title: Risk factors for child abuse: levels of knowledge and difficulties in family medicine. A mixed method study.
abstract: BACKGROUND
  Family physicians (FPs) have a central role in the detection and management of child abuse. According to the literature, only 2-5% of initial reports of child abuse come from the medical profession.
  
  
  METHODS
  The objective of this study was to assess levels of knowledge of risk factors for child abuse by Family Physicians (FPs) and the attention that the physicians pay to these risk factors. We conducted a mixed-method survey based on semi-structured interviews. 50 FPs practicing in the Somme County (northern France) were interviewed with closed and open questions. The FPs' level of knowledge of risk factors for child abuse and obstacles in the detection of child abuse were assessed.
  
  
  RESULTS
  The FPs' level of knowledge of risk factors for child abuse was similar to that reported in the literature. However, FPs knew little about the significant role of prematurity. Likewise, the FP's training did not seem to influence their knowledge of risk factors. Fear of an incorrect diagnosis was the main obstacle to reporting a suspected case. The FPs considered that they were often alone in dealing with a difficult situation and considered that the judicial system and the social services were not sufficiently active.
  
  
  CONCLUSIONS
  Few FPs had actually received specific training in the detection and management of child abuse but many stated their need for this type of training. FPs encounter many obstacles in the detection of child abuse, which sometimes make the FP reluctant to report a suspected or potential case. Medical education need to be improved in this field.
authors.affiliation: Medical School, University of PicardyJules Verne, 3 Rue des Louvels, 80000, Amiens, France. regnaut.oceane@chu-amiens.fr.|Forensic and Social Medicine Unit, Amiens University Medical Center, 80054, Amiens Cedex 1, France. regnaut.oceane@chu-amiens.fr.
authors.forename: Océane
authors.initials: O
authors.lastname: Regnaut
authors.affiliation: Medical School, University of PicardyJules Verne, 3 Rue des Louvels, 80000, Amiens, France. marie_steenhouwer@hotmail.com.|Primary Care Department, Jules Verne University of Picardy, 3 Rue des Louvels, 80000, Amiens, France. marie_steenhouwer@hotmail.com.
authors.forename: Marie
authors.initials: M
authors.lastname: Jeu-Steenhouwer
authors.affiliation: Medical School, University of PicardyJules Verne, 3 Rue des Louvels, 80000, Amiens, France. manaouil.cecile@chu-amiens.fr.|Forensic and Social Medicine Unit, Amiens University Medical Center, 80054, Amiens Cedex 1, France. manaouil.cecile@chu-amiens.fr.
authors.forename: Cécile
authors.initials: C
authors.lastname: Manaouil
authors.affiliation: Medical School, University of PicardyJules Verne, 3 Rue des Louvels, 80000, Amiens, France. gignon.maxime@chu-amiens.fr.|Laboratory Educations and Health Practices, EA 3412, University Paris 13, 74, Rue Marcel Cachin, 93017, Bobigny, France. gignon.maxime@chu-amiens.fr.|Health Training Center (SimUSanté©), Amiens University Medical Center, 80054, Amiens Cedex 1, France. gignon.maxime@chu-amiens.fr.
authors.forename: Maxime
authors.initials: M
authors.lastname: Gignon
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002648:Child; D002649:Child Abuse / Q000175:diagnosis* / Q000517:prevention & control; D004502:Education, Medical, Continuing; D005194:Family Practice / Q000941:ethics; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D010821:Physicians, Family / Q000193:education / Q000941:ethics*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D000078329:Workforce