Forsner M, Elvhage G, Ewalds-Kvist B M, Lützén K
Department of Nursing Sciences, Umeå University, 90187 Umeå, Sweden.
Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden.
Child Adolesc Social Work J. 2021;38(6):599-610. doi: 10.1007/s10560-020-00680-6. Epub 2020 Jun 16.
The World Health Organization (WHO), concludes that child maltreatment is a global concern calling for a multi sectoral interdisciplinary approach. School professionals, such as social workers, teachers, and health care professionals are in positions to discover and report maltreatment enabling social workers to intervene. However, a variety of reports reveal an evident gap between incidences and frequency of number of cases reported. A review of relevant research indicates that the problem of "not reporting" suggests that moral conflicts are activated in the process of decision-making. The aim was to gain a deeper understanding of school professionals' experiences of reporting suspected neglect and abuse to the Social Welfare Board. In a mixed method approach 32 school professionals, such as teachers, social workers, nurses and psychologists participated in interviews and responded to questionnaires. Findings from the qualitative content analysis were compared to the quantitative analysis in a meta-analysis. Moral conflicts occur when faced with making decisions about how to best deal with a child's situation. Thoughts about the child's best interest and relationship with his/her parents as well as the informants´ own safety, were central. The comparative meta- analysis of both data sets revealed these conflicts commence with a moral sensitivity of possible negative consequences for the child. Moral sensitivity can be viewed as a "good" personal attribute, it paradoxically might lead to moral stress despite an open ethical climate. Based on the results of this study, further research on the interpersonal aspects of dealing with moral conflicts involved in reporting suspected child abuse is indicated.
世界卫生组织（WHO）得出结论，儿童虐待是一个全球关注的问题，需要采取多部门跨学科的方法。学校专业人员，如社会工作者、教师和医疗保健专业人员，有能力发现并报告虐待行为，从而使社会工作者能够进行干预。然而，各种报告显示，报告的案件发生率和频率之间存在明显差距。对相关研究的综述表明，“不报告”的问题表明在决策过程中道德冲突被激活。目的是更深入地了解学校专业人员向社会福利委员会报告疑似忽视和虐待情况的经历。采用混合方法，32名学校专业人员，如教师、社会工作者、护士和心理学家参与了访谈并回答了问卷。定性内容分析的结果与荟萃分析中的定量分析进行了比较。当面临如何最好地处理儿童情况的决策时，就会出现道德冲突。关于儿童最大利益、与父母的关系以及举报人自身安全的想法是核心。对两个数据集的比较荟萃分析表明，这些冲突始于对儿童可能产生负面后果的道德敏感性。道德敏感性可以被视为一种“良好”的个人特质，但矛盾的是，尽管道德氛围开放，它可能会导致道德压力。基于这项研究的结果，表明需要进一步研究处理报告疑似儿童虐待中涉及的道德冲突的人际方面。
