School of Social Work, University of Southern California, Los Angeles, CA 90089-0411, USA.
Matern Child Health J. 2012 Feb;16(2):328-35. doi: 10.1007/s10995-010-0714-4.
The study objectives were to examine serious injuries requiring medical attention among children who remain at home after a child welfare/child protective services (CPS) maltreatment investigation in the US and to determine whether child/caregiver characteristics and ongoing CPS involvement are related to injuries requiring medical attention. Using the National Survey of Child and Adolescent Well-being, we analyzed data on the subsample of children who remained at home (N = 3,440). A multivariate logistic regression model included child characteristics, chronic illness and disability in the child, level of CPS involvement, subsequent foster care placement, caregiver characteristics, and caregiver/family psychological variables. Injuries requiring medical attention were identified in 10.6% of the in-home population over a 15-month period, with no differences in rates by age. Children with a chronic medical condition (OR = 2.07; 95% CI, 1.20-3.58) and children with depressed caregivers (OR = 2.28; 95% CI, 1.45-3.58) were more likely to have an injury that required medical care. Older caregivers (>54 years) were less likely (OR = 0.15; 95% CI, 0.03-0.69) to have a child with an injury requiring care. Injuries were not related to further involvement with CPS after the initial maltreatment investigation. Children with chronic medical conditions who remained in their biological homes or whose caregivers were depressed were likely to experience an injury requiring medical attention. Older caregivers were less likely to report a child injury. Extending existing health policies for foster children to children who remain at home following referral to CPS may encourage more comprehensive injury prevention for this population.
研究目的是在美国儿童福利/儿童保护服务（CPS）虐待调查后，检查在家中留下的儿童中需要医疗关注的严重伤害，并确定儿童/照顾者特征和持续的 CPS 参与是否与需要医疗关注的伤害有关。我们使用全国儿童和青少年健康调查，分析了在家中留下的儿童（N=3440）的子样本数据。一个多变量逻辑回归模型包括儿童特征、儿童的慢性疾病和残疾、CPS 参与程度、随后的寄养安置、照顾者特征以及照顾者/家庭心理变量。在 15 个月的时间内，有 10.6%的在家人群需要医疗关注，年龄差异与发生率无关。患有慢性疾病的儿童（OR=2.07；95%CI，1.20-3.58）和有抑郁照顾者的儿童（OR=2.28；95%CI，1.45-3.58）更有可能受伤需要医疗护理。年龄较大的照顾者（>54 岁）不太可能（OR=0.15；95%CI，0.03-0.69）让受伤需要照顾的孩子。在初次虐待调查后，受伤与 CPS 进一步介入无关。在家中留下的患有慢性疾病的儿童或其照顾者抑郁的儿童更有可能遭受需要医疗关注的伤害。年龄较大的照顾者不太可能报告儿童受伤。将现有的寄养儿童健康政策扩展到 CPS 转介后仍留在家中的儿童，可能会鼓励为这一人群更全面地预防伤害。
