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Child Abuse & Neglect Mar 2020Healthcare professionals working at community-based services have a crucial position in raising concerns about possible child maltreatment. Yet, barriers exist to...
BACKGROUND
Healthcare professionals working at community-based services have a crucial position in raising concerns about possible child maltreatment. Yet, barriers exist to healthcare professionals adhering to mandatory reporting rules and regulations.
OBJECTIVE
The current study investigated the various forms by which healthcare professionals working in community services manage mandatory reporting, their reasoning and experience with formal requirements. The study has utilized the decision-making-ecology model as a conceptual framework.
PARTICIPANTS AND SETTING
The study was carried out in the largest district of the largest health-management organization in Israel, across fourteen sites located at seven cities. Eighteen healthcare professionals of various occupational groups participated in in-depth semi-structured interviews.
RESULTS
The results reveal that out of the of 52 recent cases that have been suspected for possible child maltreatment, only 58 % were reported as legally required. Yet, about half were reported in delay. Practitioners were more likely to report after additional evidence accumulated and increased the level of suspicion or after failing to manage the issue by other means of support. The analysis identified multiple factors that combined to impact the decision-making regarding reporting. Those were clustered around the individual case, healthcare professional, organizational setting, and external context.
CONCLUSIONS
Our results emphasize the importance of workplace-environmental conditions in promoting optimal reporting behaviors, including working in multi-disciplinary teams, availability of rapid expert consultation, provision of emotional-support, and reciprocal exchange of information with child-protection-services.
Topics: Adult; Attitude of Health Personnel; Child; Child Abuse; Community Health Services; Decision Making; Female; Health Personnel; Humans; Israel; Male; Mandatory Reporting; Workplace
PubMed: 31918355
DOI: 10.1016/j.chiabu.2019.104261 -
Comprehensive Child and Adolescent... Mar 2020In the absence of a mandatory reporting (MR) structure, it is unclear how nurses perceive or exercise their role in child protection. This study examined knowledge and...
In the absence of a mandatory reporting (MR) structure, it is unclear how nurses perceive or exercise their role in child protection. This study examined knowledge and perceptions of child protection and MR among nurses working in Hong Kong. This cross-sectional web-based survey used the Child Abuse Report Intention Scale to measure nurses' child protection knowledge and attitudes, and their perceived norms, control, and intention to report suspected maltreatment. Nurses also indicated if they support MR and to provide an explanation for their preference. Quantitative data were described and analyzed using bivariate and regression analyses. Open-ended responses were analyzed using directed content analysis. A convenient sample of 91 nurses working in Hong Kong completed the survey. The majority (86%) were female with a mean of 9.5 years of nursing experience; their mean knowledge score was 6.64 out of 13 (range 2-10). Compared with other maltreatment types, sexual abuse was perceived to be most severe and most likely to be reported. Perceived severity and attitudes toward child maltreatment was significantly associated with nurses' intention to report. Over half (58%) supported MR; those against MR expressed concerns about lack of support from management. Although nurses working in Hong Kong still hold polarized views about MR, findings point to the importance of creating a supportive reporting culture, and designing training programs that focus on changing perceptions about child protection in order to improve their tendency to report.
Topics: Adult; Child; Child, Preschool; Cross-Sectional Studies; Female; Hong Kong; Humans; Knowledge; Male; Mandatory Reporting; Nurses; Perception; Surveys and Questionnaires
PubMed: 30640560
DOI: 10.1080/24694193.2018.1561763 -
Journal of Paediatrics and Child Health Nov 2018Although mandatory reporting of suspected child abuse was first introduced over 50 years ago, there are no quantitative studies addressing whether or not it achieves...
Although mandatory reporting of suspected child abuse was first introduced over 50 years ago, there are no quantitative studies addressing whether or not it achieves better outcomes for children. We report two cases of maternal infection, one with tuberculosis (TB) and one with human immunodeficiency virus (HIV), where the mothers' failure to attend follow-up appointments raised the possibility of significant harm if their infants were infected. Some health professionals argued strongly that mandatory reporting meant the mothers should be reported to child protection authorities. Others argued that the risk was not critically imminent and an immediate report could seriously compromise maternal confidentiality, risked maternal disengagement and a worse outcome. An alternative was to make more vigorous efforts to contact the mothers and report only if these failed. In the TB case, reporting to child protection was deferred in favour of making more strenuous efforts at communication, which proved successful. In the HIV case, a case worker reported the case to child protection, but when the doctor contacted child protection authorities they agreed not to contact the mother unless the doctor's vigorous attempts to communicate with her failed. We do not advocate for breaking the law regarding mandatory reporting, but we do argue for a considered approach to the timing of reporting and for a collaborative approach with child protection services.
