[Follow-up of child abuse victims: challenges for the pediatrician].
OBJECTIVE
To review practical questions about the initial assistance and follow-up of child abuse victims and their families by pediatricians.


METHODS
A literature review was carried out using the MEDLINE and LILACS databases, including the years 2000 to 2005. Some articles from past years and books were included due to their importance.


RESULTS
Initial assistance is one of the most important actions by health professionals for the protection of abused children in different healthcare sectors (community, outpatient clinics, emergency rooms and infirmary), and it is fundamental for the reduction of immediate and long-term negative consequences of violence. The protection services cannot monitor all the families under their responsibility and most child abuse cases are not even reported to those institutions; therefore, regular follow-up by a pediatrician is advisable. It is important to provide the family with support and guidance until the child is safe. The main challenges are: to be involved without causing more violence; to consider all the family as the focus of attention, including the family members who have committed the assault, helping them to change inadequate behaviors; to develop specific abilities to carry out this work, which must be multiprofessional, interdisciplinary and intersectoral.


CONCLUSIONS
Families face difficulties when their children are abused and when the situation gains notoriety, demanding interventions from many institutions. In this process, a pediatrician can guide and help them to guarantee the protection and healthy development of their children. To overcome challenges, health professionals have to be technically and emotionally prepared.
Ferreira
Ana L
AL
Departamento de Pediatria, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ. anaferr@gbl.com.br
D001291:Attitude of Health Personnel; D002648:Child; D002649:Child Abuse / Q000523:psychology* / Q000534:rehabilitation; D002662:Child Health Services / Q000592:standards*; D019548:Crime Victims / Q000523:psychology* / Q000534:rehabilitation; D005190:Family; D005500:Follow-Up Studies; D006801:Humans; D010372:Pediatrics / Q000379:methods* / Q000592:standards