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Chronic conditions in children increase the risk for physical abuse – but vary with socio-economic circumstances
Karlstad University, Faculty of Social and Life Sciences. (Folkhälsovetenskap)ORCID iD: 0000-0003-3323-0032
Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.ORCID iD: 0000-0003-0417-1686
Karlstad University, Faculty of Social and Life Sciences, Department of Health and Environmental Sciences.ORCID iD: 0000-0002-2542-6791
2011 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 100, p. 407-412Article in journal (Refereed) Published
Abstract [en]

Aim: To explore whether children (age 10, 12 and 15 years) with self-reported chronic conditions are at higher risk of physical abuse and⁄or exposure to intimate-partner violence than other children, while considering the importance of demographic factors.

Methods: A national cross-sectional study of 2771 pupils in grades 4, 6 and 9 from 44 schools in Sweden (91% response rate). Conflict Tactic Scales were used to measure physical abuse and separate questions measured exposure to intimate-partner violence. A list of 13 diagnoses was used to estimate chronic conditions.

Results: Children with chronic conditions had an increased risk for physical abuse (CPA) only (OR 1.67) as well as in combination with exposure to intimate-partner violence (IPV) (OR 2.54), but not to IPV only, compared to children without chronic conditions. Furthermore, when chronic conditions were combined with country of birth other than Sweden and living in low-income areas, the risk for CPA increased even more, indicating interactive effects.

Conclusions: A wide range of chronic health conditions in children increased the risk for physical abuse. This indicates that certain factors unite this group of children, irrespective of the type of disability or degree of severity, but where a combination with socio-economic circumstances is of importance.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2011. Vol. 100, p. 407-412
Keywords [en]
Child physical abuse, Chronic health conditions
National Category
Medical and Health Sciences Social Sciences
Research subject
Public Health Science
Identifiers
URN: urn:nbn:se:kau:diva-13133DOI: 10.1111/j.1651-2227.2010.02029.xISI: 000286837700020OAI: oai:DiVA.org:kau-13133DiVA, id: diva2:524256
Projects
Avhandlingsarbete i folkhälsovetenskapAvailable from: 2012-10-31 Created: 2012-04-30 Last updated: 2026-02-11Bibliographically 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
Keywords
Children at risk of maltreatment, Child abuse, prevention, pre-school, chronic health condition, disabilities, detection, support
National Category
Public Health, Global Health and Social Medicine
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: 2026-02-11Bibliographically approved

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Svensson, BirgittaBornehag, Carl-GustavJansson, Staffan

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