Keeping the child in focus while supporting the family

Abstract

Child maltreatment can lead to acute and long-term consequences, and it is important that at-risk children are identified early. Child healthcare (CHC) nurses in Sweden are in a position to identify child maltreatment, as they follow children and their parents from the child's birth to school age. Therefore, the aim was to describe CHC nurses' experiences when encountering families in which child maltreatment was identified or suspected. Individual open interviews with eight CHC nurses were performed and analysed using a qualitative content analysis. Findings revealed that keeping the child in focus, while supporting the family was essential for the nurses. This family-centred approach was assumed to benefit the child's interests. Meeting families where child maltreatment was identified or suspected influenced the nurses, emotionally in different ways. Nevertheless, it was important to keep an open mind and communication build on honesty. Furthermore, the nurses requested professional supervision in order to help them learn from the situation ahead of the next time. This knowledge about CHC nurses' experiences may form a basis for the development of interventions that aim to support the CHC nurses in their professional role, and thereby improve support to children and parents in the future.

A qualitative study of public health nurses' experiences detecting and preventing child maltreatment in primary care settings

“…They had to prioritize their time, felt alone in their work, and were burdened by their responsibility. This is consistent with several previous studies, where lack of time, the balance of risk and support and loneliness were highlighted (Adams et al, 2022; Dahlbo et al, 2017). Dahlbo et al (2017) studied paediatric nurses and found that their work to prevent child maltreatment often led to feelings of powerlessness and thoughts about children that persisted even after working hours.…”

“…International studies among nurses working in primary care have found the detection of child maltreatment both important and challenging (Dahlbo et al, 2017; Lines et al, 2021). A recent study among nurses in Sweden found gaps between their attitudes regarding the importance of helping families and their ability to do so (Engström et al, 2021).…”

Navigating and negotiating meanings of child abuse and neglect: Sociocultural contexts shaping Australian nurses’ perceptions

“…In some settings such as emergency departments, nurses use formalised assessment tools including screening guidelines to assess suspicious physical injuries (Escobar et al, ). However, in paediatric and community child health settings, nurses are reliant on clinical judgements to form a suspicion whether child abuse may be occurring and decide whether they should refer to child protection authorities (Dahlbo, Jakobsson, & Lundqvist, ; Saltmarsh & Wilson, ). There is limited existing research that explicitly explores nurses’ decision‐making processes in relation to child abuse and neglect, but it is known that in neonatal, school and public health settings nurses believe their initial suspicion is based upon a ‘gut feeling’ or ‘intuition’ (Kraft & Eriksson, ; Saltmarsh & Wilson, ; Schols, de Ruiter, & Ory, ).…”

O processo emocional experienciado pelos enfermeiros na interação com os pais maltratantes na consulta de saúde infantil

“…Cuidar de crianças vítimas de maus tratos implica uma multiplicidade de desafios para os enfermeiros (Dahlbo, Jakobsson & Lundqvist, 2017) e entre estes a gestão emocional. A interação dos enfermeiros com os pais maltratantes está associada a uma emocionalidade intensa (Rowse, 2009;Barrett, Denieffe & Bergin & Gooney, 2016;Taylor, Smith & Taylor 2016), uma vez que os enfermeiros têm de gerir sentimentos ambivalentes no sentido de protegerem a criança (maltratada) e simultaneamente, apoiarem os pais (maltratantes) (Tingberg, Bredlov & Ygge, 2008).…”

“…Por isso, os enfermeiros necessitam de regular as suas emoções no sentido de transformarem positivamente as suas vivências emocionalmente intensas com as pessoas que necessitam de cuidados, com a intenção de promover bem-estar das pessoas em interação (Diogo, 2015(Diogo, , 2019a. Considerando que a interação do enfermeiro com os pais maltratantes é uma experiência emocionalmente intensa que pode levar ao stress e à exaustão (Maunder, 2008;Dahlbo, Jakobsson & Lundqvist, 2017), e uma vez que a investigação sobre o processo emocional experienciado pelos enfermeiros na interação de cuidados com pais maltratantes na consulta de saúde infantil é escassa, este artigo procura dar resposta à seguinte questão: Como é que os enfermeiros de saúde infantil gerem a sua emocionalidade nos encontros com os pais maltratantes? E prossegue os seguintes objetivos: 1) analisar o que experienciam emocionalmente os enfermeiros nos encontros com os pais maltratantes e 2) compreender o processo de gestão emocional dos enfermeiros na interação de cuidados com os pais maltratantes.…”