Agathonos-Georgopoulou H, Browne K D
Institute of Child Health, Athens, Greece.
Child Abuse Negl. 1997 Aug;21(8):721-35. doi: 10.1016/s0145-2134(97)00034-3.
The study had two aims: First, to identify characteristics of physically maltreating families in the Attica region of Greece; and second, to produce a checklist of high risk predictors which may be used for screening, as an assessment, to enable secondary prevention of physical abuse and neglect.
A case control design was used with individual matching. The sample comprised 197 physically abused and neglected children and their families referred to a multidisciplinary team. These were compared with 163 control children and their families attending a community health center.
The findings suggest that abusing families differ from controls on a number of variables related to child, parental, and family characteristics. The statistical analysis produced a checklist of 15 Predictors. Their classification into High, Medium, and Low Predictors pointed out that the most prominent characteristics were those associated with parents' own adverse life experiences, mental health problems, bad quality of relationship between spouses, and parental neglect of the child's hygiene. The predictive ability of the checklist produced a sensitivity of 92% and a specificity of 96% (logistic regression) and a sensitivity of 86.8% and a specificity of 96.3% (discriminant function). The use of this checklist for screening is discussed with emphasis on methodological and ethical issues. Special emphasis is given on the cultural relevance of such an application within the Greek cultural milieu.
The findings indicate that secondary prevention of child maltreatment in Greece is feasible by using a checklist of risk factors as predictors. Such screening should be accompanied by clinical assessment based on qualitative aspects of mother-infant interaction. Special emphasis should be given to the cultural relevance of this approach while ethical issues should be considered.
本研究有两个目标:第一,确定希腊阿提卡地区身体虐待家庭的特征;第二,制定一份高风险预测因素清单,可用于筛查,作为一种评估手段,以实现对身体虐待和忽视的二级预防。
采用病例对照设计并进行个体匹配。样本包括197名遭受身体虐待和忽视的儿童及其家庭,他们被转介到一个多学科团队。将这些儿童及其家庭与163名在社区健康中心就诊的对照儿童及其家庭进行比较。
研究结果表明,虐待家庭在一些与儿童、父母和家庭特征相关的变量上与对照组不同。统计分析得出了一份包含15个预测因素的清单。将它们分为高、中、低预测因素指出,最突出的特征是与父母自身不良生活经历、心理健康问题、配偶关系质量差以及父母对孩子卫生的忽视有关的特征。该清单的预测能力在逻辑回归分析中得出的灵敏度为92%,特异度为96%;在判别函数分析中得出的灵敏度为86.8%,特异度为96.3%。文中讨论了使用这份清单进行筛查的情况,重点关注方法学和伦理问题。特别强调了这种应用在希腊文化环境中的文化相关性。
研究结果表明,在希腊,通过使用风险因素清单作为预测指标来进行儿童虐待的二级预防是可行的。这种筛查应辅以基于母婴互动定性方面的临床评估。应特别强调这种方法的文化相关性,同时应考虑伦理问题。