ABSTRACT
OBJECTIVES: To describe (1) primary care providers' experiences identifying and reporting suspected child abuse to child protective services (CPS) and (2) variables affecting providers' reporting behavior. DESIGN AND METHODS: Health care providers (76 physicians, 8 nurse practitioners, and 1 physician assistant) in a regional practice-based network completed written surveys that collected information about the demographic characteristics of each provider and practice; the provider's career experience with child abuse; and the provider's previous year's experience identifying and reporting suspected child abuse, including experience with CPS. RESULTS: All providers (N = 85) in 17 participating practices completed the survey. In the preceding 1 year, 48 respondents (56%) indicated that they had treated a child they suspected was abused, for an estimated total of 152 abused children. Seven (8%) of 85 providers did not report a total of 7 children with suspected abuse (5% of all suspected cases). A majority of providers (63%; n = 29) believed that children who were reported had not benefited from CPS intervention, and 21 (49%) indicated that their experience with CPS made them less willing to report future cases of suspected abuse. Providers who had some formal education in child abuse after residency were 10 times more likely to report all abuse than were providers who had none. CONCLUSIONS: Primary care providers report most, but not all, cases of suspected child abuse that they identify. Past negative experience with CPS and perceived lack of benefit to the child were common reasons given by providers for not reporting. Education increases the probability that providers will report suspected abuse.
Subject(s)
Child Abuse/statistics & numerical data , Child Welfare/statistics & numerical data , Mandatory Reporting , Practice Patterns, Physicians' , Primary Health Care , Attitude of Health Personnel , Chicago , Child , Female , Humans , Male , Statistics, NonparametricSubject(s)
Child Abuse/prevention & control , Child Health Services/organization & administration , Community-Institutional Relations , Foster Home Care , Hospitals, Community/organization & administration , Child , Child Advocacy , Child, Preschool , Cooperative Behavior , Health Services Needs and Demand , Humans , Illinois , Outcome Assessment, Health Care , Psychology, ChildABSTRACT
This study examined the prevalence of lead poisoning in 746 abused and neglected children taken into protective custody by Cook County, Illinois, Child Protective Services, Department of Children and Family Services (DCFS). Most of these children had a history of neglect (62%) or dependency (23%); they were predominantly African-American (88%). Venous blood lead concentrations (PbB) were obtained on 589 children, ages 6 months to 6 years, between January 1, 1992, and December 31, 1992. Three hundred eighty-one (64.7%) children tested had a PbB > or = 10 micrograms/dL (0.48 mumol/L); the mean PbB was 12.23 micrograms/dL (0.587 mumol/L). These data support a recommendation for lead screening in any child with a history of abuse or neglect if environmental risk factors cannot be assessed.
Subject(s)
Child Abuse , Lead Poisoning/epidemiology , Child , Child, Preschool , Humans , Illinois/epidemiology , Infant , Lead/blood , Prevalence , Retrospective Studies , RiskABSTRACT
Children who have been abused and neglected may have a variety of medical problems not apparent to a social worker or other nonmedical professional investigating the allegations. A joint project between a state child protective agency and an urban teaching hospital was undertaken to provide for the systematic medical screening of all children brought to the agency before their placement in foster care. These children received a complete medical evaluation with emphasis on documenting the abuse and neglect and also were screened for other medical problems. A total of 5181 children were evaluated. Forty-four percent of these children had some medical problem, including anemia, otitis media, sexually transmitted infections, and lead poisoning. Additional instances of abuse and neglect were identified and documented. This systematic evaluation allows for the optimal identification, documentation, and treatment of abuse, neglect, and other medical problems that may affect a child's outcome and adaptation.
Subject(s)
Child Abuse , Physical Examination , Adolescent , Anemia/epidemiology , Child , Child Abuse/diagnosis , Female , Humans , Illinois , Male , Morbidity , Urinary Tract Infections/epidemiologyABSTRACT
Medical students reviewing the hospital course of a young man with acute gastritis and alcoholism accurately reported the physical aspects of the patient's presentation and course, but paid less attention to the issue of alcoholism.
Subject(s)
Alcoholism/diagnosis , Referral and Consultation , Students, Medical , Adult , Attitude of Health Personnel , Depressive Disorder/diagnosis , Humans , Male , Peptic Ulcer/diagnosis , Students, Medical/psychologyABSTRACT
In 1975, the American Academy of Pediatrics (AAP) stated that there is "no medical indication for routine circumcision of the newborn." A survey was conducted among Chicago-area pediatricians, obstetricians, and family practitioners to determine what impact this statement had on their approach to circumcision. Hospitals were also surveyed to determine whether the AAP's statement had caused a change in the frequency of circumcision in area hospitals. Only 49% of the physicians were aware of the AAP's position. Forty-one percent recommended routine circumcision; 15% recommended against the practice. Age, medical specialty, religious customs, and concerns about hygiene and cancer all appeared to influence the physicians' approach to circumcision. The frequency of routine circumcision. The frequency of routine circumcision was 70% to 90% and remained unchanged in the three years following the AAP's statement.
