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[Child protection: Pediatricians' knowledge and practices in Brittany]
C Ayou1, E Gauducheau2, A Arrieta3
1Pédiatrie, CHU de Rennes, 16, boulevard de Bulgarie, 35203 Rennes cedex, France; UAED Pédiatrie, CHU de Nantes, 7, quai Moncousu, 44093 Nantes cedex, France.
Insights
Pediatricians in Brittany demonstrate significant gaps in knowledge and practice regarding child abuse and neglect, highlighting a critical need for enhanced training and support systems to improve child protection efforts.
Area of Science:
- Pediatrics
- Child Protection
- Public Health
Background:
- Reformed child protection laws in 2007 placed responsibility for child abuse and neglect management with child protection services.
- A 2014 study revealed general practitioners' (GPs) unfamiliarity with child protection updates, indicating a need for specialized training.
- Previous research highlighted knowledge gaps among GPs, prompting a similar investigation into pediatricians' understanding and practices.
Purpose of the Study:
- To assess the knowledge and practices of pediatricians in Brittany concerning child abuse and neglect.
- To compare the findings from pediatricians with those previously reported for GPs in Ille-et-Vilaine.
- To identify barriers preventing pediatricians from reporting suspected cases of child abuse and neglect.
Main Methods:
- An anonymous postal survey was conducted among pediatricians in Brittany between May and July 2014.
- A questionnaire, adapted from a prior study on GPs, was used to ensure comparability of results.
- Data collected included pediatricians' activity, knowledge of child abuse and neglect, and reporting practices.
Main Results:
- Only 4.4% of surveyed pediatricians scored over 80% on the knowledge assessment, with 12% scoring below 50%.
- 41% of pediatricians reported no cases of child abuse or neglect since 2007.
- Key barriers to reporting included lack of feedback from social services (9% received), insufficient training, and fear of misdiagnosis.
Conclusions:
- Child protection remains an under-addressed area, even among pediatricians.
- Pediatricians with more training and experience in child abuse cases demonstrated better knowledge.
- There is a strong demand for improved caregiver training (92%) and practical guidance (97%) to enhance child protection reporting.
Background And Aims:
On 5 March 2007, the law concerning the child protection system was reformed. Since then, child protection services have been responsible for the management of child abuse and neglect. Reporting and asking for child protection is now easier for every physician by submitting a "preoccupying information" form. A study conducted in 2014 in the general practitioners (GP) in the Ille-et-Vilaine department showed that they were quite unfamiliar with the child protection updates and that they needed special training. We wished to study the knowledge and practices of the pediatricians in Brittany and compare these results to the previous study.
Methods:
An anonymous postal investigation was conducted between May and July 2014. The questionnaire was referred to the previous study so the results would be comparable.
Results:
A total of 134 pediatricians (including 99 women) of the 316 pediatricians of Brittany answered our questionnaire regarding their activity and their knowledge about child abuse and neglect. These results were analyzed and compared to the data of GPs in Ille-et-Vilaine. Only 4.4 % of the pediatricians obtained more than 80 % correct answers and 12 % of the pediatricians obtained fewer than 50 % correct answers. Among the pediatricians, 41 % of them had not reported a single time since 2007. The pediatricians who obtained better results (P<0.001) had more training and were more often in contact with child abuse and neglect than the GPs. The most common reasons that clinicians gave for not reporting were lack of a return from social services after a report, lack of training and the fear of making a misdiagnosis. Indeed only 9 % had received feedback from social services. To make reporting easier, 92 % of the pediatricians would like training and 97 % found a simple practice guide on child abuse useful.
Conclusion:
Child protection is a neglected subject, including by pediatricians. To fight against professional denial and isolation, a substantial effort is still needed concerning caregivers' training as well as pediatric care organization.
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