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Audit of child maltreatment medical assessments in a culturally diverse, metropolitan setting

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dc.contributor.author Raman, S., & Hotton, P. R.
dc.date.accessioned 2017-12-11T16:22:19Z
dc.date.available 2017-12-11T16:22:19Z
dc.date.issued 2017
dc.identifier.citation Raman, S., & Hotton, P. R. (2017). Audit of child maltreatment medical assessments in a culturally diverse, metropolitan setting. BMJ Paediatrics Open, 1(1), e000125. en_US
dc.identifier.uri http://bmjpaedsopen.bmj.com/content/1/1/e000125
dc.identifier.uri http://hdl.handle.net/11212/3657
dc.description.abstract Child maltreatment (CM) is a major public health problem globally. While there is evidence for the value of medical examination in the assessment of CM, little is known about the quality of clinical assessments for CM. South Western Sydney (SWS) has a large metropolitan population with many vulnerable subgroups. We aimed to describe acute presentations of CM in SWS over a 3-year period—with a focus on the quality of the clinical assessments. We wanted to determine whether the cases assessed fulfilled established minimum standards for clinical assessment of CM and whether the assessments were performed in a child-friendly manner. We gathered data from the acute child protection database on all children <16 years referred for assessment between 2013 and 2015. We performed simple descriptive analysis on the data. We measured the assessment, report writing and follow-up against criteria for minimum standards for CM assessments, and identified whether assessments were child-friendly from available clinical information. There were 304 children referred; 279 seen for acute assessment; most (73%) were for sexual abuse, 75 (27%) were for physical abuse/neglect. Over half the assessments identified other health concerns; joint assessments performed by paediatric and forensic doctors were better at identifying these health concerns than solo assessments. Most assessments were multidisciplinary and used protocols; half were not followed up; a third were performed after-hours and a third had no carer present during assessments. We identified strengths and weaknesses in current CM assessments in our service. Locally relevant standards for CM assessments are achievable in the acute setting, more challenging is addressing appropriate medical and psychosocial follow-up for these children. While we have established baseline domains for measuring a child-friendly approach to CM assessments, more should be done to ensure these vulnerable children are assessed in a timely, child-friendly manner, with appropriate follow-up. en_US
dc.language.iso en en_US
dc.publisher BMJ Pediatrics Open en_US
dc.subject clinical assessment en_US
dc.subject child maltreatment en_US
dc.subject health en_US
dc.subject child friendly response en_US
dc.subject Aust en_US
dc.subject International Resources en_US
dc.title Audit of child maltreatment medical assessments in a culturally diverse, metropolitan setting en_US
dc.type Article en_US


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