Departments of Health Technology and Services Research, and Public Administration, Institute of Innovation and Governance Studies, University of Twente, Enschede, The Netherlands.
Department of Health Technology and Services Research, Institute of Innovation and Governance Studies, University of Twente, Enschede, The Netherlands.
Child Abuse Negl. 2017 Jul;69:242-251. doi: 10.1016/j.chiabu.2017.04.025. Epub 2017 May 6.
This study examined the presence and strengths of determinants associated with consultation of an in-house expert on child abuse and neglect (CAN) by preventive child health care professionals who suspect CAN. This study also assessed the relationship between in-house CAN expert consultation and professionals' performance of six recommended activities described in a national guideline on preventing CAN for preventive child health care professionals. A total of 154 professionals met the study's inclusion criteria. They filled in a questionnaire that measured in-house consultation practices and twelve determinants associated with the professional, the in-house expert, and the organizational context. Bivariate and multivariate regression analyses were performed. Almost half of the participants (46.8%) reported to consult the in-house expert in (almost) all of their suspected CAN cases. Professionals who reported better recollection of consulting the in-house expert (i.e. not forgetting to consult the expert) (p=.001), who were more familiar with consultation (p=.002), who had more positive attitudes and beliefs about consultation (p=.011) and who reported being more susceptible to the behavior (p=.001) and expectations/opinions (p=.025) of colleagues regarding in-house expert consultation were more likely to consult the in-house expert. Furthermore, in-house expert consultation was positively associated with two of six key guideline activities: consulting the regional child protection service and monitoring whether support was provided to families. The implications of these results for improving professionals' responses to CAN are discussed.
本研究旨在调查疑似儿童虐待和忽视（CAN）的预防儿童保健专业人员咨询内部专家的存在情况及其决定因素，并评估内部 CAN 专家咨询与专业人员执行预防儿童保健领域预防 CAN 国家指南中推荐的六项活动之间的关系。共有 154 名专业人员符合研究纳入标准。他们填写了一份问卷，该问卷测量了内部咨询实践以及与专业人员、内部专家和组织环境相关的 12 个决定因素。进行了单变量和多变量回归分析。近一半的参与者（46.8%）报告在（几乎）所有疑似 CAN 病例中咨询了内部专家。报告更能回忆起咨询内部专家（即不会忘记咨询专家）（p=.001）、对咨询更熟悉（p=.002）、对咨询持更积极的态度和信念（p=.011），以及报告更易受同事对内部专家咨询行为（p=.001）和期望/意见（p=.025）影响的专业人员更有可能咨询内部专家。此外，内部专家咨询与六项关键指南活动中的两项呈正相关：咨询地区儿童保护服务和监测是否向家庭提供支持。这些结果对改善专业人员对 CAN 的反应具有启示意义。
