Department of Clinical Psychology, University of Bergen, Bergen, Norway.
Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway and Møre Og Romsdal Hospital Trust, Volda, Norway.
Int J Qual Stud Health Well-being. 2022 Dec;17(1):2103934. doi: 10.1080/17482631.2022.2103934.
Efforts are directed both towards prevention and early detection of Child sexual abuse (CSA). Yet, only about 50% of CSA survivors disclose before adulthood, and health professionals rarely are the first disclosure recipients. Increasing the detection rate of CSA within the context of Child and Adolescent Psychiatry (CAP) therefore represents a significant secondary prevention strategy. However, facilitating CSA disclosure when the survivor is reluctant to tell is a highly complex and emotionally demanding clinical task. We therefore argue that efforts to increase detection rates of CSA within CAP need to rest on knowledge of how both survivors and health professionals experience addressing CSA.
Using meta-ethnography as method, we present separate sub-syntheses as well an overarching joint synthesis of how survivors and health professionals experience addressing CSA.
Results show how both survivors and health professionals facing CSA disclosure feel deeply isolated, they experience the consequences of addressing CSA as highly unpredictable, and they need support from others to counteract the negative impact of CSA.
The results indicate that adapting the organization of CAP to knowledge of how the survivors and health professionals experience addressing CSA is critical to facilitate earlier disclosure of CSA within CAP.
人们致力于儿童性虐待（CSA）的预防和早期发现。然而，只有大约 50%的 CSA 幸存者在成年前披露，而卫生专业人员很少成为第一个披露者。因此，在儿童和青少年精神病学（CAP）的背景下提高 CSA 的检测率代表了一个重要的二级预防策略。然而，当幸存者不愿意透露时，促进 CSA 的披露是一项非常复杂和情感要求高的临床任务。因此，我们认为，在 CAP 中提高 CSA 检测率的努力必须建立在了解幸存者和卫生专业人员如何体验 CSA 的基础上。
使用元民族志作为方法，我们分别呈现了幸存者和卫生专业人员如何体验 CSA 的单独综合分析以及一个总体的联合综合分析。
结果表明，面对 CSA 披露的幸存者和卫生专业人员都感到深深的孤立，他们认为处理 CSA 的后果是高度不可预测的，他们需要来自他人的支持来抵消 CSA 的负面影响。
研究结果表明，根据幸存者和卫生专业人员如何体验 CSA 的知识来调整 CAP 的组织对于促进 CAP 中 CSA 的早期披露至关重要。
