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Knowledge, attitude, and practice regarding child maltreatment amongst Iranian medical students through internship course: an 18-month longitudinal study. BMC PRIMARY CARE 2023; 24:37. [PMID: 36717772 PMCID: PMC9886537 DOI: 10.1186/s12875-023-01988-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 01/18/2023] [Indexed: 02/01/2023]
Abstract
BACKGROUND Child maltreatment has been a major worldwide problem and has remained a persistent public health challenge in all countries. Physicians have a significant role in the prevention and intervention of child maltreatment. An educated physician that can effectively identify and report child maltreatment can fill one of the most significant gaps in reducing child abuse. This study was performed to examine the knowledge, attitude, and practice regarding child maltreatment among Iranian medical students through an internship course. METHOD All the medical students (235 students) of the Iran University of Medical Sciences who passed the internship entrance exam in the 2019-2020 academic year participated in this study. The participants completed a 49-item scale questionnaire built by combining three other validated questionnaires that evaluate their attitude, knowledge, and practice skills in the first month of their internship course and then completed the same questionnaire 18 months later, at the end-point of the internship period. RESULTS One-hundred thirty nine (59.1%) participants were female, and 96 (40.9%) were male. The mean age of the subjects was 24.35 ± 0.76. Only 7 (3%) of them formerly received any education about child maltreatment. There was a significant improvement in scores of the knowledge of prevention (p-value = 0.001), the practice of prevention (p-value < 0.001) and the general subscale of the practice section (p-value < 0.001) during the internship course. However, the performance of participants decreased significantly in the subscales of the attitude towards diagnosis (p-value = 0.001) and the attitude towards reporting (p-value < 0.001) of child maltreatment. At the end of the study, the result of graduated physicians was: The total knowledge and attitude of participants were satisfactory, and the majority were at reasonable levels. Although in the practice subscale, 70.6% of the participants didn't identify, 84.7% didn't refer, and 86.4% didn't report a child abuse case in the past year. CONCLUSION The knowledge and attitude of Iranian physicians regarding child maltreatment are at a satisfactory level. Although, the practice level has deficiencies. In addition, our findings show that Iranian interns have a shallow experience regarding child maltreatment, particularly despite the higher scores in attitude and knowledge, which can be the reason for deficiencies in the practice level.
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Dimitropoulos G, Lindenbach D, Devoe DJ, Gunn E, Cullen O, Bhattarai A, Kuntz J, Binford W, Patten SB, Arnold PD. Experiences of Canadian mental health providers in identifying and responding to online and in-person sexual abuse and exploitation of their child and adolescent clients. CHILD ABUSE & NEGLECT 2022; 124:105448. [PMID: 34952461 DOI: 10.1016/j.chiabu.2021.105448] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 11/25/2021] [Accepted: 12/08/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Sex offenders often use the internet to communicate with children to facilitate in-person sexual abuse or to create and distribute sexual images of children. Mental healthcare providers are a major source of referrals to child welfare authorities and are well-positioned to identify sexual exploitation. OBJECTIVE This study investigated the perceived ability of mental healthcare workers to recognize and respond to concerns about online and in-person sexual exploitation of their pediatric clients. PARTICIPANTS AND SETTING The authors administered a cross-sectional survey to 209 mental healthcare providers within the public health system of Alberta, Canada. METHODS The survey contained four sections related to sexual exploitation: two of which can take place online or in-person (grooming and sexual abuse) and two of which require the internet or a digital device (luring and sexual image distribution). Each section asked whether the mental healthcare provider had experience working with clients affected by these concerns, what barriers they encounter, how confident they are in their abilities and whether they have formal training in a topic. RESULTS The vast majority of participants (83%) worked with a client impacted by grooming, luring, sexual abuse or sexual image distribution in the last year. Participants reported more training, more confidence and fewer barriers when identifying and responding to sexual abuse as compared to grooming, luring or sexual image distribution. CONCLUSIONS There is a need to improve mental health providers understanding of how technology is being utilized to exploit children, so that they can respond effectively to protect their clients.
