A profile of suspected child abuse as a subgroup of major trauma patients

Davies, Ffion; Coats, Timothy J; Fisher, Ross; Lawrence, Thomas; Lecky, Fiona

doi:10.1136/emermed-2015-205285

Cited by 45 publications

(46 citation statements)

References 4 publications

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“…0.84/0.58 Describe the terms for a better understanding of professionals using the instrument. (1) The concepts of dissociative experiences are complex and require clarity even for mental health professionals. (24) Encopresis (repeated defecation, including in inappropriate places) or enuresis (lack of control of sphincters) without the identification of stressful situations (such as mourning or parental divorce).…”

Section: 80/050mentioning

confidence: 99%

“…(1) For most children, the arrival of a new sibling is considered a period of developmental crisis and can cause changes in behavior or emotional state. (23) Excessively nice behavior (unusual) with strangers, including health professionals (looking for affection).…”

Section: 76/043mentioning

confidence: 99%

“…(1) Neglect is also characterized by disregard for the child's well-being in relation to affection, indicating the need for a thorough investigation of the family situation. (12) Burns: in covered areas of the body or posterior regions (such as palm of hands, soles, buttocks, back); in shape of a utensil (such as cigarette or iron); in shape of a glove or sock; bilateral; symmetrical.…”

Section: 80/050mentioning

confidence: 99%

“…(1) Physical violence can be practiced through slaps, pinches, kicks and by throwing objects, which causes injuries, trauma, burns and mutilations. (12) Dissociation (depersonalization and amnesia).…”

Section: 80/050mentioning

confidence: 99%

“…However, between 2000 and 2010, the increase of 13.8% in homicide rates is noteworthy in the first year of life, and of 13.5% by the age of five. (1,2) Violence and accidents are the third leading cause of death among children aged 0-9 years, characterize as a social problem and a major public health issue. Many of these injuries do not result in death of the individual, but can harm the development of the victim.…”

Section: Introductionmentioning

confidence: 99%

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Validação de conteúdo de um instrumento para identificação de violência contra criança

et al. 2016

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Objective: To elaborate and validate the contents of an instrument for identifying violence against children. Methods: Methodological study consisting of two stages: the first was the development of the instrument from the literature review; the second was content validation, with evaluation of the instrument by 25 experts. For analysis, were adopted Kappa coefficient ≥0.61, and content validity index ≥0.75. Results: In the first round, of 62 items, it was necessary to reformulate the content of 23 items. After adjustments suggested by the experts, the instrumented had 50 items in the second round. Of these, only one had Kappa> 0.61 (Kappa = 0.50). The lack of agreement among experts resulted in the exclusion of this item in the third round. Conclusion: The instrument showed satisfactory content validity index and can be used to identify signs of suspected violence and help health professionals in child care. ResumoObjetivo: Elaborar e validar o conteúdo de um instrumento para identificação de violência contra criança. Métodos: Estudo metodológico composto por duas etapas: a primeira foi a elaboração do instrumento, a partir de revisão da literatura; a segunda, de validação de conteúdo, mediante a avaliação do instrumento por 25 especialistas. Para análise, adotaram-se coeficiente Kappa ≥0,61 e índice de validade de conteúdo ≥0,75. Resultados: Na primeira rodada, dos 62 itens, observou-se necessidade de reformulação do conteúdo de 23. Após as alterações sugeridas pelos especialistas, na segunda rodada, o instrumentou passou a possuir 50 itens. Destes, apenas um apresentou Kappa >0,61 (Kappa = 0,50). A insuficiência de concordância entre os especialistas ocasionou na exclusão dele, em uma terceira rodada. Conclusão: O instrumento apresentou índice de validade de conteúdo satisfatório e pode ser utilizado para identificar os sinais de suspeita de violência e auxiliar os profissionais de saúde na assistência à criança.

