title: Exploring risk for abuse of children with chronic conditions or disabilities--parent's perceptions of stressors and the role of professionals.
abstract: BACKGROUND
  Children with chronic conditions or disabilities are at an increased risk for abuse. High level of parental stress has been identified as possible trigger for abuse, were a combination of several factors are of importance, as lack of social support and limited resources in the neighbourhood. Suggestions for preventive measures have merely focused on parenting strategies and targeted intervention programmes. So far, little attention has been paid on 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.
  
  
  METHODS
  Semi-structured in-depth interviews with 15 parents of children with chronic conditions or disability were collected and analysed according to qualitative content analysis.
  
  
  RESULTS
  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 co-ordination 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.
  
  
  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, organizational efforts and cultural awareness.
authors: Department of Health and Environment, Division of Public Health Sciences, Karlstad University, Karlstad, Sweden.
authors: B
authors: B
authors: Svensson
authors: U-B
authors: UB
authors: Eriksson
authors: S
authors: S
authors: Janson
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002649:Child Abuse / Q000517:prevention & control*; D002675:Child, Preschool; D002908:Chronic Disease; D003469:Culture; D006233:Persons with Disabilities / Q000523:psychology*; D005069:Evaluation Studies as Topic; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D011369:Professional-Patient Relations; D012307:Risk Factors; D012944:Social Support; D013315:Stress, Psychological; D055815:Young Adult
keywords: abuse; child disability; chronic (health) condition; prevention