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Affiliation(s)
- Gina Dimitropoulos
- Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, 4th floor, 3280 Hospital Dr NW, Calgary, AB T2N 4Z6, Canada; Faculty of Social Work, University of Calgary, MLT 301, 2500 University Dr NW, Calgary, AB T2N 1N4, Canada.
| | - David Lindenbach
- Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, 4th floor, 3280 Hospital Dr NW, Calgary, AB T2N 4Z6, Canada
| | - Daniel J Devoe
- Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, 4th floor, 3280 Hospital Dr NW, Calgary, AB T2N 4Z6, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3D11, 3280 Hospital Dr NW, Calgary, AB T2N 4Z6, Canada
| | - Emily Gunn
- Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, 4th floor, 3280 Hospital Dr NW, Calgary, AB T2N 4Z6, Canada; Faculty of Social Work, University of Calgary, MLT 301, 2500 University Dr NW, Calgary, AB T2N 1N4, Canada
| | - Olivia Cullen
- Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, 4th floor, 3280 Hospital Dr NW, Calgary, AB T2N 4Z6, Canada; Faculty of Social Work, University of Calgary, MLT 301, 2500 University Dr NW, Calgary, AB T2N 1N4, Canada
| | - Asmita Bhattarai
- Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, 4th floor, 3280 Hospital Dr NW, Calgary, AB T2N 4Z6, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3D11, 3280 Hospital Dr NW, Calgary, AB T2N 4Z6, Canada
| | - Jennifer Kuntz
- Alberta Health Services, Child and Adolescent Addiction Mental Health & Psychiatry Program, Calgary Zone, 10301 Southport Rd SW, Calgary, AB T2W 1S7, Canada
| | - Warren Binford
- School of Medicine, Department of Pediatrics, University of Colorado Anschutz Medical Campus, 13123 East 16th Avenue, Mail Stop B065, Aurora, CO 80045, United States
| | - Scott B Patten
- Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, 4th floor, 3280 Hospital Dr NW, Calgary, AB T2N 4Z6, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3D11, 3280 Hospital Dr NW, Calgary, AB T2N 4Z6, Canada
| | - Paul D Arnold
- Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, 4th floor, 3280 Hospital Dr NW, Calgary, AB T2N 4Z6, Canada
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Zusman N, Saporta-Sorozon K. Organizational factors affecting nurses' tendency to report child abuse and neglect. Public Health Nurs 2021; 39:601-608. [PMID: 34889475 DOI: 10.1111/phn.13030] [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: 08/22/2021] [Revised: 11/19/2021] [Accepted: 11/26/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To examine the factors that affect the tendency of nurses working in mother and child health clinics (MCHC) to report child abuse to the authorities. DESIGN Cross-sectional survey. SAMPLE Three hundred and forty-one female nurses working in MCHC across Israel. MEASUREMENTS (1) Social and organizational variables; (2) the tendency to report child abuse and neglect; (3) attitudes toward reporting child abuse and neglect. RESULTS On average, the participants perceived that they have good collaboration with other staff members and with welfare services. They showed a favorable attitude toward reporting child abuse, but less than half (44.8%) would report child abuse suspicion to the authorities. None of the organizational variables (MCHC type, collaboration among staff, collaboration with welfare services) were correlated with the tendency to report child abuse and neglect, yet all three variables were significantly correlated with attitudes toward reporting child abuse. Nurses' attitudes toward reporting were mediated by the organizational variables. CONCLUSIONS The effect of the organizational factors on the actual tendency to report child abuse is mediated by nurses' attitude toward reporting. Organizational constraints probably encourage MCHC nurses to be cautious before reporting child abuse and neglect to the authorities, restricting adherence to the law, which requires direct reporting.
