Child abuse experience, training, knowledge, and attitude of healthcare professionals in sixty hospitals in Greece

The Reliability and Validity of the Greek Version of the Child Abuse Report Intention Scale (CARIS) Questionnaire for Midwives, Along With Factors Associated With Their Intention to Report Child Abuse and Neglect

OBJECTIVE

 Child maltreatment is a serious public health issue with unquestionable short- and long-term consequences. The midwives' role in the prevention, identification, and reporting of child abuse and neglect (CAN) is crucial for children's well-being. The Child Abuse Report Intention Scale (CARIS) questionnaire was designed to measure factors influencing Taiwanese nurses to report child abuse and has been used in many studies worldwide. The purposes of this study were to test the reliability and validity of the Greek version of the CARIS questionnaire and to determine factors associated with the Greek midwives' intention to report suspected CAN.

METHODS

 A convenience sample of 70 registered midwives participated in the study from February to June 2023. After forward and backward translation, the participants completed the CARIS questionnaire twice, with a one-week interval, to determine test-retest reliability. Cronbach's alpha was used to assess the internal consistency of the questionnaire.

RESULTS

 Concerning the internal consistency, reliability, and repeatability of the Greek version of the CARIS questionnaire, our results were consistent, stable, and highly reproducible. For the CARIS, Cronbach's alpha ranged from 0.549 to 0.810 depending on the subscale, Pearson's statistic ranged from 0.649 to 0.797, while all the paired samples t-tests apart from one were nonsignificant. Concerning the subscale "Intended Practice Behaviors: Vignettes questions and Respond Options," Cronbach's alpha ranged from 0.527 to 0.890 depending on the subscale, Pearson's statistic ranged from 0.803 to 0.850, while all the paired samples t-tests apart from two were nonsignificant. Sixty-six participants (94.2%) had received no CAN training while in midwifery school. Only seven participants (10%) had ever reported suspected CAN, while 12 out of 70 (17%) did not report although they suspected CAN. Thirty-six midwives (51.4%) stated that they did not know how to report CAN cases, and 35 (50.7%) did not have the appropriate resources. Participants had overwhelmingly negative attitudes about child harsh discipline (34.34 of 36), low tolerance toward perpetrators (25.10 of 30), positive attitudes toward the responsibility of reporting suspected CAN (32.60 of 42), moderate knowledge of CAN (6.63 of 13), and increased engagement in reporting severe cases of CAN (32.37 of 40). Attitude, subjective norm, and perceived behavioral control were significantly related to the midwives' intention to report CAN.

CONCLUSIONS

 The Greek version of the CARIS is a valid and reliable instrument that can be used to determine reasons influencing midwives' intention to report CAN. One of our key findings was the lack of adequate and appropriate training in dealing with CAN cases, both at the undergraduate and postgraduate levels, that needs to be addressed by health policy makers.

Detecting and preventing child maltreatment in primary care and PHNs' role-a cross-sectional study

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.