The Child Abuse Committee at the University of Oregon Medical School has assumed a coordinating role as an attempt to provide more effective service to abused children and their families. This research report is a follow up to a 1970 study by Matusak which evaluated the effectiveness of the Committee. The Matusak study seemed to indicate that, because of Committee action resulting in appropriate intervention and services, definite improvement in the situation of the children in the study was seen. This study follows the children from the 1970 study one year later and makes further comparisons of child abuse cases seen at the hospital in 1971. The results of this study fail to support the Matusak findings. A decreased percentage of children in the 1970 study group have maintained their level of improvement one year later and an even lower percentage of the 1971 study group are improved. More children have been left in their own homes than in 1970 but there is little to indicate that the family functions any more adequately than at the time of abuse. The findings seem to reflect a need for reevaluation of management and treatment practices in child abuse cases. It appears that responsibility and authority for coordination should be placed with a single agency and that more specialized services be provided by experienced staff.

Indiana University-Purdue University Indianapolis (IUPUI) / Child abuse remains a serious health problem in the U.S. Yet, there are preventative programs that can significantly improve the parenting experienced by very young children and result in lower incidence of maltreatment. Home visitation is the most prevalent and successful form of primary prevention. These programs are staffed by home visitors who empower parents and are the lynchpin of home visitation programs. What makes some home visitors excel at this work is the focus of this research. A small, non-random, purposive sample of excellent home visitors and their administrators was used to learn about the personal characteristics of outstanding home visitors. The mixed methods design of this research included qualitative interviews, home visiting situational vignettes, and quantitative tests of personality attributes. The results indicated that this group of outstanding home visitors possessed important similarities. First, the home visitors were effective at forming and maintaining empathic relationships. The variables that facilitate the formation of the therapeutic relationships between home visitor and client include: (a) “good enough empathy” (need not be extraordinarily empathic but at least averagely so), (b) positive regard (showing respect to the families and recognizing that the parent is the expert on their child), and (c) congruence. Secondly, the home visitors possessed self-awareness allowing for reflective practice and forming and maintaining better client relationships. Thirdly, the excellent home visitors possessed an attitude of lifelong learning. Fourthly, the home visitors strongly believed in the ability of their clients to change. This was accomplished by focusing on client strengths. Finally, in order for the home visitors to assist parents in therapeutic change, they had a belief in and understanding of systems theory and the impact that the environment can or has had on those clients. Without an ecological approach, home visitors are likely to blame the families with which they work for their unfortunate situations such as poverty. Each of the five characteristics can be taught and improved, but entrenched beliefs are less easily manipulated. The five characteristics are ordered with the first (effective at forming relationships) the most amenable to change and the last (an ecological approach) the least.

