE The current study investigates predictors of intention of reporting child abuse among emergency nurses in Korea. DESIGN AND METHODS A descriptive cross-sectional design was used. Data were collected from 200 emergency nurses in eight general hospitals in Korea through a questionnaire that asked about their general characteristics, knowledge about child abuse, perceived behavioral control, experiences of child abuse cases and reporting, and attitude toward child abuse. RESULTS Multiple regression analysis indicated that attitude toward child abuse was the most influential predictor of the intention of reporting child abuse among Korea's emergency nurses. Knowledge about child abuse, and perceived behavioral control were also significant influencing predictors of reporting intention. These variables explained 22.1% of the variances in the intention of reporting child abuse among emergency nurses. CONCLUSIONS Reporting child abuse has not yet been established as a professional responsibility among Korea's emergency nurses. Increasing the level of awareness of the characteristics of child abuse and encouraging communication among nurses about the responsibility to report suspected child abuse will increase nurses' confidence to report. PRACTICE IMPLICATIONS Training for reporting child abuse should be implemented in the near future to improve emergency nurses' understanding of child abuse. A support program is also needed to help emergency nurses build confidence in reporting child abuse as a professional responsibility.
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Affiliation(s)
- Hye-Mi Lee
- Emergency Department, Sejong General Hospital, Bucheon, Republic of Korea.
| | - Ji-Soo Kim
- College of Nursing, Gachon University, Incheon, Republic of Korea.
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18
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McTavish JR, Kimber M, Devries K, Colombini M, MacGregor JCD, Wathen CN, Agarwal A, MacMillan HL. Mandated reporters' experiences with reporting child maltreatment: a meta-synthesis of qualitative studies. BMJ Open 2017; 7:e013942. [PMID: 29042370 PMCID: PMC5652515 DOI: 10.1136/bmjopen-2016-013942] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To systematically search for research about the effectiveness of mandatory reporting of child maltreatment and to synthesise qualitative research that explores mandated reporters' (MRs) experiences with reporting. DESIGN As no studies assessing the effectiveness of mandatory reporting were retrieved from our systematic search, we conducted a meta-synthesis of retrieved qualitative research. Searches in Medline (Ovid), Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Sociological Abstracts, Education Resources Information Center, Criminal Justice Abstracts and Cochrane Library yielded over 6000 citations, which were deduplicated and then screened by two independent reviewers. English-language, primary qualitative studies that investigated MRs' experiences with reporting of child maltreatment were included. Critical appraisal involved a modified checklist from the Critical Appraisal Skills Programme and qualitative meta-synthesis was used to combine results from the primary studies. SETTING All healthcare and social-service settings implicated by mandatory reporting laws were included. Included studies crossed nine high-income countries (USA, Australia, Sweden, Taiwan, Canada, Norway, Finland, Israel and Cyprus) and three middle-income countries (South Africa, Brazil and El Salvador). PARTICIPANTS The studies represent the views of 1088 MRs. OUTCOMES Factors that influence MRs' decision to report and MRs' views towards and experiences with mandatory reporting of child maltreatment. RESULTS Forty-four articles reporting 42 studies were included. Findings indicate that MRs struggle to identify and respond to less overt forms of child maltreatment. While some articles (14%) described positive experiences MRs had with the reporting process, negative experiences were reported in 73% of articles and included accounts of harm to therapeutic relationships and child death following removal from their family of origin. CONCLUSIONS The findings of this meta-synthesis suggest that there are many potentially harmful experiences associated with mandatory reporting and that research on the effectiveness of this process is urgently needed.
