Department of Pediatrics, Harvard Medical School, Children's Hospital, Massachusetts, USA.
Curr Opin Pediatr. 2010 Apr;22(2):226-33. doi: 10.1097/MOP.0b013e3283377931.
As knowledge about child abuse and neglect increases worldwide, so does the literature on abuse and neglect. The authors explore many studies published this year, with attention to the advances in understanding which are guiding prevention efforts as well as diagnosis and treatment of abuse and neglect.
The evidence base for many forms of child abuse continues to grow. Controversy around the diagnosis of child abuse still continues, with current debate focused on the diagnosis of abusive head injury and whether children with vitamin D deficiency are misdiagnosed with abusive fractures. As clinicians begin to understand the factors which may increase child vulnerability to abuse, more sophisticated and focused prevention efforts are being implemented, and researchers are evaluating these efforts with an eye to whether or not they really contribute to prevention.
The short-term and long-term impact of child maltreatment is significant not only for individuals but for families and communities in which abuse is taking place. General pediatricians have an important role to play with families and in the community as advocates for the protection of children. However, it is clear that specialists in child abuse should also play a role in order for diagnosis and management of abuse to adhere to a high standard of care. This has been validated this year by the creation of Child Abuse Pediatrics as a board certified specialty in the United States. As knowledge about abuse and neglect grows, clinicians are focusing on prevention as well as diagnosis and treatment.
随着全球对儿童虐待和忽视认识的提高,虐待和忽视相关文献也在不断增加。作者探讨了今年发表的许多研究,关注了理解虐待和忽视的进展,这些进展指导着预防工作以及虐待和忽视的诊断和治疗。
许多形式的儿童虐待的证据基础继续扩大。儿童虐待的诊断仍然存在争议,目前的争论焦点是虐待性头部损伤的诊断,以及维生素 D 缺乏症儿童是否被误诊为虐待性骨折。随着临床医生开始了解可能增加儿童易受虐待的因素,正在实施更复杂和有针对性的预防措施,研究人员正在评估这些措施,以确定它们是否真正有助于预防。
儿童虐待的短期和长期影响不仅对个人,而且对虐待发生的家庭和社区都有重大影响。普通儿科医生在家庭和社区中作为保护儿童的倡导者发挥着重要作用。然而,儿童虐待专家也应该发挥作用,以便诊断和管理虐待符合高标准的护理,这一点今年已经通过在美国创建儿童虐待儿科学作为一个获得董事会认证的专业得到了验证。随着对虐待和忽视的认识不断提高,临床医生不仅关注诊断和治疗,还关注预防。