Department of Psychosocial Medicine, National Center for Child Health and Development; Center for Child Abuse Prevention.
Department of Health Policy, National Center for Child Health and Development.
Child Abuse Negl. 2022 Dec;134:105867. doi: 10.1016/j.chiabu.2022.105867. Epub 2022 Sep 10.
Despite the potential efficacy of hospital-based multidisciplinary child protection team (CPTs), research analyzing Japanese CPT databases is scarce.
We aimed to describe the characteristics of children and families reported to a CPT in Japan and investigate factors associated with the substantiation of maltreatment.
This retrospective, cross-sectional study took place in a national children's hospital in Japan and included 350 children who were reported to CPTs between April 2014 and March 2018.
Univariable and multivariable logistic regression analyses were conducted using the CPT database and medical records.
Among 350 cases, 33.4 % were substantiated. Children of <6 years of age comprised 73.4 % of the cases. The majority (67.7 %) received an injury-related diagnosis and physical maltreatment was suspected in 68.3 % of cases. In the univariable analysis, older age, a primary diagnosis other than injury, reporting department, psychological maltreatment, witnessing intimate partner violence, maltreatment by relatives other than biological father or mother, developmental disability, emotional/behavioral difficulty or psychological disorder, maternal/paternal psychological difficulty, and maternal history of maltreatment were significantly associated with substantiation. When adjusted for demographic, child and familial factors, a diagnosis other than injury (AOR 2.02, 95 % CI = 1. 11-3.65) and parental psychological difficulties (AOR 2.49, 95 % CI = 1.37-4.55) were independently associated with substantiation.
Most cases reported to our CPT were young children with an injury-related diagnosis. Substantiation was associated with a diagnosis other than injury and parental psychological difficulties. Further prospective and comprehensive studies are needed to establish universal guidelines for databases of hospital-based CPTs.
尽管医院多学科儿童保护团队（CPT）具有潜在的疗效，但对日本 CPT 数据库进行分析的研究却很少。
我们旨在描述向日本 CPT 报告的儿童和家庭的特征，并调查与虐待证实相关的因素。
这项回顾性、横断面研究在日本一家国立儿童医院进行，纳入了 2014 年 4 月至 2018 年 3 月向 CPT 报告的 350 名儿童。
使用 CPT 数据库和病历进行单变量和多变量逻辑回归分析。
在 350 例病例中，有 33.4%的病例得到证实。年龄<6 岁的儿童占病例的 73.4%。大多数（67.7%）患儿有损伤相关诊断，68.3%的病例怀疑有身体虐待。单变量分析显示，年龄较大、非损伤的主要诊断、报告科室、心理虐待、目睹亲密伴侣暴力、非亲生父母的亲属虐待、发育障碍、情绪/行为困难或心理障碍、父母心理困难和父母虐待史与证实显著相关。当调整人口统计学、儿童和家庭因素后，非损伤诊断（AOR 2.02，95%CI=1.11-3.65）和父母心理困难（AOR 2.49，95%CI=1.37-4.55）与证实独立相关。
向我们的 CPT 报告的大多数病例是有损伤相关诊断的幼儿。证实与非损伤诊断和父母心理困难有关。需要进一步进行前瞻性和全面的研究，为医院 CPT 数据库制定通用指南。
