Laurent-Vannier A, Chevignard M
Service de rééducation pour enfants après lesions cérébrales acquises, hôpitaux de Saint-Maurice, 14, rue du Val-d'Osne, 94410 Saint-Maurice, France.
Service de rééducation pour enfants après lesions cérébrales acquises, hôpitaux de Saint-Maurice, 14, rue du Val-d'Osne, 94410 Saint-Maurice, France; Laboratoire d'imagerie biomédicale (LIB), Sorbonne université, CNRS, Inserm, 75006 Paris, France; Groupe de recherche clinique handicap cognitif et réadaptation, Sorbonne université, 75006 Paris, France.
Arch Pediatr. 2019 May;26(4):199-204. doi: 10.1016/j.arcped.2019.01.003. Epub 2019 Apr 4.
To assess the knowledge of professionals on abusive head trauma (AHT) and shaking so as to adapt their training and thus promote the improvement of AHT screening and prevention.
A questionnaire was developed on the knowledge of the intensity of movement, the frequency of repetition, the existence and progression of sequelae over time, the legal nature of AHT as a criminal offence leading to the possibility of compensation, and the existence of HAS (French National Authority for Health) recommendations on shaken baby diagnosis and legal consequences.
Over a 4-year period 311 physicians, 123 magistrates, and 644 early childhood professionals responded to the questionnaire as an introduction to a course on AHT. Whatever the professional field, incorrect answers (wrong or "I don't know") were frequent as to the possibility that play could induce AHT lesions (51-58%), the violence of the act (43-52%), the repetition of shaking (58-82.5%), the presence of side effects (52-58%), and the existence of recommendations to professionals (48-58.5%). Twenty to 47% of physicians and early childhood professionals were unaware that shaking a baby was a criminal offence and 20-27% were unaware that AHT required a report to the judicial authorities.
DISCUSSION/CONCLUSION: This lack of knowledge about AHT is detrimental to the child. The improvement of initial and continuing education is necessary to help reduce the dysfunctions existing in the care of child victims of AHT.
评估专业人员对虐待性头部创伤(AHT)和摇晃的认知,以便调整他们的培训内容,从而促进AHT筛查和预防工作的改进。
针对运动强度、重复频率、后遗症随时间的存在及进展情况、AHT作为刑事犯罪导致获得赔偿可能性的法律性质,以及法国国家卫生管理局(HAS)关于摇晃婴儿诊断和法律后果的建议等方面的知识,编制了一份问卷。
在4年时间里,311名医生、123名治安法官和644名幼儿专业人员对该问卷进行了回复,作为AHT课程的入门内容。无论专业领域如何,对于玩耍是否可能导致AHT损伤(51%-58%)、行为的暴力程度(43%-52%)、摇晃的重复情况(58%-82.5%)、副作用的存在(52%-58%)以及针对专业人员的建议的存在(48%-58.5%)等问题,错误答案(错误或“我不知道”)很常见。20%-47%的医生和幼儿专业人员不知道摇晃婴儿是刑事犯罪,20%-27%的人不知道AHT需要向司法当局报告。
讨论/结论:这种对AHT的认知不足对儿童有害。有必要改进初始教育和继续教育,以帮助减少在照顾AHT儿童受害者方面存在的功能障碍。