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Revista Paulista de Pediatria
Print version ISSN 0103-0582
BANNWART, Thais Helena and BRINO, Rachel de Faria. Difficulties to identify and report cases of abuse against children and adolescents from the viewpoint of pediatricians. Rev. paul. pediatr. [online]. 2011, vol.29, n.2, pp. 138-145. ISSN 0103-0582. http://dx.doi.org/10.1590/S0103-05822011000200002.
OBJECTIVE: To describe and analyze the difficulties found in identifying and notifying abuse against children and adolescents in the opinion of pediatricians. METHODS: Qualitative study with eight participants (four men and four women), with an average age of 48 years and an average time of professional experience of 22 years. The tool used for data collection was a questionnaire containing: a) two vignettes describing a situation involving suspected abuse against children with two questions in each sticker dealing with the process of identifying the suspect and the difficulties encountered, and b) three additional questions on specific difficulties in the procedure of identifying child abuse. RESULTS: The main difficulties noted by the pediatricians were disbelief in the effectiveness of the Child Support Service, non-existence or inadequate training on child-abuse issues by the pediatricians, and personal limitations. These difficulties are the same reported by the literature. Furthermore, professionals thought that in order to report the case, confirmation of the suspected abuse is needed, which contradicts the law. CONCLUSIONS: There was a lack of professional training to deal with victims of violence leading to ignorance about how to proceed in such cases. The current biomedical model is an obstacle for identifying possible cases because their signs and symptoms can be confused with other differential diagnoses. It is necessary to train pediatricians about diagnosis and procedures regarding child abuse as well as to evaluate the effectiveness of this training.
Keywords : mandatory reporting; Pediatrics; secondary prevention; child abuse.