Educators play a crucial role in the detection of child abuse, but there is limited research understanding the role of teachers in responding to maltreatment concerns. The purpose of this dissertation was to utilise three sequential studies, with multiple methodologies, to understand how Canadian educators are situated to detect, respond, and report suspected child abuse. In the first study, a national Canadian database was utilised to compare educator reported cases of child maltreatment to reports from all other professionals. In study two, 245 teachers completed a questionnaire examining their experiences of reporting child abuse, attitudes and beliefs, and perceived barriers and supports in reporting. Lastly, in the third study, semi-structured qualitative interviews were conducted with seven teachers who had recently reported child abuse. In integrating the results from these studies, three conclusions were drawn regarding the role of educators within the child welfare system. These included; 1) Teachers are well-positioned to detect and advocate for the needs of maltreated children; 2) Teachers have a need for greater confidence, and an increased ability to cope with uncertainty, when responding to child abuse; and 3) There is often a mismatch between the goals of teachers in the education system and the perceived response of the child welfare system. Three recommendations were then presented; 1) Educators are a key resource in supporting early detection and intervention initiatives to address child abuse and their role in these initiatives should be further explored; 2) Teachers should be provided with additional strategies to address perceived barriers in reporting child abuse; and 3) Initiatives to promote increased communication between the education and child welfare systems are required. Overall, results supported the unique child-centred perspective of educators in reporting child maltreatment. Study limitations and areas for future research were then discussed.

Educators play a crucial role in the detection of child abuse, but there is limited research understanding the role of teachers in responding to maltreatment concerns. The purpose of this dissertation was to utilise three sequential studies, with multiple methodologies, to understand how Canadian educators are situated to detect, respond, and report suspected child abuse. In the first study, a national Canadian database was utilised to compare educator reported cases of child maltreatment to reports from all other professionals. In study two, 245 teachers completed a questionnaire examining their experiences of reporting child abuse, attitudes and beliefs, and perceived barriers and supports in reporting. Lastly, in the third study, semi-structured qualitative interviews were conducted with seven teachers who had recently reported child abuse. In integrating the results from these studies, three conclusions were drawn regarding the role of educators within the child welfare system. These included; 1) Teachers are well-positioned to detect and advocate for the needs of maltreated children; 2) Teachers have a need for greater confidence, and an increased ability to cope with uncertainty, when responding to child abuse; and 3) There is often a mismatch between the goals of teachers in the education system and the perceived response of the child welfare system. Three recommendations were then presented; 1) Educators are a key resource in supporting early detection and intervention initiatives to address child abuse and their role in these initiatives should be further explored; 2) Teachers should be provided with additional strategies to address perceived barriers in reporting child abuse; and 3) Initiatives to promote increased communication between the education and child welfare systems are required. Overall, results supported the unique child-centred perspective of educators in reporting child maltreatment. Study limitations and areas for future research were then discussed.

The purpose of the study is to examine what effects the law has on principals’ approaches to mandatory reporting of child maltreatment (Social Services Act 14:1§). Moreover, the aim is to study if the regulation gets the impact intended. To respond to the purpose, legal science methods in the form of sociology of law were employed aided by qualitative semi-structured research interviews. The interviews comprised six principals in six different schools in the Stockholm area. The interviews were analyzed based on sociology of law theory, earlier research and relevant regulations in social law. The outcome indicates that principals’ understanding of the intentions behind mandatory reporting of child maltreatment is limited in some aspects. There is a difference between the interviewed principals’ official approaches and how they answer that they apply mandatory reporting in practice. When deciding how to apply the mandatory reporting, the child’s best interest is weighed against the parents’ right not to be reported to the authorities unless there is a real concern in the child. The principals suggest that in situations when a report does not lead to action, the reporting creates a bad relationship between the parents and the school. According to the principals, these situations affect the children and their wellbeing

