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Identifying signs of child neglect and abuse in general practice
Camilla Hoffmann Merrild1, Lise Frost
1chm@dcm.aau.dk.
Insights
General practitioners (GPs) face challenges identifying child neglect and abuse due to intangible signs. Reporting barriers exist, highlighting a need for better child protection training in healthcare.
Area of Science:
- Pediatrics
- General Practice
- Child Protection
Background:
- Child neglect and abuse are often identified late.
- General practice is crucial for early detection of child welfare concerns.
- Limited understanding exists regarding general practitioners' (GPs) role in identifying and reporting child abuse and neglect.
Purpose of the Study:
- To explore the challenges faced by GPs in identifying child neglect and abuse.
- To identify barriers preventing GPs from reporting suspected cases of child neglect and abuse.
Main Methods:
- An explorative pilot study.
- Eight semi-structured interviews with Danish general practitioners (GPs).
- Thematic analysis of transcribed interviews.
Main Results:
- GPs infrequently encountered concrete signs of child neglect and abuse.
- Suspicion often arose from intangible indicators, such as changes in caregiver-child interactions or help-seeking behavior.
- Reporting to social services was frequently viewed as a means to provide families with necessary support.
Conclusions:
- The intangible nature of warning signs complicates action and reporting for GPs.
- GPs reported feeling limited in their ability to intervene effectively.
- Enhanced knowledge and training are needed across health professions for child protection and wellbeing.
Introduction:
Children who live with neglect and abuse are often identified late in the process. At the front line of Danish healthcare, where most children are seen regularly, general practice is well placed to raise concerns about child health and wellbeing. Little is known about the role general practitioners (GPs) play in suspecting and reporting child neglect and abuse. We explored challenges GPs are facing in identifying such children and illustrated some of the barriers preventing GPs from reporting on these cases.
Methods:
This was an explorative pilot study, preceding a larger multidisciplinary project. We conducted eight semi-structured interviews with selected Danish GPs. The interviews were transcribed verbatim and coded using thematic analysis.
Results:
GPs rarely experienced concrete signs of child neglect and abuse, and reporting to the social services was often a way of helping families to get the support they needed. When GPs suspected that "something was wrong", this was based on a gut feeling, triggered by non-measurable and intangible signs such as changes in health-seeking behaviour or in the relationship between caregivers and children.
Conclusions:
The intangibility of signs provoking suspicion of neglect and abuse made acting or reporting difficult and GPs felt that they lacked opportunities to take action. More knowledge is needed on how to approach matters of child protection and wellbeing across health professions and specialities.
Funding:
The study was funded by the Danish Victims Fund.
Trial Registration:
not relevant.
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