Practice variation amongst preventive child healthcare professionals in the prevention of child maltreatment in the Netherlands: Qualitative and quantitative data.
Ontology highlight
ABSTRACT:
SUBMITTER: Visscher SJA
PROVIDER: S-EPMC5671414 | biostudies-literature | 2017 Dec
REPOSITORIES: biostudies-literature
Publications
Practice variation amongst preventive child healthcare professionals in the prevention of child maltreatment in the Netherlands: Qualitative and quantitative data.
Visscher Simeon J A SJA van Stel Henk F HF
Data in brief 20171002
This article provides both qualitative and quantitative data on practice variation amongst preventive child healthcare professionals in the prevention of child maltreatment in the Netherlands. Qualitative data consist of topics identified during interviews with 11 experts (with quotes), resulting in an online survey. The quantitative data are survey responses from 1104 doctors and nurses working in 29 preventive child healthcare organizations. Additionally, the interview topic list, the qualitat ...[more]
Similar Datasets
Project description:BackgroundWith regular contacts to the general child population, healthcare professionals could play an important role in the detection of child maltreatment. However, a majority of child maltreatment cases go unnoticed by the healthcare system. Child protection legislations usually offer terms like "reasonable suspicion" to corner a threshold that warrants reporting to child protection services (CPS) is defined as. The indistinct legal terminology leads to marked differences in the interpretation of this threshold. Therefore, we aimed to systematically assess the understanding of reasonable suspicion and subsequent handling of cases in the German context.MethodsA cross-sectional online survey was conducted among 2485 physicians and psychotherapists working with children and adolescents. Field access was gained by German professional associations. Via case vignettes, predictors of thresholds for reporting were assessed.ResultsThe probability of a report to CPS increased positively with the degree of suspicion for maltreatment. However, even if participants were certain that child maltreatment occurred, 20% did not chose to report to CPS. Training in child protection lowered the professionals' threshold for reasonable suspicion; experience with child protection cases and good knowledge of the legal framework increased the likelihood to report an alleged situation of child maltreatment to CPS.ConclusionOur data show that a significant proportion of health care professionals are uncertain about estimating reasonable suspicion and on how to proceed when there are strong indications for child maltreatment Therefore, data point towards the relevance of training in child protection among healthcare professionals in order to improve detection and adequate handling of cases of child maltreatment.
| S-EPMC8204433 | biostudies-literature
Project description:ObjectivesThe aim of this study was to explore health professionals' perception of risk factors related to child maltreatment in China.DesignQualitative research.SettingThe study was conducted in November and December 2014 in Hunan, Zhejiang, Shaanxi and Guangdong provinces in China.ParticipantsFive urban communities and five rural communities were randomly selected in each province, and interviews were conducted in maternal and child health hospitals, children's hospitals, community health service centres and township hospitals in the selected areas. Doctors, nurses and administrators involved in child healthcare services were selected for in-depth-interview.ResultsA total of 102 health professionals were approached but 95 completed the interview. From their perspective, risk factors causing child maltreatment were categorised into four domains: (1) cultural factors, including parents' absolute authority over their children and son preference; (2) social factors, including a fast-paced and stressful lifestyle, children left behind by migrant worker parents and lack of quality child care and education; (3) family factors, including economic status, family structure, parents' inability to provide parental care, experience of maltreatment and parents' illnesses; (4) children's factors, including gender, temper, disabilities and poor awareness of self-protection.ConclusionsThe results indicate that health professionals in China are aware of certain risk factors for child maltreatment; however, some views are outdated and wrong. Based on the perception of health professionals, targeted training courses are needed to enable them to correctly identify and deal with suspected cases of child maltreatment.
