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General practitioners' knowledge and management of children co-victimized by intimate partner violence
Justine Launey1, Bernard Brau1, Mathieu Kuchenbuch2
1Department of General Medicine, University of Rennes 1, Rennes, France.
Insights
General practitioners (GPs) in France often encounter intimate partner violence (IPV) situations affecting children but lack adequate training and confidence in child protection. Enhancing GP education and specialized consultations is crucial for safeguarding children exposed to IPV.
Area of Science:
- Public Health
- Pediatrics
- Social Sciences
Background:
- Intimate partner violence (IPV) significantly impacts children as secondary victims globally.
- There is a notable lack of research on French general practitioners' (GPs) roles in identifying and managing children exposed to IPV.
- Understanding GPs' current practices is essential for improving child protection frameworks.
Purpose of the Study:
- To evaluate the knowledge and practices of GPs in France concerning child protection in IPV cases.
- To identify existing gaps in GPs' training and clinical approaches to children exposed to IPV.
- To inform strategies for enhancing support systems for children affected by domestic violence.
Main Methods:
- An electronic survey was administered to 91 GPs in Bretagne between May 2020 and May 2022.
- The survey assessed GPs' demographic data, clinical experience with IPV, management strategies for exposed children, and perceived impact on child well-being.
- Data analysis focused on understanding current practices and identifying areas for improvement in child protection.
Main Results:
- 67% of GPs reported encountering IPV situations in the past year, with an average of 2 children per practitioner identified as in danger.
- 48% of children were noted to live in families with IPV, yet 35% of GPs observed exposed children without recognizing them as endangered.
- GPs rated their knowledge of IPV's impact on children as 5/10, expressed discomfort (4/10), and found their training inadequate (3/10).
Conclusions:
- GPs play a vital role in identifying and managing children exposed to IPV in France, despite current knowledge and practice limitations.
- Strengthening GP training, standardizing child protection protocols, and improving access to specialized consultations (e.g., UAPED) are recommended.
- Enhanced interprofessional collaboration is essential for improving child protection outcomes in IPV contexts.
Background:
Intimate partner violence (IPV) is a major global public health issue, frequently impacting children as secondary victims. However, research on the involvement of general practitioners (GPs) in identifying and managing children exposed to IPV in France is lacking.
Objective:
This study aimed to assess GPs' knowledge and practices regarding child protection in IPV cases, shedding light on gaps in their training and practices.
Methods And Settings:
An electronic survey was conducted among GPs in Bretagne from May 2020 to May 2022, assessing demographic characteristics, clinical experiences, management practices for children exposed to IPV, and understanding its impact on children and adolescents.
Results:
The study involved 91 GPs (sex ratio: 0.34, median: 15 [interquartile: 5.75-23] years of practice experience, and 25 % [18-30] of their practice focused on paediatrics). Results showed that 67 % encountered IPV situations within the past year, 46 % of children were in danger (2[1-2] per practitioner), and 48 % of children lived in a family with IPV (2[1-3] per practitioner). Thirty-five percent of GPs observed children exposed to IPV without recognizing them as endangered. Regarding knowledge of the impact of IPV on children, practitioners rated it at 5 out of 10, expressing discomfort (Likert scale from 0 to 10 (LS0-10): 4[3:5]) and perceiving their training as inadequate (LS0-10: 3[2:4]). They emphasized the need for better stakeholder understanding, favoring in-person training and enhanced access to specialized consultations to enhance their expertise.
Conclusion:
These findings highlight the critical role of GPs in identifying and managing children exposed to IPV in France, despite gaps in knowledge and practice. Strengthening GPs' training, standardizing protocols, improving and developing access to specialized consultations, such as hospital-based Unit for Endangered Children ("Unité d'Accueil Pédiatrique Enfant en Danger", UAPED), and fostering interprofessional collaboration could enhance child protection efforts in IPV contexts.
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