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Affiliation(s)
- Jill R McTavish
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Melissa Kimber
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Karen Devries
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Manuela Colombini
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | | | - C Nadine Wathen
- Faculty of Information and Media Studies, Western University, London, Ontario, Canada
| | - Arnav Agarwal
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Harriet L MacMillan
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
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19
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Al-Yateem N, Docherty C, Brenner M, Alhosany J, Altawil H, Al-Tamimi M. Research Priorities for School Nursing in the United Arab Emirates (UAE). J Sch Nurs 2016; 33:393-401. [PMID: 27698210 DOI: 10.1177/1059840516671783] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
School nurses are challenged with more children having complex conditions, who are now surviving into school age. This is paralleled by a shift in focus of health systems toward primary care, and national efforts to develop the health-care services, especially those offered to vulnerable populations. Being at the forefront of this change, school nurses in United Arab Emirates (UAE) are finding themselves under pressure to adapt to and facilitate these changes both by improving their practice and by contributing to its underpinning evidence. A cross-sectional design was used in this study in which 370 school nurses participated, identifying 11 research priorities. The three most important, as ranked by participants, were management of children with complex health-care needs; nutrition, obesity, and lifestyle issues of schoolchildren; and managing illnesses, injuries, and emergencies in schools and provision of medical support. These priorities should direct future research activities in the field.
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Affiliation(s)
- Nabeel Al-Yateem
- 1 Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.,2 Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.,3 Faculty of Science, School of Nursing, and Midwifery and Indigenous Health, Charles Sturt University, Orange, Australia
| | - Charles Docherty
- 1 Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Maria Brenner
- 4 School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | | | - Hanan Altawil
- 1 Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Muna Al-Tamimi
- 1 Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
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20
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Lines LE, Hutton AE, Grant J. Integrative review: nurses' roles and experiences in keeping children safe. J Adv Nurs 2016; 73:302-322. [PMID: 27509334 DOI: 10.1111/jan.13101] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2016] [Indexed: 11/28/2022]
Abstract
AIM To identify nurses' role and experiences of keeping children safe. BACKGROUND Approaches to preventing, identifying and responding to child abuse and neglect have moved towards a multidisciplinary approach where all professionals are expected to contribute to the goal of keeping children safe. Frequently in contact with children and families, nurses well positioned to contribute to keeping children safe from abuse and neglect. Much has been published around nurses' experiences of their role in keeping children safe, but this literature has not yet been synthesized to determine the challenges and potential scope of this role. DESIGN Integrative review following an Integrative Review framework. DATA SOURCES Studies were identified through a search of the electronic databases CINAHL, Medline, Web of Science, Scopus and Informit to identify literature published between 2005-2015. REVIEW METHODS All the studies were critically appraised for methodological quality using the Critical Skills Appraisal Programme. Data from each study were extracted and categorized according to the review aims and the study's major findings. RESULTS Inclusion criteria were met in 60 studies. Three main findings were identified including nurses' insufficient knowledge, need for validation and improved communication and balancing surveillance and support for vulnerable families. CONCLUSIONS Nurses have many roles and experiences in keeping children safe but often felt they did not have the knowledge, skills and support to take action in this area. Further research is needed to understand why nurses feel inadequate and disempowered to advocate and intervene on the behalf of children at risk of abuse or neglect.
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Affiliation(s)
- Lauren E Lines
- School of Nursing and Midwifery, Flinders University, Adelaide, South Australia, Australia
| | - Alison E Hutton
- School of Nursing and Midwifery, Flinders University, Adelaide, South Australia, Australia
| | - Julian Grant
- School of Nursing and Midwifery, Flinders University, Adelaide, South Australia, Australia
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21
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Engh Kraft L, Rahm G, Eriksson UB. School Nurses Avoid Addressing Child Sexual Abuse. J Sch Nurs 2016; 33:133-142. [DOI: 10.1177/1059840516633729] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Child sexual abuse (CSA) is a global public health problem with major consequences for the individual child and society. An earlier Swedish study showed that the school nurses did not initially talk about nor mention CSA as one form of child abuse. For the child to receive adequate support, the disclosure is a precondition and is dependent on an available person prepared to listen. The aim of the study was to explore the ability of the school nurses to detect and support sexually abused children. It is a secondary analysis of focus group interviews with school nurses. Thematic analysis was performed. Results showed that the school nurses avoided addressing CSA due to arousal of strong emotions, ambivalence, and a complicated disclosure process. In order to detect CSA and support abused children, attentiveness of sexual abuse as a possible cause of physical and mental ill-health is crucial.
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Affiliation(s)
- Lisbet Engh Kraft
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
| | - GullBritt Rahm
- Department of Health Sciences, Karlstad University, Karlstad, Sweden
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