Consensus and difference among hospital professionals in evaluating child maltreatment.

The decision-making process in suspected cases of child maltreatment involves reaching interprofessional consensus. Interprofessional consensus in seriousness ratings of maltreatment incidents for the welfare of the child was examined by surveying 39 case vignette ratings by 295 pediatric hospital professionals from five occupations. The survey instrument was derived from research by Giovannoni and Becerrra (1979). An exploratory factor analysis yielded five categories of maltreatment: physical abuse, sexual abuse, general failures in care, minor neglect/discipline, and lifestyles/values. A sixth category, parental sexual preference, was rated not very serious and did not appear to belong in the maltreatment domain. Nurses and social workers rated incidents as most serious, differing significantly from psychiatrists and, often, from physicians and psychologists. Professions agreed on rank ordering of categories by seriousness. Variables such as sex, parenthood status, years of experience, and medical specialty showed some relationship to ratings within some professional groups.