Bakgrund: Vetskapen om att barn utsätts för övergrepp, kränkningar eller försummelse berör oss människor starkt. Utsatthet är när en vuxen person utsätter ett barn för fysiskt eller psykiskt våld, sexuella övergrepp, kränkningar eller försummar att tillgodose barnets grundläggande behov. Distriktssköterskans roll i barnhälsovården är att minska skadlig påfrestning för barnföräldrar samt att minska hälsoproblem för barnfamiljen och ge stöd och vård till barn och föräldrar. Syftet med studien var att undersöka distriktssköterskans erfarenhet av att arbeta med utsatta barn och deras familjer, samt hur distriktssköterskan stödjer och bemöter familjen. Metod: Åtta distriktssköterskor intervjuades och kvalitativ innehållsanalys med induktiv ansats användes för att analysera data. Resultat: Studien resulterade i tre huvudkategorier samt nio underkategorier. Huvudkategorierna är: Utsatthet utifrån ett distriktssköterskeperspektiv. Distriktssköterskan värnar om familjen. Distriktssköterskans engagemang.  Slutsats: Distriktssköterskors intervention i arbetet med utsatta barn och deras familjer, kan underlättas genom att tydliggöra deras yrkesansvar för relationen till familjerna. Då skapas förutsättning för att familjerna kommer med barnen till BHV, vilket möjliggör att distriktssköterskan kan värna och stödja barnet och familjen. / Background: The knowledge that children are exposed to child abuse or neglect affects humans strongly. Child maltreatment is when an adult exposes a child to physical or mental violence, sexual assault, abuse or neglect, and failure to meet the child´s basic needs. District nurse's role in child health care is to reduce harmful stress on the families with children, and to reduce health problems for families and provide support and care to children and parents. The Aim of this study was to explore district nurses experiences in working with vulnerable children and their families, and how the district nurse support and treat the family. Method: Eight district nurses were interviewed and a qualitative content analysis with inductive approach was used to analyze data. Results: This study results in three main categories and nine sub-categories. The main categories are: Vulnerability from a district nurse perspective. The district nurses protect the family. District nurse's engagement: Conclusion: District nurse's interventions in daily work with vulnerable children and their families, has to be facilitated by clarifying their professional liability of the relationships with families. That will provide the families to come with their children to the child health care, and enable the district nurses to protect and support them.

No description available.

La présente étude vise à vérifier si la forme de maltraitance subie par l’enfant modère les effets d’un programme d’entrainement aux habiletés parentales (PEHP) sur la probabilité de fermeture du dossier de l’enfant et la probabilité que l’enfant fasse l’objet d’un nouveau signalement fondé aux services de protection de la jeunesse (PJ). L’étude porte sur 736 enfants ayant eu un dossier actif aux services de PJ de Montréal entre 2007 et 2015. Le groupe expérimental est composé de tous les enfants dont le parent a participé au PEHP Incredible Years (n=368). Un groupe contrôle a été apparié au groupe expérimental sur la base d’un score de propension. Des régressions de Cox ont révélé qu’à partir du moment où les parents ont participé au PEHP, la probabilité de fermeture du dossier des enfants suivis pour des motifs de négligence augmente davantage que celle des enfants suivis pour des motifs de mauvais traitements psychologiques. La participation au PEHP n’a pas d’effet sur la récurrence de la maltraitance signalée, et ce, peu importe la forme de mauvais traitements subis. Les résultats démontrent que la participation des parents à un PEHP permet d’augmenter la probabilité de fermeture du dossier de leur enfant, et donc, de diminuer les durées de prise en charge en PJ. / Abstract: The study examines whether the form of maltreatment experienced by the child moderates the effects of a parent training program (PTP) on the probability that the child’s case will be closed and that the child will be the subject of a new founded report to child protective services (CPS). This study involved 736 children on whom the Montreal CPS agency had an active file between 2007 and 2015. The experimental group was composed of all children with a parent who participated in the PTP Incredible Years (n=368). A control group was matched with the experimental group based on a propensity score. Cox regression revealed that once parents have participated in the PTP, the probability that their children’s cases will be closed increases more for children being followed because of neglect than for those being followed because of emotional maltreatment. Participating in the PTP has no effect on the recurrence of reported maltreatment, regardless of what form of maltreatment the child has been subjected to. Results show that a parent’s participating in a PTP increases the probability that his or her child’s CPS case will be closed and hence reduces the length of time that the child must receive protective services.

