The Reliability and Validity of the Greek Version of the Child Abuse Report Intention Scale (CARIS) Questionnaire for Midwives, Along With Factors Associated With Their Intention to Report Child Abuse and Neglect.

OBJECTIVE

Child maltreatment is a serious public health issue with unquestionable short- and long-term consequences. The midwives' role in the prevention, identification, and reporting of child abuse and neglect (CAN) is crucial for children's well-being. The Child Abuse Report Intention Scale (CARIS) questionnaire was designed to measure factors influencing Taiwanese nurses to report child abuse and has been used in many studies worldwide. The purposes of this study were to test the reliability and validity of the Greek version of the CARIS questionnaire and to determine factors associated with the Greek midwives' intention to report suspected CAN.

METHODS

A convenience sample of 70 registered midwives participated in the study from February to June 2023. After forward and backward translation, the participants completed the CARIS questionnaire twice, with a one-week interval, to determine test-retest reliability. Cronbach's alpha was used to assess the internal consistency of the questionnaire.

RESULTS

Concerning the internal consistency, reliability, and repeatability of the Greek version of the CARIS questionnaire, our results were consistent, stable, and highly reproducible. For the CARIS, Cronbach's alpha ranged from 0.549 to 0.810 depending on the subscale, Pearson's statistic ranged from 0.649 to 0.797, while all the paired samples t-tests apart from one were nonsignificant. Concerning the subscale "Intended Practice Behaviors: Vignettes questions and Respond Options," Cronbach's alpha ranged from 0.527 to 0.890 depending on the subscale, Pearson's statistic ranged from 0.803 to 0.850, while all the paired samples t-tests apart from two were nonsignificant. Sixty-six participants (94.2%) had received no CAN training while in midwifery school. Only seven participants (10%) had ever reported suspected CAN, while 12 out of 70 (17%) did not report although they suspected CAN. Thirty-six midwives (51.4%) stated that they did not know how to report CAN cases, and 35 (50.7%) did not have the appropriate resources. Participants had overwhelmingly negative attitudes about child harsh discipline (34.34 of 36), low tolerance toward perpetrators (25.10 of 30), positive attitudes toward the responsibility of reporting suspected CAN (32.60 of 42), moderate knowledge of CAN (6.63 of 13), and increased engagement in reporting severe cases of CAN (32.37 of 40). Attitude, subjective norm, and perceived behavioral control were significantly related to the midwives' intention to report CAN.

CONCLUSIONS

The Greek version of the CARIS is a valid and reliable instrument that can be used to determine reasons influencing midwives' intention to report CAN. One of our key findings was the lack of adequate and appropriate training in dealing with CAN cases, both at the undergraduate and postgraduate levels, that needs to be addressed by health policy makers.