Document Type : original article

Authors

1 Department of Pediatrics, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran

2 Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran

3 Community Based Participatory Research Center, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran

4 Sina Trauma & Surgery Research Center, Tehran University of Medical Sciences, Tehran,Iran.

5 Pediatrician, Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran

6 Nursing Care Research Center, Department of Psychiatric Nursing, Iran University of Medical Sciences, Tehran, Iran

7 School of Medicine, Bahrami Hospital, Tehran University of Medical Sciences, Tehran ,Iran

8 Sina Trauma and Surgery Research Centre. Sina Hospital. Tehran University of Medical Sciences, Iran

Abstract

Background: Child Abuse and Neglect (CAN) is a major health problem with serious consequences. Since health care professionals play an important role in identification, management, and reporting CAN cases, they should have precise knowledge on this subject. The aim of this study is to investigate the level of knowledge, attitude and practice of the pediatricians, pediatric residents, and nurses regarding CAN issues as well as their possible needs for any educational programs in this regard.
Methods: 130 pediatric nurses and physicians working at two pediatric tertiary centers, in Tehran, Iran participated in this descriptive cross-sectional study. An anonymous validated and standardized self-report questionnaire was used as the study instrument. The questionnaire consisted of five sections on demographic information, knowledge, attitude, practice and needs assessment. Analytical statistical tests including t-test, Kruskal–Wallis and Mann-Whitney tests were used to analyze the data.
Results: The level of the participants’ knowledge was moderate (mean score: 16.6±3.17) and their attitude towards child abuse and neglect was at a good level (mean score: 45.72 ±4.25). The results of this study revealed that the overall performance of the participants in dealing with a suspicious case of child abuse and neglect was moderate. Almost all participants (95.5%) indicated the need for educational programs on child abuse both for nurses and physicians.
Conclusion: Results of our study revealed that the overall knowledge, attitude, and practice of the health care professionals in the field of pediatrics regarding child abuse and neglect are not satisfactory and training programs on this issue are mandatory for pediatricians, pediatric residents, and nurses due to their serious role in caring for children.

Keywords

  1. WHO fact sheet on Child abuse, updated 8 June 2020. Available from: https://www.who.int/news-room/fact-sheets/detail/child-maltreatment.
  2. Sahebihagh MH, Hosseini SZ, Hosseinzadeh M, Shamshirgaran SM. Knowledge, attitude and practice of community health workers regarding child abuse in Tabriz health centers in 2015-2016. International journal of community based nursing and midwifery. 2017; 5(3):264.
  3. P n. Prevalence of Child Abuse in Khorramabad Secondary Schools. Iranian Journal of Psychiatry and Clinical Psychology. 2003.
  4. Duhig M, Patterson S, Connell M, Foley S, Capra C, Dark F, Gordon A, Singh S, Hides L, McGrath JJ, Scott J. The prevalence and correlates of childhood trauma in patients with early psychosis. Australian & New Zealand Journal of Psychiatry. 2015; 49(7):651-9.
  5. Torkashvand F, Jafary F, Rezaeian M, SheikhFathollahi M. A survey on child abuse and some demographic factors affecting students of the third grade of guidance school in Zanjan in 2011. Journal of Rafsanjan University of Medical Sciences. 2013; 12(6):447-60.
  6. Nourazar S, Kakaie M, Ranjbar F, Sadeghi-Bazargani H, Farahbakhsh M. Prevalence of child abuse in child and adolescent clinical population referred to psychiatric facilities in Tabriz University of Medical Sciences, Iran. Journal of Analytical Research in Clinical Medicine. 2014; 2.
  7. Teeuw AH, Derkx BHF, Koster WA, van Rijn RR. Educational paper: Detection of child abuse and neglect at the emergency room. Eur J Pediatr. 2012; 171(6):877-85.
  8. Mohammadi MR, Zarafshan H, Khaleghi A. Child Abuse in Iran: a systematic review and meta-analysis. Iranian journal of psychiatry. 2014; 9(3):118.
  9. Sathiadas MG, Viswalingam A, Vijayaratnam K. Child abuse and neglect in the Jaffna district of Sri Lanka – a study on knowledge attitude practices and behavior of health care professionals. BMC Pediatr. 2018; 18.
  10. King W, Kiesel E, Simon H. Child Abuse Fatalities: Are We Missing Opportunities for Intervention? Pediatric emergency care. 2006; 22:211-4.
  11. Van Haeringen AR, Dadds M, Armstrong KL. The child abuse lottery-Will the doctor suspect and report? Physician attitudes towards and reporting of suspected child abuse and neglect. Child Abuse & Neglect. 1998; 22(3):159-69.
  12. Açık Y, Deveci SE, Oral R. Level of knowledge and attitude of primary care physicians in Eastern Anatolian cities in relation to child abuse and neglect. Preventive medicine. 2004; 39(4):791-7.
  13. Paavilainen E, Astedt-Kurki P, Paunonen-Ilmonen M, Laippala P. Caring for maltreated children: A challenge for health care education. Journal of advanced nursing. 2002; 37:551-7.
  14. Garousi B SH, Bahramnezhad. Kerman GPs’ knowledge and attitudes

