Parents' Opinion About a Routine Head-to-Toe Examination of Children as a Screening Instrument for Child Abuse and Neglect in Children Visiting the Emergency Department

Arianne Hélène Teeuw, Eva M. Hoytema van Konijnenburg, Tessa Sieswerda-Hoogendoorn, Sjaak Molenaar, Hugo S. Heymans, Rick R. van Rijn

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

To improve detection of child abuse and neglect (CAN), many emergency departments use screening methods. Apart from diagnostic accuracy, possible harms of screening methods are important to consider, especially because most children are not abused and do not benefit from screening. We performed a systematic literature review to assess parents' opinions about CAN screening, in which we could only include 7 studies, all reporting that the large majority of participating parents favor screening. Recently, a complete physical examination (called "top-toe" inspection [TTI], a fully undressed inspection of the child) was implemented as a CAN screening method at the emergency department of a teaching hospital in The Netherlands. This study describes parents' opinions about the TTI. Methods: We used a questionnaire to assess parents' opinions about the TTI of their children when visiting the emergency department. During the study period, 1000 questionnaires were distributed by mail. Results: In total, 372 questionnaires were returned (37%). A TTI was performed for 194 children (52%). The overall attitude of parents whose children underwent a TTI was positive; 77.3% of the respondents found the TTI acceptable, and 1.5% (N = 3) found it unacceptable. Seventy percent of the respondents agreed with the theorem that all children who visit the emergency department should have a TTI performed, and 7.3% (N = 14) disagreed. Discussion: Contrary to what is commonly believed, both in our systematic literature review and in our questionnaire study, the majority of participating parents agree with screening for CAN in general and with the TTI specifically. Sharing the results of this study with ED personnel and policy makers could take away prejudices about perceived disagreement of parents, thereby improving implementation of and adherence to CAN screening.

Original languageEnglish
Pages (from-to)128-138
Number of pages11
JournalJournal of Emergency Nursing
Volume42
Issue number2
DOIs
Publication statusPublished - 1 Mar 2016
Externally publishedYes

Keywords

  • Child abuse
  • Emergency department
  • Patient satisfaction
  • Physical examination
  • Screening

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