A descriptive survey of Swedish child health nurses' awareness of abuse and neglect. I. Characteristics of the nurses.
OBJECTIVE
The objectives were to assess: (1) child health nurses' identification of abuse/neglect of children of preschool age in their districts; (2) overall prevalence of abuse/neglect according to the nurses; (3) determinants of nurse identification; (4) determinants of nurse-reported district prevalences; and (5) determinants of reporting to the child protection services (CPS).


METHODS
Questionnaires were mailed to about 3,000 child health centers.


RESULTS
Fifty-five percent responded. Of these, 22% identified no case and 33% at least one (mostly five or fewer). The overall prevalence was 1.4%. Identification correlated with general participation rate in the county. Other determinants of identification were acquaintance with the district, large district populations, and three variables assumed to reflect a personal interest. Determinants of prevalences were small district populations, regular contacts with the social services, and two personal interest variables. With large district populations, identification increased, whereas prevalences decreased. Only 30.3% had made a report to the CPS. Regular contacts with the social services correlated with reporting. Personal interest was a determinant of the decision to report, and acquaintance with the district a determinant of reporting rate.


CONCLUSIONS
Abuse and neglect did not appear as priorities for the Child Health Services. The method probably led to an underestimation of the true prevalence. Personal interest and social services contacts emerged as important determinants. However, the assumed criteria of "interest" were not validated. For effective identification, no nurse should be responsible for more than 400 to 500 children. Implications for practice and research are discussed.
Lagerberg
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Department of Women's and Children's Health, University Children's Hospital, Uppsala, Sweden.
D001364:Awareness; D002648:Child; D002649:Child Abuse / Q000517:prevention & control* / Q000523:psychology / Q000706:statistics & numerical data; D002662:Child Health Services / Q000592:standards*; D002675:Child, Preschool; D002983:Clinical Competence; D003151:Community Health Centers; D003657:Decision Making; D019538:Health Care Surveys; D006801:Humans; D007231:Infant, Newborn; D019221:Mandatory Reporting; D009733:Nursing Diagnosis / Q000592:standards* / Q000706:statistics & numerical data; D010371:Pediatric Nursing / Q000592:standards* / Q000706:statistics & numerical data; D015995:Prevalence; D012308:Risk Management; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology