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Violence against children and adolescents by nursing staff: prevalence rates and implications for practice
Ulrike Hoffmann1, Vera Clemens2, Elisa König2
1Department for Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Steinhövelstr. 5, 89073, Ulm, Germany. ulrike.hoffmann@uniklinik-ulm.de.
Insights
Child maltreatment by nursing staff is a significant risk in medical facilities, particularly psychiatric hospitals. This retrospective survey highlights the need for systemic changes and zero tolerance for assaults against children and adolescents.
Area of Science:
- Medical Sociology
- Child Psychology
- Healthcare Management
Background:
- Child maltreatment is a global issue with substantial individual, social, and economic consequences.
- Healthcare settings can be sites of child maltreatment, both by external perpetrators and healthcare professionals.
- Data on child maltreatment by nursing staff is notably scarce.
Purpose of the Study:
- To investigate the prevalence of child maltreatment experienced by patients from nursing staff within medical institutions.
- To compare the incidence of such maltreatment in psychiatric versus general/pediatric hospitals.
Main Methods:
- A large-scale, representative retrospective survey of 2,516 individuals aged 14-91 in Germany.
- Assessment of experiences of child maltreatment by nursing staff during inpatient stays before age 18.
Main Results:
- 33.3% of individuals with prior inpatient stays in child and adolescent psychiatry reported maltreatment by nursing staff.
- 17.3% of individuals with prior inpatient stays in general or pediatric hospitals reported maltreatment by nursing staff.
- Maltreatment was significantly more frequent in psychiatric hospitals compared to general and pediatric settings.
Conclusions:
- Maltreatment by nursing staff is not isolated but indicates systemic risks within medical facilities.
- Medical institutions, especially psychiatric ones, must proactively address the risk of assaults.
- Implementing structural changes and fostering a zero-tolerance attitude towards violence are crucial for prevention.
Background:
International studies show that child maltreatment is a widespread but often underestimated problem that causes high individual, social and economic costs. Child maltreatment is an important topic for the medical sector as well. On the one hand, affected persons often seek support and help from healthcare professionals, but on the other hand, assaults can also occur in medical institutions by healthcare professionals. Surprisingly, there is hardly any data on the frequency of child maltreatment by healthcare professionals in general and particularly by nursing staff.
Methods:
Therefore, in a large representative survey of the German population of 2,516 subjects aged between 14 and 91, the experience of child maltreatment in medical institutions by nursing staff was assessed retrospectively.
Results:
Of the 46 subjects who had an inpatient stay in a child and adolescent psychiatry before the age of 18, 33.3% reported to have experienced maltreatment by nursing staff, while 17.3% of the 474 persons who had an inpatient stay in general or pediatric hospitals experienced maltreatment by nursing staff. All forms of maltreatment were significantly more frequent in psychiatric compared to general and pediatric hospitals.
Conclusions:
The results of our representative retrospective survey demonstrate that maltreatment by nursing staff are not rare individual cases, but that medical facilities bear systemic risks for assault. Therefore, it is necessary that all medical institutions, in particular psychiatric hospitals, address this issue. In order to reduce the risk for assaults, it is important not only to implement structural measures but also to develop an attitude that emphasizes zero tolerance for violence against children and adolescents.
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