Topics: Case-Control Studies; Child Protective Services; Female; HIV Infections; Humans; Infant; Mandatory Reporting; Pregnancy; Public Health; Risk Assessment; Tuberculosis, Pulmonary; Vulnerable Populations
PubMed: 30387255
DOI: 10.1111/jpc.14208 -
Child Abuse & Neglect Nov 2022Child maltreatment reporting is critical for case investigation and service disposition. However, reporting discrepancies across informants is a challenge for child...
BACKGROUND
Child maltreatment reporting is critical for case investigation and service disposition. However, reporting discrepancies across informants is a challenge for child welfare services.
METHODS
Using data from the Fragile Families and Child Wellbeing Study (n = 3150), the current study examined child-caregiver discrepancies in reporting the frequencies of psychological and physical maltreatment. Multivariate models were used to examine how caregivers' reports, children's reports, and discrepancies between the two were associated with child anxiety, depression, aggression, and delinquency.
RESULTS
A quarter of the children reported psychological maltreatment at a higher (25.7 %) or lower (23.8 %) frequency than their caregivers' report, respectively; 8.4 % and 8.7 % of the children did so in physical maltreatment reports, respectively. Multivariate models showed that children's maltreatment reports were more closely associated with children's anxiety, depression, and delinquency than caregivers' reports, while caregivers' reports were more closely associated with children's aggression. After accounting for caregivers' reporting and other covariates, children who reported more frequent psychological maltreatment than their caregivers' report had a higher level of anxiety, depression, and delinquency (b = 0.17 to 0.25, p < 0.001), and the opposite was true (b = -0.36 to -0.13, p < 0.001). Similarly, children who reported more frequent physical maltreatment than their caregivers' report had a higher level of all negative outcomes (b = 0.04 to 0.44; p = 0.04 to <0.00), and the opposite was true for aggression (b = -0.08, p = 0.004).
CONCLUSIONS
The findings suggest that in addition to other reporting barriers, children and caregivers may perceive maltreatment differently, and such discrepancies are related to children's wellbeing.
Topics: Caregivers; Child; Child Abuse; Child Health; Family; Humans; Mandatory Reporting
PubMed: 36058065
DOI: 10.1016/j.chiabu.2022.105858 -
Health Physics May 2017The definitions of "radiation area," "high radiation area," and "very high radiation area," provided by the U.S. Department of Energy in 10 CFR Part 835.2, and by the...
The definitions of "radiation area," "high radiation area," and "very high radiation area," provided by the U.S. Department of Energy in 10 CFR Part 835.2, and by the Nuclear Regulatory Commission in 10 CFR Part 20.1003, appear to require redundant posting. This is counterintuitive and would be confusing if the regulations were followed as currently written. We suspect that this is unintentional. However, until the relevant regulations are revised, it is recommended that licensees request written clarification from the regulators to ensure that they are able to demonstrate regulatory compliance.
Topics: Documentation; Government Agencies; Government Regulation; Guideline Adherence; Mandatory Reporting; Radiation Protection; Terminology as Topic; United States
PubMed: 28350706
DOI: 10.1097/HP.0000000000000661 -
Nursing Standard (Royal College of... Aug 20161 The first-ever publication of statistics on female genital mutilation (FGM) has revealed 5,700 new cases in England over the past year. Nurses, midwives, doctors and...
1 The first-ever publication of statistics on female genital mutilation (FGM) has revealed 5,700 new cases in England over the past year. Nurses, midwives, doctors and teachers are legally required to report cases of FGM involving girls aged under 18 to the police. Read more rcni.com/FGM-reporting.
Topics: Adolescent; Child; Child, Preschool; Circumcision, Female; England; Female; Humans; Infant; Infant, Newborn; Internet; Mandatory Reporting; Nursing Staff
PubMed: 27484528
DOI: 10.7748/ns.30.49.11.s11 -
Nursing Inquiry Apr 2019Nurses are well positioned to contribute to child protection efforts but are underutilised. This paper describes a critical discursive analysis of nursing responses to...
Nurses are well positioned to contribute to child protection efforts but are underutilised. This paper describes a critical discursive analysis of nursing responses to child neglect and abuse (CN&A) in British Columbia, Canada. Legal and practice guidelines were analysed alongside nurse interview texts, offering a glimpse into how nurses prevent CN&A in their everyday practice with families. Results show how the primacy of mandatory reporting to child protection authorities coordinates a series of deferrals and how nurses engage with and interrupt these deferrals in everyday practice. Nurses' relational approaches are essential to gain access to the private sphere of the family to assess, plan, elicit cooperation with interventions and monitor the situation. They considered reporting to be one among many possible responses. This study highlights how nursing contributions to prevention are largely overlooked and points to the potential for a more significant role for nurses in a public health approach to child protection.
