Instrumentação e conhecimento dos profissionais da equipe saúde da família sobre a notificação de maus-tratos em crianças e adolescentes

Child Maltreatment: Skills and Perceptions as Competencies in Higher Nursing Education

Child maltreatment is any action, neglect or aggression towards a child caused by parents, family members or others. The objective of this study is to find out the beliefs and attitudes regarding abuse among nursing students.

METHODS

This was an exploratory study with the aim of validating the questionnaire, made up of four dimensions. This questionnaire was administered during the 2020/2021 academic year to 370 undergraduate nursing students (first and third year), in Toledo, Talavera de la Reina and Albacete of the University of Castilla-La Mancha, in addition to resident nurses, master's students and doctoral students during the first four-month period (September, October, November and December). A statistical analysis was carried out observing internal consistency for Cronbach's alpha.

RESULTS

In total, 61.6% of the students concluded that the child was not responsible for maltreatment, and 41.6% thought that it was independent of gender. Furthermore, 65.7% stated that it is human nature for parents to care for their children, 74.1% considered maltreatment to be a crime in the family, and 15.4% said that it does not exist in higher social classes. A total of 23.2% said that those in nursing professions should not intervene in child abuse. With regard to Münchausen syndrome, there was less agreement among the participants, being unknown to the great majority of the students.

CONCLUSIONS

Among the participants, a lack of knowledge about child abuse was observed, as well as the role of nursing in its detection. Subsequently, given the importance of nursing and its professionals in the detection and management of child abuse, it is necessary to implement knowledge and skills in undergraduate training.

Barriers and Facilitators Associated With Child Abuse and Neglect Reporting Among Child Care Professionals: A Systematic Review

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.].

ARTICULAÇÃO ENTRE O CONSELHO TUTELAR E O SETOR SAÚDE NO ENFRENTAMENTO À VIOLÊNCIA INTRAFAMILIAR

Resumo Este Estudo qualitativo focalizou a articulação do conselho tutelar com o setor saúde e o modo como se realizava essa parceria, durante os anos de 2013 e 2014. Participaram do estudo 45 conselheiros tutelares da Região Metropolitana de Fortaleza. Os dados foram construídos por entrevista semiestruturada e analisados em seus conteúdos. Os resultados apontaram para duas situações: o conselho tutelar parceiro do setor saúde e a inexistência de parceria. Esse descompasso entre as atuações do conselho tutelar e do setor saúde demonstra lacunas intersetoriais. Interlocução resolutiva da abordagem clínica e de garantia de direitos resultaria em menores custos e mais ações exitosas na redução da violência contra crianças e adolescentes.

[Challenges facing health professionals in the notification of violence: mandatory implementation and follow-up procedures]

The notification of the occurrence or suspicion of violence is mandatory for health professionals and is a key tool for epidemiological surveillance and the definition of public policies for prevention and intervention. However, professionals feel unprepared for this assignment, which renders underreporting prevalent. To address this issue, the objective is to identify the means available to the professional to submit notification as well as ensure due process follow-up. For this purpose, research and document analysis was conducted in Brazilian legislation, ordinances, and government programs, codes of ethics and consultation of the literature in databases on the subject over a period of five years to establish a brief comparative analysis with other countries. The conclusion drawn is that while some measures are inapplicable, knowledge about the appropriate process for the notification and routing to specific organs will enable healthcare professionals to make the appropriate decisions for the protection and safety of the victim, besides the measures in order to change this situation of violence in the country.