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Affiliation(s)
- Nurit Zusman
- Academic Nursing School, Barzilai Medical Center, Ashkelon, Israel
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Nunes LS, Silva-Oliveira F, Mattos FF, Maia FBF, Ferreira EFE, Zarzar PMPDA. Prevalence of recognition and reporting of child physical abuse by dental surgeons and associated factors. CIENCIA & SAUDE COLETIVA 2021; 26:5013-5022. [PMID: 34787194 DOI: 10.1590/1413-812320212611.3.02442020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 02/24/2020] [Indexed: 11/21/2022] Open
Abstract
Studies evaluating the factors associated with under reporting and with the recognition and reporting of child physical abuse are scarce and highly necessary. This study aimed to assess the prevalence of recognition and reporting of child physical abuse (CPA) by Brazilian dentistsin primary care and associated factors. A cross-sectional study was carried out with a representative sample of dentistsfrom the Family Health Strategy in Belo Horizonte. A self-administered questionnaire validated to Brazilian Portuguesewas used for data collection. Statistical analysis included univariate and multiple analyses through Poisson regression. A total of 181dentists participated in the study. Among them, 73 (40.3%) had already recognized some cases of CPA, but only 11 (6.1%) ended up reporting. Dentists with six to 19 years of experience as a municipal worker presented 2.38 times [PR = 2.38 (95%CI: 1.29-4.41)] more probability to recognize cases of CPA than the ones with less than six years. Having a graduate degree with a major in childcare [PR = 4.50 (95%CI: 1.08-18.68)] was associated with a larger number of reports. The employment duration as municipal worker was positively associated with the recognition of CPA cases and the prevalence of reporting was low.
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Affiliation(s)
- Laís Soares Nunes
- Departamento de Saúde Bucal da Criança e do Adolescente, Universidade Federal de Minas Gerais. Av. Presidente Antônio Carlos 6627, Pampulha. 31270-90 Belo Horizonte MG Brasil.
| | - Fernando Silva-Oliveira
- Departamento de Odontologia Social e Preventiva, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil
| | - Flávio Freitas Mattos
- Departamento de Odontologia Social e Preventiva, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil
| | - Fernanda Bartolomeo Freire Maia
- Departamento de Saúde Bucal da Criança e do Adolescente, Universidade Federal de Minas Gerais. Av. Presidente Antônio Carlos 6627, Pampulha. 31270-90 Belo Horizonte MG Brasil.
| | | | - Patrícia Maria Pereira de Araújo Zarzar
- Departamento de Saúde Bucal da Criança e do Adolescente, Universidade Federal de Minas Gerais. Av. Presidente Antônio Carlos 6627, Pampulha. 31270-90 Belo Horizonte MG Brasil.
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Bahrami N, Tork-Torabi M, Sotoudeh R, Namnabati M. Perceived Child Abuse and Neglect in Hospitalized Children with Special Health Care Needs in Iran. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2021; 26:526-530. [PMID: 34900652 PMCID: PMC8607892 DOI: 10.4103/ijnmr.ijnmr_296_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 02/11/2020] [Accepted: 05/23/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Child Abuse and Neglect (CAN) is an important public health concern. Nurses play a key role in caring for the children and keeping them safe from abuse and neglect. The aim of this study was to determine the rate of perceived CAN in Hospitalized Children with Special Health Care Needs (CSHCN) as well as the relationship between the rate and some effective factors. MATERIALS AND METHODS This is a descriptive cross-sectional study on 199 CSHCN aged 6-18 years old, admitted to the pediatric wards in an educational hospital, in Isfahan, Iran, in 2018. Children were selected through convenience sampling method and assessed for CAN through a child abuse questionnaire. The Pearson correlation coefficient and Kruskal-Wallis and Mann-Whitney U tests were used to analyze the data. The p values smaller than 0.05 were regarded as significant. RESULTS According to the findings, 173 children (86.93%) had perceived CAN, the average total score of which was 9.36 contributing commonly to malnutrition 3.01 (2.36) followed by psycho-emotional abuse 2.71 (1.76), neglect 1.62 (1.23), and physical 1.52 (1.08) and sexual 0.54 (0.31) abuse based on mean (SD). Statistical analysis indicated a significant effect of child's age, economic situation of the family, mother's education and occupation, and parents' illness on the total score of perceived CAN (p < 0.05). CONCLUSIONS Malnutrition was found to be the most common type of perceived CAN. Therefore, parents and the health system are advised to prioritize nutritional needs when planning their nutrition.
