Crisp Beth R, Lister Pam Green
Department of Social Work, University of Glasgow, Glasgow, UK.
J Adv Nurs. 2004 Sep;47(6):656-63. doi: 10.1111/j.1365-2648.2004.03154.x.
Health care workers have been recognized as having a key role in the protection and care of Scotland's children, particularly in respect of identification and detection of child abuse. Nurses, especially health visitors, are often the first professionals to suspect that child abuse has taken place. While previous research has found that health visitors have primarily perceived their role as that of providing support and advice to vulnerable families, there are pressures on them to fulfil a more narrow surveillance role. Concurrent with a lack of clarity about the role of health visitors in child protection, there has been increasing recognition that other nurses can also make an important contribution, including those who do not work directly with children.
The aim of the study was to explore nurses' understanding of their professional responsibilities in relation to child protection, and the potential for nurses to be involved in the protection of children from abuse.
A qualitative interview-based design was used, and 99 nurses working in an National Health Service trust in a Scottish city were interviewed, either individually or in groups, about their professional involvements in child protection issues. Interview data were subjected to thematic analysis.
There was lack of consensus among interviewees about the nursing remit in child protection issues, particularly with respect to the extent to which nurses should actively seek to detect cases of child abuse. An emphasis on identification and detection was not easily accepted by many nurses, and was perceived by some to be a change from their more traditional role of supporting families, as well as being potentially in conflict with some public health responsibilities.
In spite of the perception of some nurses that there is a sharp divide between child protection work and public health interventions, many of the child protection roles identified by nurses, such as supporting families, parenting education and service development, are clearly within the ambit of contemporary notions of public health. Furthermore, it is clear that there is a role in child protection for a much wider group of nurses than health visitors.
医护人员在保护和照顾苏格兰儿童方面发挥着关键作用，尤其是在识别和发现虐待儿童问题上。护士，特别是健康访视员，往往是最早怀疑发生虐待儿童行为的专业人员。虽然先前的研究发现，健康访视员主要将自己的角色视为为弱势家庭提供支持和建议，但他们面临着履行更狭义监测角色的压力。在健康访视员在儿童保护中的角色缺乏明确性的同时，人们越来越认识到其他护士也能做出重要贡献，包括那些不直接与儿童打交道的护士。
本研究的目的是探讨护士对其在儿童保护方面专业职责的理解，以及护士参与保护儿童免受虐待的可能性。
采用基于定性访谈的设计，对苏格兰一个城市国民保健服务信托机构工作的99名护士进行了访谈，访谈形式为单独或分组，内容涉及她们在儿童保护问题上的专业参与情况。访谈数据进行了主题分析。
受访者在儿童保护问题上的护理职责方面缺乏共识，特别是在护士应积极发现虐待儿童案件的程度上。许多护士不容易接受强调识别和发现，一些人认为这与她们更传统的支持家庭的角色有所不同，并且可能与一些公共卫生职责相冲突。
尽管一些护士认为儿童保护工作与公共卫生干预之间存在明显分歧，但护士确定的许多儿童保护角色，如支持家庭、育儿教育和服务发展，显然属于当代公共卫生概念的范畴。此外，很明显，在儿童保护方面，除了健康访视员外，还有更广泛的护士群体可以发挥作用。