Nonostante il maltrattamento all’infanzia costituisca un’esperienza relazionale patogena, alcuni bambini maltrattati mostrano un itinerario di sviluppo resiliente. La tesi si focalizza sul possibile ruolo giocato da meaning-making e mindfulness skills nel funzionamento resiliente. Il primo obiettivo è stato esplorare la relazione tra meaning-making, mindfulness skills e benessere in bambini non maltrattati. Il secondo obiettivo è stato valutare meaning-making e mindfulness skills in minori maltrattati, per determinare se il funzionamento resiliente fosse in relazione con questi costrutti. Il terzo obiettivo è stato creare un intervento per minori maltrattati ospitati in comunità (MBYR), testandone la fattibilità. Lo studio 1 ha esplorato il meaning-making in bambini non maltrattati, non evidenziando alcuna relazione con le loro competenze e difficoltà. Lo studio 2 ha mostrato che le mindfulness skills correlavano negativamente con outcome avversi, ma positivamente con le competenze dei bambini. Lo studio 3 ha esplorato la relazione tra funzionamento resiliente, meaning-making e mindfulness skills in minori maltratti, evidenziando che il meaning-making era legato a livelli più bassi di qualità della vita, mentre le mindfulness skills erano in relazione con il funzionamento resiliente. Questi risultati hanno informato il razionale dell’MBYR, che ha significativamente ridotto i sintomi traumatici, aumentando mindfulness skills e competenze generali (studio 4). / Child maltreatment is a pathogenic relational experience representing one of the most difficult challenges to children’s healthy adaptation; nonetheless, some maltreated children develop resiliently. The thesis focuses on the possible role played by meaning-making and mindfulness skills in resilient functioning. The first aim was to investigate the relation between meaning-making, mindfulness skills, and wellbeing in nonmaltreated children. The second aim was to explore meaning-making and mindfulness skills in maltreated children and adolescents, to determine whether resilient functioning was related to these constructs. Finally, the third aim was to design an intervention for maltreated youths in residential care (MBYR) and to test its feasibility. Study 1 explored meaning-making in nonmaltreated children, showing that it was not related to their competencies and difficulties. Study 2 highlighted that mindfulness skills were negatively related to adverse outcomes and positively related to children’s competencies. Study 3 explored the relation between different domains of resilient functioning, meaning-making, and mindfulness skills in maltreated youths, showing that meaning-making was related to lower levels of quality of life, whereas mindfulness skills were related to resilient functioning. These results informed the rationale for the MBYR, which significantly reduced traumatic symptoms while enhancing mindfulness skills and general competencies (study 4).

Bakgrund: Barn som far illa är ett omfattande problem och bidrar till allvarliga konsekvenser för barnet. Barnhälsovårdssjuksköterskor är många gånger de enda utanför familjen som träffar barn under sex år regelbundet och har därför en viktig roll i att uppmärksamma barn som far illa eller riskerar att fara illa. Samverkan mellan professionella är viktigt i situationer där barn misstänks fara illa, tidigare studier har dock visat att det finns brister i samverkan. Syfte: Syftet med studien är att beskriva barnhälsovårdssjuksköterskors erfarenheter av samverkan mellan professionella vid misstanke om att ett barn far illa. Metod: En kvalitativ metod med en induktiv ansats tillämpades i studien. Data samlades in genom semistrukturerade intervjuer. Åtta barnhälsovårdssjuksköterskorintervjuades. Det insamlade materialet analyserades utifrån en kvalitativinnehållsanalys. Resultat: Analysen resulterade i två kategorier och sex subkategorier. Kategorin ”Välfungerande samverkan för barnets bästa” beskrev att samverkan var betydelsefullt i det förebyggande arbetet. Det var viktigt att få råd och stöd av kollegor och andra professioner. I arbetet användes flerpartssamtal för att tillvaratapå andra professioners kunskaper. Kategorin ”Hinder för samverkan” beskrev attbristen av återkoppling från socialtjänsten upplevdes som ett problem. Vidare beskrevs att avsaknad av resurser påverkade samverkan negativt. Ytterligare hinder för samverkan var då barnhälsovårdssjuksköterskorna och andra professioner saknade gemensamma mål.  Slutsats: Samverkan är extra viktig i det förebyggande arbetet, men det finns behov av utveckling. Barnhälsovårdssjuksköterskorna efterfrågar gemensamma mål för samverkande professioner. Hinder för samverkan är avsaknad av återkoppling och bristande resurser / Background: Child maltreatment is a major problem and contribute to serious consequences for the child. Child health care nurses are often the only ones outside the family who meet children under the age of six regularly and that’s why they have an important role to notice child maltreatment. In situations where children are victims of child maltreatment, is collaboration between professionals important.Previous studies have shown that there are obstacles in the interaction between professionals. Aim: The aim of the study is to describe child health care nurses’ experiences of collaboration between professionals in case of child maltreatment. Method: A qualitative method with an inductive approach was used for the study. Data was collected through semi-structured interviews. Eight child health carenurses were interviewed. The collected material was analyzed based on a qualitative content analysis. Findings: The analysis resulted in two categories and six subcategories. The category “Well-functioning collaboration for the best interests of the child”described that collaboration was important in the preventive work. It was important to get advice and support from colleagues and other professionals. Multi-party conversations were used to apply other professionals’ knowledge. The category “Obstacles for collaboration” described that the lack of feedback from social services was experienced as a problem. It was further described that a lack of resources had a negative effect on collaboration. Additional obstacles for collaboration were when the child health care nurses and other professionals didn´thave common goals.  Conclusion: Collaboration is considered especially important in the preventive work, but there is a need for development. The child health care nurses demand common goals for collaborating professionals. Barriers to collaboration are a lack of feedback and a lack of resources.

