The evaluation of general knowledge of emergency care providers about child abuse and neglect

Year 2017, Volume: 8 Issue: 1, 16 - 22, 16.03.2017

Mehmet Özen Hayri Ramadan Sevilay Vural Figen Coşkun

https://doi.org/10.18663/tjcl.298251

Cited By: 3

Abstract

Aim: Child abuse and
neglect is a public healthcare problem with medical, legal, developmental and
psychosocial comprehension, having complex causes and tragic consequences. The
incidence of it in societies is not fully detected. We aimed to measure the
knowledge levels of doctors and allied healthcare personnel in emergency
departments (ED) about child maltreatment, compare with non-healthcare control
group and find out the altering factors.

 

Material
and Methods: In
our study, a group of 400 consisted of ED doctors, pediatricians and other
healthcare providers who were working in Teaching, University and General
Hospital ED in Ankara and 105 subjects as a control group were included. A
survey consisting of the demographic questions which also had myth part about
child abuse and neglect was configured. 

 

Results:
Among the demographics and myth beliefs, it was found that the institutions
where the doctors and allied staff work affect their belief in myths, the
experience duration is a variable between healthcare staff, receiving training
about child abuse is an altering factor for success rate and having children of
own doesn’t affect the accuracy significantly (P > 0.05). The success rates
of the control group showed similarity with allied personnel to each myth (P >
0.05). However, the control group had low accuracy on myths 7, 18, 19, 22, 25,
27, 30, and 35 than doctors.

 

Conclusion:
All the healthcare providers who work in pediatric and emergency medicine
clinics where pediatric patients are encountered mostly should know signs and
symptoms of child abuse and neglect, in addition have responsibilities for
reporting them to the legal departments. Furthermore, regular training programs
should be applied both to community and healthcare system to disprove the myths
on this topic.

Keywords

Child abuse, neglect, sexual abuse

Acil sağlık çalışanlarının çocuk istismarı ve ihmali hakkında genel bilgilerinin değerlendirilmesi

Abstract

Amaç: Çocuk
istismarı ve ihmali, karmaşık nedenleri ve trajik sonuçları sebebiyle tıbbi,
yasal, gelişimsel ve psikososyal bir halk sağlığı sorunudur. Toplum içindeki
gerçek insidansı tam olarak bilinmemektedir. Çalışmamızda acil servislerde
çalışan hekimler ve yardımcı sağlık personelinin çocuk istismarı ve ihmali
hakkında bilgi düzeylerini ölçmeyi; elde edilen sonuçları sağlık çalışanı
olmayan kontrol grubuyla karşılaştırmayı amaçladık.

  

Gereç ve
Yöntemler: Çalışmamıza Ankara İlindeki Eğitim Araştırma,
Üniversite ve Devlet hastanelerinde çalışan acil doktorları, pediatri hekimleri
ve diğer sağlık çalışanlarından oluşan 400 kişilik bir çalışma grubu ve 105
katılımcıdan oluşan kontrol grubu dahil edilerek yapılmıştır. Katılımcılara hem
demografik sorulardan oluşan hem de çocuk istismarı ve ihmali konusunda genel
olarak inanılan mitleri içeren birer anket uygulanmıştır.

 

Bulgular: Demografik
sorular ve mitler içeren ankette, doktorlar ve yardımcı sağlık çalışanlarının
çalıştıkları kurumların mitlere bakış açısını etkilediği, deneyim süresinin
sağlık çalışanları için bir değişken olduğu, çocuk istismarı konusunda eğitim
almış olmanın belirleyici olduğu fakat çocuk sahibi olmanın cevaplardaki
doğruluğu anlamlı şekilde etkilemediği tespit edilmiştir (p>0,05). Kontrol
grubunun başarı oranları her mit için yardımcı sağlık personeli ile benzerlik
göstermiştir (p> 0,05). Ancak kontrol grubunun 7, 18, 19, 22, 25, 27, 30 ve
35 numaralı mitlerde doktorlara göre düşük doğruluk oranları tespit edilmiştir.

 

Sonuçlar: Acil
servislerinde ve çoğunlukla çocuk yaş grubunun bakıldığı pediatrik acil
servislerinde çalışan tüm sağlık çalışanlarının çocuk istismarı ve ihmaline
dair belirti ve bulgularını bilmeleri gerekmektedir. Ayrıca yasal birimlere
bildirmeye yönelik sorumlulukları mevcuttur. Bu konudaki mitleri çürütmeye
yönelik düzenli eğitim programları hem sağlık sisteminde hem de toplum
düzeyinde uygulanmalıdır.

