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Identification of child maltreatment while caring for them in a university hospital
Eija Paavilainen1, Juhani Merikanto, Päivi Astedt-Kurki
1Department of Nursing Science, University of Tampere, 33014, Tampere, Finland. nueipa@uta.fi
Insights
Healthcare professionals often struggle to identify child maltreatment, despite having theoretical knowledge. Improved education and clear hospital guidelines are crucial for better identification and care of abused children.
Area of Science:
- Pediatrics
- Medical Education
- Social Work
Background:
- Child maltreatment poses significant health risks.
- Accurate identification is critical for timely intervention.
- Healthcare professionals' self-assessed ability to identify child maltreatment is under-explored.
Purpose of the Study:
- To evaluate nurses' and physicians' perceived ability to identify child maltreatment.
- To understand the challenges faced by healthcare professionals in identifying child maltreatment.
- To identify areas for improvement in healthcare settings.
Main Methods:
- Survey of 513 healthcare staff at a university hospital.
- Data collected via a custom-developed questionnaire.
- Analysis using statistical methods and quantitative content analysis.
Main Results:
- 67% believed they could identify child maltreatment, yet 40% reported never caring for a maltreated child.
- Fractures, multiple bruises, and frequent injuries were key indicators.
- Identification was rated difficult by 71% due to complexity, workload, and lack of guidelines.
Conclusions:
- Healthcare professionals possess theoretical knowledge but face practical challenges in identifying child maltreatment.
- Lack of standardized guidelines and interdisciplinary collaboration hinders effective identification.
- Enhanced education and development of operational models are essential for improving child maltreatment identification and care.
Abstract:
The purpose of the study was to look at how nurses and physicians of a university hospital rated their ability to identify child maltreatment while caring for those children. In this study, child maltreatment was defined as physical, psychological or sexual abuse or neglect of a child under the age of 18 by parents or caregivers. The total population of staff caring for children (N=513) in a university hospital were surveyed. Data were collected with a questionnaire developed for this study with reference to the literature. Altogether 317 questionnaires were returned, which yielded a response rate of 62%. The data were analysed using statistical methods and quantitative content analysis. Forty per cent of the respondents estimated that they had never cared for a maltreated child. Two-thirds of the respondents believed that they would be able to identify a child maltreatment case. The most distinct signs by which maltreatment could be identified were fractures, multiple bruises and the fact that the child had frequent injuries. The child's or parent's behaviour often aroused suspicion of maltreatment. Seventy-one per cent of the respondents rated the identification of maltreatment as rather difficult or difficult. Awkwardness of the phenomenon, the staff's pressure of work and relative unfamiliarity with the phenomenon were assessed as things that make the identification difficult. The fact that no jointly agreed guidelines were available for handling the matter was seen as a particular weakness. The respondents had fairly much theoretical knowledge about child maltreatment. However, child maltreatment is a multi-dimensional phenomenon that calls forth emotions. The development and improvement of practical nursing and medical care and of staff collaboration require that education be provided to different occupational groups and parties caring for children and that jointly agreed hospital-specific and regional models for operation be developed.