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Section: 80/050mentioning

confidence: 99%

Section: 76/043mentioning

confidence: 99%

Section: 80/050mentioning

confidence: 99%

Section: 80/050mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Validação de conteúdo de um instrumento para identificação de violência contra criança

et al. 2016

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International Consensus Statement on the Radiological Screening of Contact Children in the Context of Suspected Child Physical Abuse

et al. 2023

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ImportancePhysical abuse is a common but preventable cause of long-term childhood morbidity and mortality. Despite the strong association between abuse in an index child and abuse in contact children, there is no guidance outlining how to screen the latter, significantly more vulnerable group, for abusive injuries. Consequently, the radiological assessment of contact children is often omitted, or variably performed, allowing occult injuries to go undetected and increasing the risk of further abuse.ObjectiveTo report an evidence-based and consensus-derived set of best practices for the radiological screening of contact children in the context of suspected child physical abuse.Evidence ReviewThis consensus statement is supported by a systematic review of the literature and the clinical opinion of an internationally recognized group of 26 experts. The modified Delphi consensus process comprised 3 meetings of the International Consensus Group on Contact Screening in Suspected Child Physical Abuse held between February and June 2021.FindingsContacts are defined as the asymptomatic siblings, cohabiting children, or children under the same care as an index child with suspected child physical abuse. All contact children should undergo a thorough physical examination and a history elicited prior to imaging. Contact children younger than 12 months should have neuroimaging, the preferred modality for which is magnetic resonance imaging, and skeletal survey. Contact children aged 12 to 24 months should undergo skeletal survey. No routine imaging is indicated in asymptomatic children older than 24 months. Follow-up skeletal survey with limited views should be performed if abnormal or equivocal at presentation. Contacts with positive findings should be investigated as an index child.Conclusions and RelevanceThis Special Communication reports consensus recommendations for the radiological screening of contact children in the context of suspected child physical abuse, establishing a recognized baseline for the stringent evaluation of these at-risk children and providing clinicians with a more resilient platform from which to advocate for them.

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Eight‐Year Period Prevalence of Physical Abuse in Hospitalised Infants and Corresponding In‐hospital Mortality in France

et al. 2019

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Child abuse is a global public health issue; however, there is a severe lack of reliable epidemiological data. This study estimates the period prevalence of child physical abuse requiring hospitalisation and the corresponding in‐hospital mortality, using the French medico‐administrative database. We included all children less than one year old who were hospitalised from 2007 to 2014. Three groups were defined: group one – physically abused children; group two – possible physically abused children; and group three – all other hospitalised children. Estimation of the national eight‐year period prevalence of physical abuse among hospitalised children was equivalent to the number of children included in group one or groups one and two divided by the number of children aged less than one year in France from 2007 to 2014. Infants hospitalised for physical abuse represent between 0.04 per cent (group 1) and 0.10 per cent (groups 1 and 2) of all children less than one year old in France, which corresponds to 0.28 per cent (group 1) and 0.74 per cent (groups 1 and 2) of all hospitalised children (less than one year old). Hospital mortality at first admission ranged from 2.93 per cent (group 1) to 2.36 per cent (groups 1 and 2). To our knowledge, this is the first study to provide an estimation of the period prevalence of child physical abuse requiring hospitalisation in France and the corresponding in‐hospital mortality. More effective prevention strategies are needed to help health professionals identify and protect at‐risk children. © 2019 John Wiley & Sons, Ltd.Key Practitioner Messages The average hospital stay for physically abused children was much longer than for other children. The in‐hospital mortality rate is higher for physically abused children than for those with other trauma‐related cases. Identifying and coding child abuse accurately is an important step towards understanding the extent of this public health problem.

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A profile of suspected child abuse as a subgroup of major trauma patients

Cited by 45 publications

References 4 publications

Validação de conteúdo de um instrumento para identificação de violência contra criança

Validação de conteúdo de um instrumento para identificação de violência contra criança

International Consensus Statement on the Radiological Screening of Contact Children in the Context of Suspected Child Physical Abuse

Eight‐Year Period Prevalence of Physical Abuse in Hospitalised Infants and Corresponding In‐hospital Mortality in France

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