Recognition of child physical abuse by a group of Brazilian primary care health professionals

Abstract

Background Child maltreatment is a complex social and public health problem. Aim To evaluate the frequency of the recognition by Brazilian health professionals in primary care of child physical abuse (CPA) and associated factors. Design A representative cross‐sectional study was conducted with dentists, nurses, family physicians, and pediatricians who participated in the network of the Family Health Strategy in the city of Belo Horizonte, Brazil. Data collection involved in the administration of a questionnaire validated for use in Brazil. Data were collected from 181 dentists, 235 nurses, 203 family physicians, and 96 pediatricians. Results Among the 715 health professionals, 499 (69.8%) had some type of postgraduate degree and 414 (57.9%) recognized suspected or proved cases of CPA. The recognition was associated with occupation, as pediatricians recognized 14.11‐fold [OR = 14.11 (95% CI: 3.73 to 53.43)] more cases of CPA compared with dentists. The recognition was also associated with a longer period of time working in the city [OR = 2.79 (95% CI: 1.24 to 6.29)]. Conclusion The recognition of cases was positively associated with the longer working time in the municipal network and with pediatricians. The dentist was the category that was least associated with the recognition of CPA.

Prevalence of recognition and reporting of child physical abuse by dental surgeons and associated factors

“…A survey conducted in Northern Ireland with primary heathcare workers showed that dentists were the professionals with the highest underreporting rates 24 . These findings are in line with some studies that found a low number of cases of child abuse reported by dentists 2,25,16,27 .…”

“…By looking at the high rate of non-reporting behavior observed in the present study and in similar studies carried out with health professionals 14,16,25,31 , one perceives the need of further investigation into the factors related to these low reporting rates that could provide clearer evidence and contribute to the debate on this topic, allowing for new measures and public policies for the prevention of child abuse and for the health support of children and adolescents.…”

“…With integral, equitable and continuous attention, the FHS is considered the gateway to the Brazilian health system 13 . Despite being inserted in the FHS and consequently in a strategic position to identify violence against children, some studies have shown that a significant number of dental surgeons have difficulties and seem to be unable to recognize child physical abuse among their patients [14][15][16] .…”

“…Dentistas com seis a 19 anos de trabalho no município apresentaram probabilidade 2,38 vezes [RP = 2,38 (CI 95%: 1,41)] maior de identificar casos de AFI do que aqueles com menos de seis anos de atuação. Possuir pós-graduação com foco em crianças [PR = 4,50(CI 95%: 1,[8][9][10][11][12][13][14][15][16][17][18]68)] esteve positivamente associado a um maior número de notificações. O tempo de trabalho no município esteve associado à identificação de casos de AFI.…”

Conhecimentos e atitudes de cirurgiões-dentistas da rede pública de Pelotas-RS frente aos maus-tratos infantis

“…Apesar de uma boa parcela da amostra se considerar de certa forma capaz de identificar MTI, corroborando com os achados de Azevedo et al (2012) 32 , outros estudos demonstram que existe subnotificação dos casos por profissionais de saúde, o que pode expor a existência de uma lacuna entre a identificação dos casos e sua notificação 8,[32][33][34][35][36] . Mesmo considerando-se capaz de identificar um caso suspeito, muitos CD não sabem como proceder.…”