The aim of the study was to examine what obstacles and possibilities nurses at the Swedish child health services (CHS) experience in collaborating with social services when suspecting child maltreatment. Empirical data was collected through interviews with three CHS nurses and analyzed with a phenomenological approach. The theoretical perspectives used are Luhmann’s systems theory and domain theory. The results show that the nurses interviewed in this study consider themselves having good opportunities of detecting signs of child maltreatment and that they wanted more cooperation with the social services. Theoretical concepts of systemic and environmental complexity address organizational factors that affect collaboration. How collaboration between the CHS and the social services could be improved are discussed. / Studien syftade till att undersöka vilka hinder och möjligheter BVC-sköterskor upplever i samverkan med socialtjänsten vid misstanke om att ett barn far illa. Studiens teoretiska utgångspunkter är systemteori, specifikt Luhmanns teorier om sociala system, och domänteori. En fenomenologisk ansats har använts vid datainsamlingen och analys av det empiriska materialet, som består av kvalitativa intervjuer med tre BVC-sköterskor. Resultatet visar bland annat att de intervjuade sköterskorna upplever sig ha goda möjligheter att upptäcka missförhållanden i barnets situation och att de önskar mer samverkan med socialtjänsten. Med hjälp av de teoretiska begreppen system- och miljökomplexitet belyses hur betingelser inom och mellan organisationerna påverkar samverkan. Förbättringsmöjligheter angående samverkan mellan BVC och socialtjänsten diskuteras.

Bakgrund: Barnsjuksköterskor omfattas av anmälningsskyldighet redan vid misstanke om ett barn far illa. Risk finns för att etiska svårigheter kan förhindra eller påverka beslutet om en orosanmälan. Forskning inom ämnet visar att illafarande hos barn kan leda till psykisk och fysisk ohälsa och i värsta fall död. För att dessa barn skall få tillgång till stöd samt för att förstå varför underrapporteringar av orosanmälningar föreligger är det betydelsefullt att förstå vad som påverkar barnsjuksköterskan i beslutsprocessen.  Syfte: Syftet var att beskriva barnsjuksköterskans erfarenheter av beslutsprocessen kring orosanmälan vid misstanke om barn som far illa. Metod: Kvalitativ metod med induktiv ansats tillämpades. Barnsjuksköterskor från öppenvård och slutenvård valdes genom bekvämlighetsurval och semistrukturerade intervjuer genomfördes. Antal år inom professionen varierade och arbetsplatserna gav en geografisk spridning över hela Sverige. Kvalitativ innehållsanalys genomfördes enligt Elo och Kyngnäs. Resultat: I resultatet framkom tre generiska kategorier: Att känna osäkerhet i beslutsprocessen, Behov av stöd i beslutsprocessen samt Orosanmälans påverkan på vårdrelationen. Barnsjuksköterskornas erfarenheter av att göra en orosanmälan visade att det kunde vara ett svårt beslut. Känslor av osäkerhet och rädsla för eventuell framtida påverkan på vårdrelationen eller barnsjuksköterskans eget privatliv var något som försvårade beslutsprocessen. Slutsats: Barnsjuksköterskorna beskrev anmälningsplikten som diffus, vilket gav rum för egen tolkning. Därför är det viktigt att utbildning och tydliga riktlinjer tillhandahålls.