Management of child maltreatment suspicions in general practice: A mixed methods study
Date
2023
Journal Title
Journal ISSN
Volume Title
Publisher
Scandinavian Journal of Primary Health Care
Abstract
Background: Maltreated children have many long-term consequences throughout their lives,
but often maltreated children are not recognised in time by professionals. General practice
could be central to the early recognition of child maltreatment due to the long-term relationship with families.
Objective: How do general practitioners (GPs) and practice nurses (PNs) deal with suspected
maltreatment in children below 18 years of age, and which factors influence them to report
cases to social authorities.
Design and setting: A mixed methods study set in general practice in Denmark.
Method and subjects: We combined data from a nationwide questionnaire with observations
from five clinics and 20 interviews with GPs and PNs. We explored our data using the concept
of uncertainty as a driver that shapes action and decision-making in general practice.
Results: Most GPs (94%) said they would discuss cases of suspected child maltreatment with
social services, but in many cases they would prefer to discuss their suspicions with a colleague
first (83%) – most likely where there are no clear-cut signs. The qualitative data added nuance
to these findings by highlighting the difficulty of communicating across sectors, the importance
of maintaining a connection with the child’s family, and practicing watchful waiting.
Conclusion: General practice has an opportunity to act early in cases of suspected child maltreatment if uncertainty is accepted as a critical part of the process of reaching a diagnosis.
Communication across sectors is key, as is support for GPs with suspicions and for families in
need of help.
Description
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Article
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Keywords
primary care, child maltreatment, health, child abuse, diagnositcs
Citation
Hoffmann Merrild, C., Kjeldsen, H. C., & Milidou, I. (2023). Management of child maltreatment suspicions in general practice: a mixed methods study. Scandinavian Journal of Primary Health Care, 1-10.