Fallon Barbara, Filippelli Joanne, Joh-Carnella Nicolette, Miller Steven P, Denburg Avram
Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada.
Division of Neurology, Department of Paediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
BMJ Paediatr Open. 2019 Feb 4;3(1):e000386. doi: 10.1136/bmjpo-2018-000386. eCollection 2019.
There is a dearth of literature surrounding mandated reporters to child welfare services in the Canadian context. This paper examines 20 years of reporting patterns from hospitals, which represent 5% of all referrals to child welfare services in Ontario.
The Ontario Incidence Study of Reported Child Abuse and Neglect (OIS) is a representative study that has taken place every 5 years since 1993. The OIS is a multistage cluster sample design, intended to produce an estimate of reported child abuse and neglect in the year the study takes place.
There have been significant changes in referral patterns over time. Hospital referrals in 2013 are more likely to involve a concern of neglect, risk of maltreatment or exposure to intimate partner violence. In 1993, children were more likely to be referred from a hospital for a concern of physical abuse. Between 1993 and 1998, there was a significant drop in the number of sexual abuse investigations referred from a hospital. Hospitals have low rates of substantiation across all of the OIS cycles.
This is the first study to examine hospital-based referral patterns in Canada. The relatively low percentage of hospital referrals across the cycles of the OIS is consistent with the extant literature. The findings warrant further discussion and research. This study is foundational for future research that can assist in identifying and developing responses across sectors that meet the complex needs of vulnerable families and that ultimately promote children's safety and well-being.
在加拿大的背景下,关于向儿童福利服务机构进行强制报告的文献匮乏。本文研究了来自医院的20年报告模式,这些报告占安大略省所有儿童福利服务转介案例的5%。
安大略省报告的儿童虐待和忽视事件发生率研究(OIS)是一项具有代表性的研究,自1993年以来每5年进行一次。OIS采用多阶段整群抽样设计,旨在对研究开展当年报告的儿童虐待和忽视事件进行估计。
随着时间的推移,转介模式发生了显著变化。2013年来自医院的转介更有可能涉及忽视问题、虐待风险或遭受亲密伴侣暴力。1993年,儿童更有可能因身体虐待问题从医院被转介。1993年至1998年期间,医院转介的性虐待调查数量大幅下降。在OIS的所有周期中,医院的证实率都很低。
这是加拿大第一项研究基于医院的转介模式的研究。在OIS的各个周期中,医院转介的比例相对较低,这与现有文献一致。这些发现值得进一步讨论和研究。本研究为未来的研究奠定了基础,有助于跨部门识别和制定应对措施,以满足弱势家庭的复杂需求,并最终促进儿童的安全和福祉。