Identification of child maltreatment while caring for them in a university hospital
Section snippets
Types of maltreatment
Caffey (1946) was the first to launch scientific discussion about child abuse having an influence on medical and nursing practice after having observed in children's X-rays of fractures which were not explained by the accidents described by parents. Kempe et al. (1962) continued to clarify the phenomenon with their article “The battered child syndrome”. The issue, which had been suspected but not much discussed, was thus brought to public notice. On the other hand, children had been sacrificed
Purpose of the study
The purpose of this study was to ascertain and describe how the nursing and medical staff admitting and treating children in a university hospital rate their ability to identify child maltreatment. An additional purpose was to explore which factors make the identification easy or difficult, and what nurses’ and physicians’ actions are while suspecting child maltreatment. The aim is to acquire knowledge for developing the identification of child maltreatment and care of maltreated children and
Materials and methods
The study sample comprised the entire nursing staff (nurses, paediatric nurses, practical nurses and paramedics), medical and other staff (therapists and psychologists) (N=513) caring for children in a university hospital. The subjects worked in the paediatric clinic, surgical clinic, child psychiatry clinic and women's clinic. The total number of the participants was 317, which yielded a response rate of 62%. It was not possible to perform a drop-out rate analysis, because there was no
Demographic data
Ninety-one per cent of the respondents were women. More than half the respondents were registered nurses. One in ten respondent was a physician (Table 1). Nearly half of the respondents worked on paediatric wards or in a paediatric outpatient department. One in ten worked in an emergency unit, 6% worked on a paediatric surgical ward, a little less than one-tenth on child psychiatric wards or outpatient department and about one quarter in maternity care (Table 2).
The sample was evenly
Reliability of the study and ethical considerations
The questionnaire was developed for this study with reference to the literature concerning child maltreatment (Tzeng et al., 1991; Ney et al., 1994; Berliner and Elliott; 1996, Hart et al., 1996; Kolko, 1996). The questionnaire was pilot tested and on the basis of pilot testing some questions were adjusted and reworded. The questionnaire asked no names and the questionnaires were not numbered, so the respondents’ anonymity is assured. The respondents mailed the questionnaires in prepaid
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