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Affiliation(s)
- Niloofar Bahrami
- Student Research Committee, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Tork-Torabi
- Emam Hosseine Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reza Sotoudeh
- Isfahan Disaster and Emergency Medical Management Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahboobeh Namnabati
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran,Address for correspondence: Dr. Mahboobeh Namnabati, Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan - 73461-81746, Iran. E-mail:
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Vosoghi N, Fallahi-Khoshknab M, Hosseini M, Ahmadi F. Nursing Care Challenges of Child Violence Victims: A Qualitative Study. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2021; 26:430-436. [PMID: 34703782 PMCID: PMC8491823 DOI: 10.4103/ijnmr.ijnmr_151_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 07/07/2020] [Accepted: 04/19/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Violence against children is a serious global phenomenon. The severity of the injuries caused due to violence toward a child is sometimes so great that it sends them to the hospital. Nurses have the first contact with Child Violence Victims (CVVs). These nurses experience different challenges. This study was aimed at exploring nurses' experiences of challenges in care provision to CVVs. MATERIALS AND METHODS This conventional content analysis and qualitative study was conducted in 2018-2019. Using a purposive sampling method, 17 nurses with experience in care delivery to CVVs were recruited from among those working in Children's Medical Center, Tehran, Iran, and Bu-Ali Subspecialty Hospital, Ardabil, Iran. In-depth semi-structured interviews were conducted to collect the required data. Data were analyzed through the conventional content analysis method. RESULTS During data analysis, the 3 main categories of role conflict, lack of continuity of care, and emotional resentment and 9 subcategories were identified. Nurses experience challenges in care provision to CVVs. They do not have enough knowledge about CVVs, are unable to maintain the continuity of care, and experience role conflicts and emotional resentment. CONCLUSIONS Nurses experience some difficulties and challenges in the process of care delivery to CVVs. They tried to overcome emotional resentment, different conflicts, and concerns about the lack of continuity of care without adequate support and resources. Thus, planning to support nurses in this regard seems essential.
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Affiliation(s)
- Nazila Vosoghi
- Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | - Mohammadali Hosseini
- Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Fazlollah Ahmadi
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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Pournaghash-Tehrani SS, Zamanian H, Amini-Tehrani M. The Impact of Relational Adverse Childhood Experiences on Suicide Outcomes During Early and Young Adulthood. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:8627-8651. [PMID: 31142213 DOI: 10.1177/0886260519852160] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This study aimed at investigating the degree to which relational adverse childhood experiences (ACEs) would affect suicide outcomes during early and young adulthood of Iranian female and male students. In all, 487 undergraduate students (59.2% females) with a mean age of 20.66 ± 1.42 were recruited using a multistage clustering sampling method from eight schools from the fields of humanities, engineering, and basic sciences. Suicide Behavior Questionnaire-Revised form (SBQ-R) was employed for assessing past year suicidal ideation (PYSI, once or more), the meaningful likelihood of future suicide (mLoFS, a score of 2 or more), and suicide risk (SR ≥7). Relational ACEs were assessed in the form of a yes/no question, including caregivers' maltreatment, household relational dysfunction, family loss events, school events, and sexual abuse. Analyses were conducted using Fisher's exact test, chi-square test, and univariate binary logistic regression. The rates of PYSI, LoFS, and SR were, respectively, 37.2%, 44.6%, and 30.8%. The most experienced event was witnessing verbal violence (68.8%) and the least was divorce/separation (6.2%). All the events and domains (except family loss events), the interaction of domains, and cumulative events significantly increased the odds of suicide outcomes, in which females were more affected by all types of relational ACEs. Students whose ethnicity was Azari & Turk and who were studying in humanities or basic sciences showed a higher suicide risk than their counterparts. The study showed that the rates of relational ACEs and suicide outcomes were remarkable, in Iran. Because of the detrimental effects of relational ACEs on suicidality, mostly for females, it is necessary to improve the initiatives promoting child protection and legal support for health professionals to address child abuse. There is also an urgent need for providing young students with supports and effective interventions.
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Relational adverse childhood experiences questionnaire: development and retrospective validation among young Iranian people. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01874-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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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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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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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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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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