Childhood abuse, whether physical or sexual, is a major public health issue. The most recent United States data from Child Protective Services (CPS) show that in 2013 there were 3.5 million referrals of child maltreatment involving 6.4 million children. Out of these cases, 18% were for physical abuse and 9% were for sexual abuse. However, researchers argue that CPS data grossly underestimate the prevalence of childhood abuse as most childhood abuse goes unreported. Indeed, to date, the true prevalence of childhood abuse remains unknown as research has been hampered by inconsistent definitions of abuse and wide variation in methodologies including measures for its identification and modes of administration of these measures. Although a health care visit presents an opportunity to identify a childhood abuse history, health care providers frequently fail to ask about it. The reasons doctors give for not asking about abuse include lack of training, not knowing how to ask, and lack of familiarity with practical methods for screening that can be used in primary care settings. There is little to no research on effective means for identifying childhood abuse histories, especially in the adolescent and young adult population, or on how different modes of administration of screens to identify childhood abuse compare to each other. The net result is that most childhood physical and sexual abuse is never identified and many victims do not get the needed services to help them heal. When unaddressed, childhood abuse has negative impacts on victims’ health and wellbeing over the life course. Prior studies of adults show that when compared with non-victims of abuse, victims tend to perceive their health as poorer and utilize more health care services including emergency room and urgent outpatient care. These studies also suggest that adult victims use less routine and preventive care than non-victims. Only two studies, conducted among widely different adolescent populations, have examined how adolescent victims perceive their health. Similarly, limited evidence examining perception of health is available for young adults. These studies found that victims perceive their health as poorer than non-victims. There have been no adolescent-specific studies of how victimization impacts adolescents’ utilization of health care. One study includes participants ages 15 to 98 years and only two studies focusing on this issue in samples primarily of young adults attending college have been published. These studies found that victims utilize more health care than non-victims. Therefore, we lack a sufficient body of evidence to come to clear conclusions of how childhood abuse affects self-perceived health in adolescents and young adults. The general lack of evidence about both how childhood abuse impacts perception of health and utilization of health care in adolescents and young adults indicates a need for further study. Given that little is known about how to best identify an abuse history in adolescents and young adults and the impact of abuse on perception of health and utilization of health care, this dissertation pursued three aims: (1) to review the literature comparing modes of administration of screens to identify adolescent and young adult victims of childhood physical and sexual abuse; (2) to investigate how different modes of administration of screens to identify adolescent and young adult victims of childhood physical abuse within a primary care health setting compare to each other, and; (3) to examine the association of a history of childhood abuse (defined as none, physical only, and sexual with or without physical) with perceived health status and the health care utilization patterns among adolescents and young adults. For aim 1, a comprehensive literature review was conducted via PubMed of studies, published between January 1st, 1994 and December 31st, 2014 that compared modes of administration of screens to identify a history of childhood physical and sexual abuse in adolescents and young adults. Only one study was found. This study compared paper and pencil questionnaire, computer assisted survey, and face to face structured interview in the identification of childhood physical and sexual abuse among young adults in a college setting. No significant difference in the proportion of childhood physical abuse or childhood sexual abuse was identified by mode of administration. The identification through this search of only one study – which was conducted among college students, with no studies done among adolescents – shows a significant gap in our knowledge regarding this issue. Given that understanding how to identify childhood abuse is a critical issue, this gap is disturbing and underscores the need for studies of identification of childhood abuse to be a research priority. For aim 2, a sample of participants, ages 12-24 years, receiving health services at the Mount Sinai Adolescent Health Center in New York City were randomized to one of four modes of administration to identify a history of childhood physical abuse. The four modes of administration of screens to identify childhood abuse were paper and pencil screen, Audio Computer Assisted Self Interview screen (ACASI), face to face structured screen and face to face unstructured interview. The full sample also completed measures to assess demographic characteristics and to screen for depression symptoms. Of the sample, 44.5% of the participants disclosed childhood physical abuse. There was a statistically significant difference in the proportion of childhood physical abuse identified according to mode of administration: face to face unstructured interview identified the highest proportion of childhood physical abuse victims, followed by face to face structured screen. After adjusting for age, gender, race/ethnicity, depression, living arrangement and last grade completed, the odds of identifying physical abuse was 1.6 (95%CI: 1.0, 2.7) and 4.5 (95%CI: 2.6, 7.8) greater for face to face structured screen and for face to face unstructured interview, respectively as compared to paper and pencil screen. ACASI and paper and pencil were similar to each other but inferior to the face to face methods. For aim 3, in addition to what was measured for aim 2, the sample completed measures on a history of childhood sexual abuse and perceived health and health care utilization. The sample was then categorized into three groups: no abuse, physical abuse only, and sexual abuse with or without physical abuse. The association of childhood abuse status with perceived health and health care utilization were examined. There was no statistical significant association between a history of childhood abuse status and perceived health. However, the odds of reporting a fair/poor perception of health among those reporting childhood abuse were at least 40% lower regardless of whether the abuse was physical (OR: 0.60; 95%CI: 0.3,1.2) or sexual (OR: 0.50; 95%CI: 0.2,1.1). No significant association was found between childhood abuse status and health care utilization. However, the odds of victims reporting using urgent care only versus routine care only were at least 10% lower regardless of whether the abuse was physical (OR: 0.50; 95%CI: 0.3, 1.1) or sexual (OR: 0.90; 95%CI: 0.4,1.9). The odds of reporting using both urgent and routine care versus routine care only was similar between victims and non-victims for physical abuse (OR: 1.0; 95%CI: 0.6, 1.5) and was 30% higher for victims of sexual abuse (OR: 1.3; 95%CI: 0.8, 2.2). The findings from the three aims examined identified significant gaps in our knowledge on childhood abuse among adolescents and young adults suggesting an urgent need for further research. While much research has focused on the impact of childhood abuse on health and well-being, aim 1 reveals that little is known about which mode of administration of screens to identify childhood abuse is most effective in the identification of childhood abuse in adolescent and young adults. Furthermore, we know even less about what modes of administration of screens might be practical in primary care settings, or what must be done to improve the level of screening for childhood abuse by physicians and other health care providers. Although the findings from aim 2 suggest that face to face modes of administration are most effective in screening for childhood physical abuse in primary care settings, further studies are needed to support these findings. In addition, there is a need for studies that examine what are the best methods to use to identify childhood sexual abuse in primary care settings. The findings from aim 3 suggest that adolescents and young adults with a history of childhood physical and sexual abuse, receiving health care at the Mount Sinai Adolescent Health Center, do not perceive their health as worse than non-victims nor do they appear to utilize health care differently from non-victims. These findings contrast with results from prior studies of perceived health status and health care utilization among adolescents and young adult childhood abuse victims. Understanding how abuse impacts both the perception of health and health care utilization will be crucial in the development of interventions to identify and support adolescent and young adult victims of childhood physical and sexual abuse.

