Woolf A, Taylor L, Melnicoe L, Andolsek K, Dubowitz H, De Vos E, Newberger E
Division of Ambulatory Medicine, Boston Children's Hospital, MA 02115.
Am J Dis Child. 1988 Jun;142(6):668-72. doi: 10.1001/archpedi.1988.02150060102042.
Residency training programs are the appropriate milieu in which physicians should receive specialized training in the diagnosis and management of child abuse. The purposes of the present study were to assess and compare residents' knowledge of child abuse and their attitudes toward the propriety of different forms of childhood discipline. We surveyed 192 residents from seven different training programs with questionnaires probing their knowledge of child abuse and their attitudes toward childhood disciplinary measures; 161 (84%) of the questionnaires were satisfactorily completed by residents in pediatrics (n = 87), family medicine (n = 51), and surgery (n = 23). Both pediatric residents and family medicine residents outperformed surgery residents in one subscale and the total score on the test. Scores were not related to year of training or attitudes toward childhood discipline but were correlated with self-reports of previous child abuse teaching. Residents' performance on a childhood disciplinary measure demonstrated wide latitude in their rating of the acceptability of 23 different modes of childhood discipline. Our findings indicate a need for a more systematic approach to residents' education in childhood intentional injuries and some value clarification of their attitudes toward various forms of childhood discipline.
住院医师培训项目是医生接受儿童虐待诊断和管理专业培训的合适环境。本研究的目的是评估和比较住院医师对儿童虐待的认识以及他们对不同形式的儿童管教方式适当性的态度。我们用问卷对来自七个不同培训项目的192名住院医师进行了调查，问卷涉及他们对儿童虐待的认识以及对儿童管教措施的态度；儿科（n = 87）、家庭医学（n = 51）和外科（n = 23）的住院医师圆满完成了161份（84%）问卷。在一个子量表和测试总分方面，儿科住院医师和家庭医学住院医师的表现均优于外科住院医师。分数与培训年份或对儿童管教的态度无关，但与之前接受过儿童虐待教学的自我报告相关。住院医师在一项儿童管教措施上的表现表明，他们对23种不同儿童管教方式可接受性的评分存在很大差异。我们的研究结果表明，需要采用更系统的方法对住院医师进行儿童故意伤害方面的教育，并对他们对各种儿童管教方式的态度进行一些价值观澄清。
