Grietens Hans, Geeraert Liesl, Hellinckx Walter
Centre for Disability, Special Needs Education, and Child Care, Katholieke Universiteit Leuven, Vesaliusstraat 2, B-3000 Leuven, Belgium.
Child Abuse Negl. 2004 Mar;28(3):321-37. doi: 10.1016/j.chiabu.2003.10.011.
The aim was to construct and test the reliability (utility, internal consistency, interrater agreement) and the validity (internal validity, concurrent validity) of a scale for home visiting social nurses to identify risks of physical abuse and neglect in mothers with a newborn child.
A 71-item scale was constructed based on a literature review and focus group sessions with social nurses and paraprofessionals who had experience with underprivileged families. This scale was applied in a random sample of 40 home visiting social nurses, who collected data in a sample of 373 nonabusive and 18 abusive/neglectful mothers with a newborn child.
Items with prevalence rates below 5% and items making no significant difference between maltreating and non-maltreating mothers were omitted. The final version contained 20 items. This scale showed high internal consistency (alpha = .92) and high interrater reliability (r = .97). Exploratory factor analysis yielded a three-factor solution: Isolation (8 items, explaining 62.17% of the common variance), Psychological complexity (6 items, 18.86%), and Communication problems (6 items, 8.41%). Scores on Communication problems and Isolation significantly predicted scores on a social deprivation scale, which significantly distinguished maltreating from non-maltreating mothers. Mothers scoring high on Communication problems or Isolation obtained higher scores for social deprivation than low-scoring mothers.
Home visiting nurses can identify risks for physical abuse and neglect among mothers with a newborn infant by focusing on signs of social isolation, distorted communication and psychological problems.
构建并检验一种用于家访社会护士的量表的可靠性（实用性、内部一致性、评分者间一致性）和有效性（内部效度、同时效度），以识别有新生儿的母亲遭受身体虐待和忽视的风险。
基于文献综述以及与有贫困家庭工作经验的社会护士和辅助专业人员进行的焦点小组讨论，构建了一个包含71个条目的量表。该量表应用于40名家访社会护士的随机样本，这些护士在373名非虐待和18名虐待/忽视新生儿母亲的样本中收集数据。
患病率低于5%的条目以及在虐待和非虐待母亲之间无显著差异的条目被剔除。最终版本包含20个条目。该量表显示出高内部一致性（α = 0.92）和高评分者间信度（r = 0.97）。探索性因素分析得出一个三因素解决方案：孤立（8个条目，解释共同方差的62.17%）、心理复杂性（6个条目，18.86%）和沟通问题（6个条目，8.41%）。沟通问题和孤立方面的得分显著预测了社会剥夺量表的得分，该量表能显著区分虐待和非虐待母亲。在沟通问题或孤立方面得分高的母亲比得分低的母亲获得更高的社会剥夺分数。
家访护士可以通过关注社会孤立、沟通扭曲和心理问题的迹象，识别有新生儿的母亲遭受身体虐待和忽视的风险。