Factors associated with the type of violence perpetrated against adolescents in the state of Pernambuco, Brazil

To analyze the factors associated with the types of violence against adolescents reported in Pernambuco, Brazil, from 2009 to 2012. Prevalence study conducted through an electronic database from the Violence Surveillance Official System in a population of 5259 adolescents (aged 10-19 years). Poisson regression was used, with significance level at 5%. There was a significant increase of 204% in the number of violence reports, and the number of reporting units increased by 92.6%. When separately evaluated, physical violence was the most prevalent type, accounting for 44.7% of the reports. Taking as independent variables the age range of 15-19 years, female, having no disability, and public roads as place of occurrence, the positively and independently associated factors were: male gender (OR 1.5, 95% CI 1.4-1.6) with physical violence; having deficiency (OR 1.7, 95% CI 1.5-2.0) with psychological violence; age range of 10-14 years (PR 2.4, 95% CI 2.2-2.6) with sexual assault; and male (OR 3.9, 95% CI 2.0-7.5), having disabilities (PR 4.6, 95% CI 2.7-9.7), and occurrence in residence (PR 2.8, 95% CI 1.3-6.1) with neglect. Age between 10 to 14 years was associated with the occurrence of sexual assault; male with the occurrence of physical violence and neglect; having disabilities with psychological violence and neglect; and occurrence in the residence was associated with neglect.

Integrative review: nurses' roles and experiences in keeping children safe

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.

Violence against children in Latin America and Caribbean countries: a comprehensive review of national health sector efforts in prevention and response

Background

Violence against children (VAC) remains a global problem. The health sector has an opportunity and responsibility to be part of the multi-sector collaboration to prevent and respond to VAC. This review aimed to assess the health sector’s response to VAC among Latin American & Caribbean (LAC) countries, particularly as it relates to physical violence, sexual violence, and neglect.

Method

National protocols for the identification and provision of health care to child survivors of violence, abuse and neglect were solicited in partnership with UNICEF and PAHO/WHO country offices within the LAC region. A parallel systematic review was undertaken in January 2015 to review studies published in the last 10 years that describe the regional health sector response to VAC.

Results

We obtained health sectors guidelines/protocols related to VAC from 22 of 43 (51 %) countries and reviewed 97 published articles/reports that met the review inclusion criteria. Country protocols were presented in Spanish (n = 12), Portuguese (n = 1), and English (n = 9). Thematic areas of country protocols included: 1) identifying signs and symptoms of VAC, 2) providing patient-centered care to the victim, and 3) immediate treatment of injuries related to VAC. The systematic review revealed that health professionals are often unaware of national protocols and lack training, resources, and support to respond to cases of VAC. Further, there is limited coordination between health and social protection services.

Conclusions

VAC remains an international, public health priority. Health professionals are well-positioned to identify, treat and refer cases of VAC to appropriate institutions and community-based partners. However, poor protocol dissemination and training, limited infrastructure, and inadequate human resources challenge adherence to VAC guidelines.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-016-3562-3) contains supplementary material, which is available to authorized users.

Risk factors for child abuse: levels of knowledge and difficulties in family medicine. A mixed method study

Background

Family physicians (FPs) have a central role in the detection and management of child abuse. According to the literature, only 2–5 % of initial reports of child abuse come from the medical profession.

Methods

The objective of this study was to assess levels of knowledge of risk factors for child abuse by Family Physicians (FPs) and the attention that the physicians pay to these risk factors. We conducted a mixed-method survey based on semi-structured interviews. 50 FPs practicing in the Somme County (northern France) were interviewed with closed and open questions. The FPs’ level of knowledge of risk factors for child abuse and obstacles in the detection of child abuse were assessed.

Results

The FPs’ level of knowledge of risk factors for child abuse was similar to that reported in the literature. However, FPs knew little about the significant role of prematurity. Likewise, the FP’s training did not seem to influence their knowledge of risk factors. Fear of an incorrect diagnosis was the main obstacle to reporting a suspected case. The FPs considered that they were often alone in dealing with a difficult situation and considered that the judicial system and the social services were not sufficiently active.

Conclusions

Few FPs had actually received specific training in the detection and management of child abuse but many stated their need for this type of training. FPs encounter many obstacles in the detection of child abuse, which sometimes make the FP reluctant to report a suspected or potential case. Medical education need to be improved in this field.

Electronic supplementary material

The online version of this article (doi:10.1186/s13104-015-1607-9) contains supplementary material, which is available to authorized users.