Topics: Child Protective Services; Humans; Mandatory Reporting; Nursing; Qualitative Research; Surveys and Questionnaires
PubMed: 30801853
DOI: 10.1111/nin.12285 -
BMJ Open Oct 2017To systematically search for research about the effectiveness of mandatory reporting of child maltreatment and to synthesise qualitative research that explores mandated... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To systematically search for research about the effectiveness of mandatory reporting of child maltreatment and to synthesise qualitative research that explores mandated reporters' (MRs) experiences with reporting.
DESIGN
As no studies assessing the effectiveness of mandatory reporting were retrieved from our systematic search, we conducted a meta-synthesis of retrieved qualitative research. Searches in Medline (Ovid), Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Sociological Abstracts, Education Resources Information Center, Criminal Justice Abstracts and Cochrane Library yielded over 6000 citations, which were deduplicated and then screened by two independent reviewers. English-language, primary qualitative studies that investigated MRs' experiences with reporting of child maltreatment were included. Critical appraisal involved a modified checklist from the Critical Appraisal Skills Programme and qualitative meta-synthesis was used to combine results from the primary studies.
SETTING
All healthcare and social-service settings implicated by mandatory reporting laws were included. Included studies crossed nine high-income countries (USA, Australia, Sweden, Taiwan, Canada, Norway, Finland, Israel and Cyprus) and three middle-income countries (South Africa, Brazil and El Salvador).
PARTICIPANTS
The studies represent the views of 1088 MRs.
OUTCOMES
Factors that influence MRs' decision to report and MRs' views towards and experiences with mandatory reporting of child maltreatment.
RESULTS
Forty-four articles reporting 42 studies were included. Findings indicate that MRs struggle to identify and respond to less overt forms of child maltreatment. While some articles (14%) described positive experiences MRs had with the reporting process, negative experiences were reported in 73% of articles and included accounts of harm to therapeutic relationships and child death following removal from their family of origin.
CONCLUSIONS
The findings of this meta-synthesis suggest that there are many potentially harmful experiences associated with mandatory reporting and that research on the effectiveness of this process is urgently needed.
Topics: Child; Child Abuse; Developed Countries; Developing Countries; Humans; Mandatory Reporting; Qualitative Research
PubMed: 29042370
DOI: 10.1136/bmjopen-2016-013942 -
Rhode Island Medical Journal (2013) Apr 2022The opioid epidemic has renewed debate about how to structure laws, agency policies and hospital protocols for mandatory reporting of illicit substances during...
The opioid epidemic has renewed debate about how to structure laws, agency policies and hospital protocols for mandatory reporting of illicit substances during pregnancy. This paper analyzes the ethics of Rhode Island's approach to mandatory reporting - in particular, reporting of positive maternal and newborn drug tests at time of delivery. Given that state intervention is generally perceived by pregnant people as punitive and threatening to their family, we consider how four elements often used to justify punitive action by the state - retribution, deterrence, rehabilitation, and incapacitation (societal protection) - apply to Rhode Island's policy and approach to prenatal substance use. In addition, the paper considers the equity implications of Rhode Island's approach. It concludes that, given the potential for the policy to do more harm than good, investment of resources would be better spent on clinical and community services that support substance using parents and their newborns.
Topics: Female; Humans; Infant, Newborn; Mandatory Reporting; Parents; Policy; Pregnancy; Substance Abuse Detection; Substance-Related Disorders
PubMed: 35349617
DOI: No ID Found -
Pediatric Clinics of North America Oct 2014The most common medicolegal issues include reporting child maltreatment, the presentation of ethical and effective expert testimony, informed consent in child... (Review)
Review
The most common medicolegal issues include reporting child maltreatment, the presentation of ethical and effective expert testimony, informed consent in child maltreatment cases, and various liability risks related to child maltreatment cases. The health care professional who remains knowledgeable about the laws within their jurisdiction, the mandates of their professional society and state medical board, and the local resources (eg, child abuse pediatrician and hospital counsel) available to them minimizes medicolegal risk.
Topics: Child; Child Abuse; Expert Testimony; Humans; Informed Consent; Mandatory Reporting
PubMed: 25242715
DOI: 10.1016/j.pcl.2014.06.016