| S-EPMC6561447 | biostudies-literature
Project description:BackgroundThere is increasing research interest in the development of preventive treatment for individuals at risk of rheumatoid arthritis (RA). Previous studies have explored the perceptions of at-risk groups and patients about predictive and preventive strategies for RA, but little is known about health care professionals' (HCPs) perspectives.MethodsOne-to-one semi-structured qualitative interviews were conducted (face-to-face or by telephone) with HCPs. Audio recordings of the interviews were transcribed, and the data were analysed by thematic analysis.ResultsNineteen HCPs (11 female) were interviewed, including ten GPs, six rheumatologists and three rheumatology nurse specialists. The thematic analysis identified four organising themes: 1) Attributes of predictive and preventive approaches; 2) Ethical and psychological concerns; 3) Implementation issues and 4) Learning from management of other conditions. Theme 1 described necessary attributes of predictive and preventive approaches, including the type and performance of predictive tools, the need for a sound evidence base and consideration of risks and benefits associated with preventive treatment. Theme 2 described the ethical and psycho-social concerns that interviewees raised, including the potential negative economic, financial and psychological effects of risk disclosure for 'at-risk' individuals, uncertainty around the development of RA and the potential for benefit associated with the treatments being considered. Theme 3 describes the implementation issues considered, including knowledge and training needs, costs and resource implications of implementing predictive and preventive approaches, the role of different types of HCPs, guidelines and tools needed, and patient characteristics relating to the appropriateness of preventive treatments. Theme 4 describes lessons that could be learned from interviewees' experiences of prediction and prevention in other disease areas, including how preventive treatment is prescribed, existing guidelines and tools for other diseases and issues relating to risk communication.ConclusionsFor successful implementation of predictive and preventative approaches in RA, HCPs need appropriate training about use and interpretation of predictive tools, communication of results to at-risk individuals, and options for intervention. Evidence of cost-efficiency, appropriate resource allocation, adaptation of official guidelines and careful consideration of the at-risk individuals' psycho-social needs are also needed.
| S-EPMC10548722 | biostudies-literature
Project description:BackgroundPublic child healthcare doctors and nurses, and primary school teachers play a pivotal role in the detection and reporting of child abuse, because they encounter almost all children in the population during their daily work. However, they report relatively few cases of suspected child abuse to child protective agencies. The aim of this qualitative study was to investigate Dutch frontline workers' child abuse detection and reporting behaviors.MethodsFocus group interviews were held among 16 primary school teachers and 17 public health nurses and physicians. The interviews were audio recorded, transcribed, and thematically analyzed according to factors of the Integrated Change model, such as knowledge, attitude, self-efficacy, skills, social influences and barriers influencing detection and reporting of child abuse.ResultsFindings showed that although both groups of professionals are aware of child abuse signs and risks, they are also lacking specific knowledge. The most salient differences between the two professional groups are related to attitude and (communication) skills.ConclusionThe results suggest that frontline workers are in need of supportive tools in the child abuse detection and reporting process. On the basis of our findings, directions for improvement of child abuse detection and reporting are discussed.
| S-EPMC3847190 | biostudies-literature
Project description:Healthcare professionals (HCPs) have a key role in promoting physical activity, particularly among populations at greatest risk of poor health due to physical inactivity. This research explored HCPs' knowledge, decision making, and routine practice of physical activity promotion with older adults. Furthermore, it aimed to enhance our understanding of the supports that HCPs need to effectively promote physical activity in routine practice across a wide range of healthcare professions, settings, and sectors. Semi-structured online interviews were completed with HCPs between November 2020-March 2021. Data were first analysed by coding instances within the transcripts, mapping onto relevant Theoretical Domains Framework (TDF) domains utilising a deductive thematic analysis approach. The data were then analysed utilising an inductive approach to thematically generate explanatory subthemes within the identified domains. Participants (n = 63) included general practitioners (15.87%), occupational therapists (30.16%), physiotherapists (38.10%), and nurses (15.87%) from the island of Ireland (Ireland and Northern Ireland). Of those interviewed, 10 (15.87%) were male and 53 (84.13%) were female. Two thirds (65.08%) were HCPs practicing in Ireland. Domains and subthemes related to the application of physical activity, and emergent themes on developing practice to support the application and integration of physical activity in routine practice are discussed. HCPs identified that focused education, appropriate training, and access to tailored resources are all essential to support the promotion of physical activity in routine practice. For such supports to be effective, a 'cultural shift' is required in HCP training and health service provision to adopt the growing evidence base that physical activity promotion must be part of disease prevention and treatment in routine practice. HCPs highlighted a range of areas for service development to support them to promote physical activity. Further research is required to explore the feasibility of implementing these recommendations in routine practice.