About child abuse. Payesh. 2005; 5:213-20.

  1. Habib HS. Pediatrician knowledge, perception, and experience on child abuse and neglect in Saudi Arabia. Ann Saudi Med. 2012; 32(3):236-42.
  2. Jahanimoghadam F, Kalantari M, Horri A, Ahmadipour H, Pourmorteza E. A survey of knowledge, attitude and practice of Iranian dentists and pedodontists in relation to child abuse. Journal of Dentistry. 2017; 18(4):282.
  3. Regnaut O, Jeu-Steenhouwer M, Manaouil C, Gignon M. Risk factors for child abuse: levels of knowledge and difficulties in family medicine. A mixed method study. BMC Res Notes. 2015; 8.
  4. Flaherty EG, Sege R, Price LL, Christoffel KK, Norton DP, O’Connor KG. Pediatrician characteristics associated with child abuse identification and reporting: results from a national survey of pediatricians. Child maltreatment. 2006; 11(4):361-9.
  5. Kara Ö, Çalışkan D, Suskan E. Comparison of the levels of knowledge and approaches in relation with child abuse and neglect in residents of pediatrics, pediatricians and practitioners working in the province of Ankara. Turk Pediatri Ars. 2014; 49(1):57-65.
  6. Woolf A, Taylor L, Melnicoe L, Andolsek K, Dubowitz H, De Vos E. What Residents Know About Child Abuse: Implications of a Survey of Knowledge and Attitudes. American Journal of Diseases of Children. 1988; 142(6):668-72.
  7. Lazenbatt A, Freeman R. Recognizing and reporting child physical abuse: A survey of primary healthcare professionals. Journal of advanced nursing. 2006; 56:227-36.
  8. Jones R, Flaherty EG, Binns HJ, Price LL, Slora E, Abney D, Harris DL, Christoffel KK, Sege RD, Child Abuse Reporting Experience Study Research Group. Clinicians’ Description of Factors Influencing Their Reporting of Suspected Child Abuse: Report of the Child Abuse Reporting Experience Study Research Group. Pediatrics. 2008; 122:259-66.
  9. Morris J, Johnson CF, Clasen M. To report or not to report. Physicians' attitudes toward discipline and child abuse. American journal of diseases of children. 1985; 139 2:194-7.
  10. Child and Adolescent Protection Act 2020, updated 2020. Available from: https://dotic.ir/news/7053.
  11. Paek SH, Kwak YH, Noh H, Jung JH. A survey on the perception and attitude change of first-line healthcare providers after child abuse education in South Korea: A pilot study. Medicine (Baltimore). 2019; 98(2).
  12. Froula LM, Lenane AM, Pasternack JR, Garfunkel LC, Baldwin CD. Case-Based Workshop for Teaching Child Abuse Prevention to Resident Physicians. MedEdPORTAL.13.