 

Keywords

Çocuk istismarı, ihmal, cinsel istismar

References

• Definition of Child Abuse. World Health Organization website. http://www.who.int/violence_injury_prevention/violence/child/en/index.html. Accessed March 1, 2015.
• Parker K, Pitetti R. Mortality and child abuse in children presenting with apparent lifethreatening events. Pediatr Emerg Care 2011; 27: 591-5.
• Kempe CH, Silverman FN, Steele BF, Droegemueller W, Silver HK. The battered child Syndrome. JAMA 1962; 181: 17-24.
• Lynne EG, Gifford EJ, Evans KE. Rosch Barriers to reporting child maltreatment: do emergency medical services professionals fully understand their role as mandatory reporters? N C Med J 2015; 76: 13-8.
• Louwers EC, Korfage IJ, Affourtit MJ, De Koning HJ, Moll HA. Facilitators and barriers to screening for child abuse in the emergency department. BMC Pediatr 2012; 12: 167.
• Markenson D, Tunik M, Cooper A, et al. A national assessment of knowledge, attitudes, and confidence of prehospital providers in the assessment and management of child maltreatment. Pediatrics 2007; 119: 103-8.
• Al-Moosa A, Al-Shaiji J, Al-Fadhli A, Al-Bayed K, Adib SM. Pediatricians' knowledge, attitudes and experience regarding child maltreatment in Kuwait. Child Abuse Negl 2003; 27: 1161-78.
• Fagan D. Child abuse and neglect: the knowledge and practice of the A & E nurse. Accid Emerg Nurs 1998; 6: 30-5.
• Davidhizar R, Newman-Giger J. Recognizing abuse. Int Nurs Rev 1996; 43: 145-50.
• Menoch M, Zimmerman S, Garcia-Filion P, Bulloch B. Child abuse education: an objective evaluation of resident and attending physician knowledge. Pediatr Emerg Care 2011; 27: 937-40.
• Starling SP, Heisler KW, Paulson JF, Youmans E. Child abuse training and knowledge: a national survey of emergency medicine, family medicine, and pediatric residents and program directors. Pediatrics 2009; 123: 595-602.
• Keane C, Chapman R. Evaluating nurses' knowledge and skills in the detection of child abuse in the Emergency Department. Int Emerg Nurs 2008; 16: 5-13.
• Feng JY, Jezewski MA, Hsu TW. The meaning of child abuse for nurses in Taiwan. J Transcult Nurs 2005; 16: 142-9.
• Definitions of Abuse. Center for the Prevention of Child Abuse website. http://www.preventchildabusedutchess.org/about/definitions-of-abuse. Accessed March 1, 2015.
• UNICEF official website. Child abuse: myths and facts. http://www.unicef.org/malaysia/GetonBoard-Factsheet-Child-Abuse-Myths_Facts.pdf. Accessed March 1, 2015.
• Adults surviving child abuse organisation website. Abuse types. http://www.asca.org.au/displaycommon.cfm?An=1&subarticlenbr =44. Accessed March 1, 2015.
• Child matters organisation website. Myths and Realities. http://www.childmatters.org.nz/58/learn-about-child-abuse/myths-andrealities. Accessed March 1, 2015.
• dreamcatchers organisation website. Profile of a child molester. http://dreamcatchersforabusedchildren.webs.com/childsexoffenders.html http://rapeinfo.wordpress.com/2008/07/08/profile-of-a-child-molester/. Accessed March 1, 2015.
• Humanity Against Local Terrorism (HALT) organization website. Myths and facts about child abuse and neglect. http://www.haltnow.ca/abuse/childabuse/188-myths-and-facts-about-child-abuse-and-neglect.html. Accessed March 1, 2015.
• Helping People organisation website. Myths and facts about sex offenders. http://www.helpingpeople.info/articles/myths_and_facts.html. Accessed March 1, 2015.
• African Network fort he Prevention and Protection against Child Abuse and Neglect (ANPPCAN) organisation website. Myths and facts on child abuse. http://www.anppcankenya.co.ke/index.php?option=com_content&task=view&id=16&Itemid=67. Accessed March 1, 2015.
• The University of Iowa official website. Rape victim Advocacy Program. Responding to sexuel abuse. http://www.rvap.org/pages/myths_and_facts_about_child_sexual_abuse/. Accessed March 1, 2015
• Rape and Abuse Crisis Center Organisation website. Myhts and facts about child sexuel abuse.https://www.raccfm.com/files/Myths%20and%20Facts %20about%20Child%20Sexual%20Abuse.pdf. Accessed March 1, 2015.
• The Lutheran Family Services (LFS) website. Myths and facts about childhood sexual abuse. http://www.lfsneb.org/behavioralhealth/sexualabu se/myths.asp. Accessed March 1, 2015.
• Leadership Council website. Eight common myths about child sexuel abuse. http://www.leadershipcouncil.org/1/res/csa_m yths.html. Accessed March 1, 2015.
• Akçay Ş. İstanbul Üniversitesine bağlı tıp fakültelerinde çocuk sağlığı ve hastalıkları anabilim dalları ile travma ve acil cerrahi birimlerinde görev yapan son dönem tıpta uzmanlık öğrencilerinin çocuk ihmali ve istismarı konusunda bilgi, deneyim ve davranışlarını belirleme araştırması. phD Thesis, İstanbul University Faculty of Medicine, Department of Family Medicine, İstanbul; 2008.
• Markenson D, Foltin G, Tunik M, et al. Knowledge and attitude assessment and education of prehospital personnel in child abuse and neglect: report of a National Blue Ribbon Panel. Prehosp Emerg Care 2002; 6: 261-72.
• Newton AS, Zou B, Hamm MP, et al. Improving child protection in the emergency department: a systematic review of professional interventions for health care providers. Acad Emerg Med 2010; 17: 117-25.
• Lawrence LL, Brannen SJ. The impact of physician training on child maltreatment reporting: a multi-specialty study. Mil Med 2000; 165: 607-11.
• Khan AN, Rubin DH, Winnik G. Evaluation of the mandatory child abuse course for physicians: do we need to repeat it? Public Health 2005; 119: 626-31.