| S-EPMC8582732 | biostudies-literature
Project description:ObjectivesCatheter-related bloodstream infections (CRBSI) are a common healthcare-associated infection and therefore targeted by surveillance programmes in many countries. Concerns, however, have been voiced regarding the reliability and construct validity of CRBSI surveillance and the connection with the current diagnostic procedures. The aim of this study was to explore the experiences of infection control practitioners (ICPs) and medical professionals with the current CRBSI surveillance in the Netherlands and their suggestions for improvement.DesignQualitative study using focus group discussions (FGDs) with ICPs and medical professionals separately, followed by semistructured interviews to investigate whether the points raised in the FGDs were recognised and confirmed by the interviewees. Analyses were performed using thematic analyses.SettingBasic, teaching and academic hospitals in the Netherlands.Participants24 ICPs and 9 medical professionals.ResultsMain themes derived from experiences with current surveillance were (1) ICPs' doubt regarding the yield of surveillance given the low incidence of CRBSI, the high workload and IT problems; (2) the experienced lack of leadership and responsibility for recording information needed for surveillance and (3) difficulties with applying and interpreting the CRBSI definition. Suggestions were made to simplify the surveillance protocol, expand the follow-up and surveillance to homecare settings, simplify the definition and customise it for specific patient groups. Participants reported hoping for and counting on automatisation solutions to support future surveillance.ConclusionsThis study reveals several problems with the feasibility and acceptance of the current CRBSI surveillance and proposes several suggestions for improvement. This provides valuable input for future surveillance activities, thereby taking into account automation possibilities.
| S-EPMC8375748 | biostudies-literature
Project description:IntroductionMost studies have reported barriers to guideline usage mainly from doctors' perspective; few have reported the perspective of other stakeholders. This study aimed to determine the views and barriers to adherence of a national clinical practice guideline (CPG) on management of hypertension from the perspectives of policymakers, doctors and allied healthcare professionals.MethodsThis study used a qualitative approach with purposive sampling. Seven in depth interviews and six focus group discussions were conducted with 35 healthcare professionals (policy makers, doctors, pharmacists and nurses) at a teaching hospital in Kuala Lumpur, Malaysia, between February and June 2013. All interviews were audio-recorded, transcribed verbatim and checked. Thematic approach was used to analyse the data.ResultsTwo main themes and three sub-themes emerged from this study. The main themes were (1) variation in the use of CPG and (2) barriers to adherence to CPG. The three sub-themes for barriers were issues inherent to the CPG, systems and policy that is not supportive of CPG use, and attitudes and behaviour of stakeholders. The main users of the CPG were the primary care doctors. Pharmacists only partially use the guidelines, while nurses and policy makers were not using the CPG at all. Participants had suggested few strategies to improve usage and adherence to CPG. First, update the CPG regularly and keep its content simple with specific sections for allied health workers. Second, use technology to facilitate CPG accessibility and provide protected time for implementation of CPG recommendations. Third, incorporate local CPG in professional training, link CPG adherence to key performance indicators and provide incentives for its use.ConclusionsBarriers to the use of CPG hypertension management span across all stakeholders. The development and implementation of CPG focused mainly on doctors with lack of involvement of other healthcare stakeholders. Guidelines should be made simple, current, reliable, accessible, inclusive of all stakeholders and with good policy support.
| S-EPMC4420249 | biostudies-literature
Project description:BackgroundCoronavirus Disease 2019 (COVID-19) is an acute respiratory illness first discovered and identified in China. Countries are taking precautions to prevent COVID-19 in accordance with WHO guidelines.ObjectiveThe objective of this study was to assess the practice of the COVID-19 prevention strategy post-vaccination and associated factors among health care professionals in Felege Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia, in 2021.MethodsAn institutional-based cross-sectional study was carried out at Felege Hiwot Referral Hospital, Bahir Dar. Data were entered into Epi-Info software, version 7.1, and exported to SPSS, version 23, for analysis. Descriptive statistics were used to describe the socio-demographic characteristics of the respondents. The crude odds ratio (COR) and the adjusted odds ratio (AOR) with 95% CI were calculated to determine the coefficient of the COVID-19 prevention strategy.ResultsIn this study, 68.7% (95% CI: 63.7, 73.8) of health care professionals had good practice of the COVID-19 prevention strategy post-vaccination. Sex (AOR: 1.76; 95% CI: 1.08, 2.89), marital status (AOR: 1.75; 95% CI: 1.09, 2.93), and good attitude toward vaccination (AOR: 3.24; 95% CI: 2.13, 5.48) were significantly associated with the practice of COVID-19 prevention strategies post vaccination.ConclusionsThe practices of COVID-19 preventive strategies post-vaccination were good among healthcare professionals. Good attitude toward vaccination, sex (male), marital status (married) were factors determining the occurrences of COVID-19 preventive strategies post-vaccination.
