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Exploring risk for abuse of children with chronic conditions or disabilities: parent’s perceptions of stressors and the role of professionals
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences.
2013 (English)In: Child Care Health and Development, ISSN 0305-1862, E-ISSN 1365-2214, Vol. 39, no 6, 887-893 p.Article in journal (Refereed) Published
Abstract [en]

Background: Children with chronic conditions or disabilities are at an increased risk for abuse. High-levels of parental stress have been identified as possible trigger for abuse, where a combination of several factors are of importance, such as lack of social support and limited resources in the neighborhood. Suggestions for preventive measures have merely focused on parenting strategies and targeted intervention programs. So far, little attention has been paid to how the risk for abuse might relate to parent’s perceptions of stressors and the role of professionals. The purpose of the current study was therefore to explore risk factors for abuse with focus on both parent-child and parent-professional relationships.

Method:Semi-structured in-depth interviews with 15 parents of children with chronic conditions or disabilities were collected and analysed according to qualitative content analysis.

Findings:Three major themes were found that could be seen as risk factors for child abuse: 1) Emotional demands in precarious situations between parent and child. 2) Gradual shift in responsibility from professionals to parents concerning access to and coordination of service and support. 3) Emotionally closed environment between professionals and parents and taboo on talking about abuse. The gradual shift in responsibility had emotional implications, which could reinforce parental stress and thereby also indirect increase the risk of child abuse. The gradual shift in responsibility also seemed to generate an emotionally closed environment and reinforce the taboo on talking about abuse, which in turn hindered preventive measures. 2

Conclusions:In the light of parent’s perceptions of stressors and the role of professionals the findings indicate that abuse against children with chronic conditions or disability is not only a family matter, but also depending on qualities in service, professional support and social norms. The result pinpoints three challenges for preventive measures, all with emotional implications; parental strategies, organisational efforts and cultural awareness.

Place, publisher, year, edition, pages
2013. Vol. 39, no 6, 887-893 p.
Keyword [en]
abuse, child disability, chronic health condition, prevention
National Category
Medical and Health Sciences
Research subject
Public Health Science
Identifiers
URN: urn:nbn:se:kau:diva-26455DOI: 10.1111/cch.12030ISI: 000325138300017ScopusID: 23461758OAI: oai:DiVA.org:kau-26455DiVA: diva2:607202
Available from: 2013-02-22 Created: 2013-02-22 Last updated: 2016-01-26Bibliographically approved
In thesis
1. Barn som riskerar att fara illa i sin hemmiljö: Utmaningar i ett förebyggande perspektiv
Open this publication in new window or tab >>Barn som riskerar att fara illa i sin hemmiljö: Utmaningar i ett förebyggande perspektiv
2013 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[en]
Children at risk of maltreatment : Challenges in a preventive perspective
Abstract [sv]

Baksidestext

Barnmisshandel är ett omfattande folkhälsoproblem med långsiktiga negativa konsekvenser för den enskilda individen och för samhället i stort. Förebyggande insatser kan vara livsavgörande för de utsatta barnen. Denna avhandlings övergripande syfte var att öka kunskapen om barn som riskerar att fara illa i sin hemmiljö samt att identifiera utmaningar i ett förebyggande perspektiv. Två områden har studerats:

(1) Våld mot barn med långvarig sjukdom/funktionsnedsättning

(2) Förskolan som upptäckande och stödjande arena

Gemensamt för inriktningarna är att barn med långvarig sjukdom/funktionsnedsättning och barn i förskoleåldern utgör särskilt sårbara grupper, som löper ökad risk att fara illa i sin hemmiljö. De har också unik kontakt med professionella med möjlighet att upptäcka och agera vid oro.

Avhandlingen bygger på fyra delstudier; en nationell kartläggning riktad till skolelever, en intervjustudie med föräldrar samt två förskolestudier. Resultaten från studierna diskuteras utifrån identifierade utmaningar i ett förebyggande perspektiv. Utmaningarna inkluderar emotionella hinder samt behov av ett mer nyanserat och proaktivt förhållningssätt för att kunna utveckla tidiga insatser till barn och föräldrar.

Abstract [en]

The aim with this thesis was to increase the knowledge about children at risk of maltreatment and to identify challenges in a preventive perspective. Two areas have been studied; Physical abuse of children with chronic conditions/disabilities and Detection and support within the pre-school environment. 

Four data sets were used: a national survey of school children (I), an in-depth interview study with parents (II) and two pre-school studies (III, IV).

I-II: Chronic conditions in children increase the risk for physical abuse, but vary with socio-economic circumstances. The highest risk for physical abuse was found among children with chronic conditions born outside Sweden. The subsequent study revealed direct risk factors related to parent and child (emotional demands in precarious situations), and indirect risk factors related to parent and professional (gradual shift in responsibility and emotionally closed environment) and social norms (taboo on talking about abuse).

III-IV: Preschool staff suspected child maltreatment for two percent of the preschool children. In less than half of the cases, the parents were informed and a report to social services was made in a third of the cases. The most common reason for not making a report was that the staff believed that the pre-school had sufficient resources to help the child. In the subsequent study, preschool teachers’ concerns about the child’s home environment were explored in a broader perspective over a one year period. The study showed that concern for the children’s home situation related to increased concern for several aspects of children’s health and development, increased need of special support in preschool, insufficient contact with parents, and lower parental socioeconomic status.

The results are discussed according to identified challenges in a preventive perspective. These include emotional obstacles for prevention and a need for a more nuanced and proactive professional approach to enable early support to children at risk of maltreatment and their parents.

Place, publisher, year, edition, pages
Karlstad: Karlstads universitet, 2013
Series
Karlstad University Studies, ISSN 1403-8099 ; 2013:13
Keyword
Children at risk of maltreatment, Child abuse, prevention, pre-school, chronic health condition, disabilities, detection, support
National Category
Medical and Health Sciences
Research subject
Public Health Science
Identifiers
urn:nbn:se:kau:diva-26456 (URN)978-91-7063-488-8 (ISBN)
Public defence
2013-04-26, Lagerlöfsalen, 1A 305, Karlstads universitet, Karlstad, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2013-04-05 Created: 2013-02-22 Last updated: 2013-04-05Bibliographically approved

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