Child abuse and neglect has been an historical problem which has only entered our consciousness as legislation to protect children has been passed. Public and media awareness has mushroomed along with the number of disclosures and increasingly dramatic stories of abuse and neglect. Nurses, because of their many different places of practise, come in contact with many victims and offenders. How does their education prepare them for this task? The study surveyed of schools of nursing in British Columbia and the state of Washington through the directors of nursing, associate deans, deans and coordinators, to instructors and faculty members who teach child abuse and neglect education. Instructors and faculty members completed a questionnaire of 23 questions about child abuse and neglect education in their schools of nursing and about their own educational preparation and experience. The questionnaire was expanded from a similar study done in 1985-86. Not all schools of nursing have child abuse and neglect education. Of those indicating they teach child abuse and neglect, most devote 2-4 hours to teaching. Child abuse and neglect education is taught in a wide variety of nursing subject areas. There are fewer resources (both personnel and print and media) being used in teaching child abuse and neglect in 1993 than in 1985-86. The majority of faculty members and instructors were not educated in the province or state in which they now teach and also the majority did not receive child abuse and neglect education during their baccalaureate education. Instructors and faculty members from Washington had more suggestions for improving child abuse and neglect education than did those from British Columbia. Education about reporting child abuse and nursing and sexually transmitted diseases is inconsistent. There is very little child abuse and neglect interprofessional education. While the diversification of nurses' job placements makes them ideal professionals to identify, prevent, and treat child abuse and neglect, their educational preparation does not appear adequate for this task.

Thesis (Ph. D.)--University of Texas at Austin, 2006. / Vita. Includes bibliographical references.

Child abuse and neglect has been an historical problem which has only entered our consciousness as legislation to protect children has been passed. Public and media awareness has mushroomed along with the number of disclosures and increasingly dramatic stories of abuse and neglect. Nurses, because of their many different places of practise, come in contact with many victims and offenders. How does their education prepare them for this task? The study surveyed of schools of nursing in British Columbia and the state of Washington through the directors of nursing, associate deans, deans and coordinators, to instructors and faculty members who teach child abuse and neglect education. Instructors and faculty members completed a questionnaire of 23 questions about child abuse and neglect education in their schools of nursing and about their own educational preparation and experience. The questionnaire was expanded from a similar study done in 1985-86. Not all schools of nursing have child abuse and neglect education. Of those indicating they teach child abuse and neglect, most devote 2-4 hours to teaching. Child abuse and neglect education is taught in a wide variety of nursing subject areas. There are fewer resources (both personnel and print and media) being used in teaching child abuse and neglect in 1993 than in 1985-86. The majority of faculty members and instructors were not educated in the province or state in which they now teach and also the majority did not receive child abuse and neglect education during their baccalaureate education. Instructors and faculty members from Washington had more suggestions for improving child abuse and neglect education than did those from British Columbia. Education about reporting child abuse and nursing and sexually transmitted diseases is inconsistent. There is very little child abuse and neglect interprofessional education. While the diversification of nurses' job placements makes them ideal professionals to identify, prevent, and treat child abuse and neglect, their educational preparation does not appear adequate for this task. / Education, Faculty of / Curriculum and Pedagogy (EDCP), Department of / Graduate

文玉清. / 論文(哲學博士)--香港中文大學, 2004. / 附參考文獻. / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts also in English. / Wen Yuqing. / Lun wen (Zhe xue bo shi)--Xianggang Zhong wen da xue, 2004. / Fu can kao wen xian.

Thesis (Ph.D. (Adult Education)) -- University of Limpopo, 2013 / The sexual abuse of children seems to be a worldwide community-based problem. In any attempts to address this problem, community participation is crucial. The study, which was conducted in the Vhembe district of the Limpopo province of South Africa, focused on the factors that contribute to child sexual abuse in this area. The aims of the study were to encourage community participation in the reduction of child sexual abuse and to educate the community on child sexual abuse in order to improve the quality of life of the community members. The study adopted a participatory action research approach utilising a qualitative technique to collect the data. Interviews were conducted with educators, nurses, social workers, traditional leaders, church leaders, members of the civic organisation, policing staff and the Victim Empowerment Group. A data matrix was used to analyse the data. Community education was found to be the most successful way of addressing child sexual abuse. According to the responses of all target groups, community participation is imperative to reduce the incidence of child sexual abuse. All target groups seemed to be aware of the problem and ready to work together to reduce the prevalence of child sexual abuse. It is recommended that community education programmes be organised by each particular community to address any community-based problems such as child sexual abuse. Some of the recommendations in this study could help the community to become involved in the fight against child sexual abuse. The research indicated that educational programmes bring about greater change in the behaviour and beliefs of a community if the programmes allow the participants to articulate and examine their personal values and beliefs concerning the sexual abuse of children. In the study, participants themselves demonstrated strategies to encourage community members to become involved in the reduction of child sexual abuse. The participants developed a positive attitude towards the reduction of child sexual abuse. They appeared to believe in community education programmes and were committed and willing to support such initiatives. By the end of the project, participants were empowered to fight against child sexual abuse

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