| S-EPMC9805928 | biostudies-literature
Project description:ObjectivesTo provide a rich description of current responses to concerns related to child maltreatment among a sample of English general practitioners (GPs).DesignIn-depth, face-to-face interviews (November 2010 to September 2011). Participants selected and discussed families who had prompted 'maltreatment-related concerns'. Thematic analysis of data.Setting4 general practices in England.Participants14 GPs, 2 practice nurses and 2 health visitors from practices with at least 1 'expert' GP (expertise in child safeguarding/protection).ResultsThe concerns about neglect and emotional abuse dominated the interviews. GPs described intense and long-term involvement with families with multiple social and medical problems. Narratives were distilled into seven possible actions that GPs took in response to maltreatment-related concerns. These were orientated towards whole families (monitoring and advocating), the parents (coaching) and children (opportune healthcare), and included referral to or working with other services and recording concerns. Facilitators of the seven actions were: trusting relationships between GPs and parents, good working relationships with health visitors and framing the problem/response as 'medical'. Narratives indicated significant time and energy spent building facilitating relationships with parents with the aim of improving the child's well-being.ConclusionsThese GPs used core general practice skills for on-going management of families who prompted concerns about neglect and emotional abuse. Policy and research focus should be broadened to include strategies for direct intervention and on-going involvement by GPs, such as using their core skills during consultations and practice systems for monitoring families and encouraging presentation to general practice. Exemplars of current practice, such as those identified in our study, should be evaluated for feasibility and acceptability in representative general practice settings as well as tested for efficacy, safety and cost. The seven actions could form the basis for the 'lead professional' role in general practice as proposed in the 2013 version of 'Working Together 'guidance.
| S-EPMC3855649 | biostudies-literature
Project description:ObjectiveTo systematically search for research about the effectiveness of mandatory reporting of child maltreatment and to synthesise qualitative research that explores mandated reporters' (MRs) experiences with reporting.DesignAs no studies assessing the effectiveness of mandatory reporting were retrieved from our systematic search, we conducted a meta-synthesis of retrieved qualitative research. Searches in Medline (Ovid), Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Sociological Abstracts, Education Resources Information Center, Criminal Justice Abstracts and Cochrane Library yielded over 6000 citations, which were deduplicated and then screened by two independent reviewers. English-language, primary qualitative studies that investigated MRs' experiences with reporting of child maltreatment were included. Critical appraisal involved a modified checklist from the Critical Appraisal Skills Programme and qualitative meta-synthesis was used to combine results from the primary studies.SettingAll healthcare and social-service settings implicated by mandatory reporting laws were included. Included studies crossed nine high-income countries (USA, Australia, Sweden, Taiwan, Canada, Norway, Finland, Israel and Cyprus) and three middle-income countries (South Africa, Brazil and El Salvador).ParticipantsThe studies represent the views of 1088 MRs.OutcomesFactors that influence MRs' decision to report and MRs' views towards and experiences with mandatory reporting of child maltreatment.ResultsForty-four articles reporting 42 studies were included. Findings indicate that MRs struggle to identify and respond to less overt forms of child maltreatment. While some articles (14%) described positive experiences MRs had with the reporting process, negative experiences were reported in 73% of articles and included accounts of harm to therapeutic relationships and child death following removal from their family of origin.ConclusionsThe findings of this meta-synthesis suggest that there are many potentially harmful experiences associated with mandatory reporting and that research on the effectiveness of this process is urgently needed.
| S-EPMC5652515 | biostudies-literature