Made available in DSpace on 2015-03-05T19:36:36Z (GMT). No. of bitstreams: 0 Previous issue date: 31 / Nenhuma / O foco desse estudo foi a psicoterapia de crianças que sofreram maus-tratos, especificamente no que se refere à possibilidade de desenvolvimento da função reflexiva e da capacidade de mentalização durante o processo de intervenção. A função reflexiva e a capacidade de mentalização são conceitos que vêm sendo elaborados com base na vertente psicanalítica da teoria do apego, nas contribuições de alguns teóricos das relações objetais, especialmente Bion e Winnicott e na Psicologia Cognitiva. Baseado na abordagem qualitativa de pesquisa, esse estudo foi pautado pelo método clínico. O procedimento adotado foi o Estudo de Casos Múltiplos, que permite a investigação sistemática e tão exaustiva quanto possível de casos individuais. Os participantes foram duas meninas de classe média baixa de 10 e 12 anos de idade e seus pais ou cuidadores. Eles foram atendidos na clínica-escola de uma universidade da Região Sul do Brasil, e apresentavam história de vivência de alguma forma de maus-tratos. Os procedimentos para coleta

Barn kan ha det svårt och fara illa på olika sätt i sina familjer. När dessa barn kommer till vården finns det en risk att hälso- och sjukvårdspersonal saknar kunskaper och riktlinjer om hur de ska upptäcka och ta hand om sådana barn. Därför kan det vara av vikt att beskriva hur en distriktssköterska kan identifiera barn som far illa för att barn som far illa ska kunna upptäckas i tid samt att hjälpinsatser sätts in så tidigt som möjligt för att kunna öka dessa barns välbefinnande och minska deras lidande. Vår frågeställning var: vilka metoder finns det för att kunna upptäcka ett utsatt barn? Syftet med studien är att beskriva hur distriktssköterskan kan arbeta för att identifiera barn som far illa.Studien är en litteraturstudie där nio vetenskapliga artiklar analyserats enligt Friberg (2006). Resultatet beskrivs i tre huvudkategorier: Ökad kunskap, Dokumentationens betydelse och Ökad medvetenhet om problemet. Första kategorin beskrivs med tre underkategorier: att genomgå fortbildning, att få handledning och att samverka, andra kategorin har inga underkategorier och den tredje kategorin beskrivs med fyra underkategorier: att träna att våga se problemet, att ha helhetssyn på familjen, att lära känna familjen och att känna igen tecken. Resultatet visar på olika metoder som distriktssköterskan kan använda sig av för att identifiera barn som far illa samt att distriktssköterskor upplever stor osäkerhet i mötet med ett barn som far illa och dess familj. Det finns en brist på medvetande om problemet och behov av mer utbildning och klara rutiner inom detta område. De metoder och det resultat som den här studien visar skulle det kunna bidra till att barn som far illa skulle kunna upptäckas i tid samt att hjälpinsatser sätts in så tidigt som möjligt för att kunna öka dessa barns välbefinnande och minska deras lidande. / Program: Specialistsjuksköterskeutbildning med inriktning mot distriktssköterska

I samhället finns flera lagar och föreskrifter för att garantera barn trygga uppväxtvillkor. Trots regelverk kan konstateras en ökning vad gäller barn som far illa. Avgörande för efterlevnaden av fastlagda bestämmelser är bland annat distriktssköterskans, inom barnhälsovården, möjligheter till att uppmärksamma signaler kring barns situation samt att vid behov vidta adekvata åtgärder. Det finns dock flera faktorer som kan vara avgörande för distriktssköterskans ställningstagande. Syftet med studien är att beskriva faktorer som påverkar distriktssköterskans beslut om en anmälan till socialtjänsten om att ett barn far illa. Sammanlagt åtta distriktssköterskor inom BVC-verksamhet i Västra Götalandsregionen har intervjuats. Studien har en kvalitativ inriktning. Materialet har analyserats induktivt med kvalitativ innehållsanalys som metod. Resultatet visar flertalet faktorer som påverkar distriktssköterskans beslut om en anmälan till socialtjänsten på olika sätt. Ett bra samspel med familjen underlättar distriktssköterskans beslut, behov finns dock av möjligheter till stöd på olika sätt från tillgängliga resurser för att underlätta i processen. Samverkan med socialtjänsten ser olika ut men överlag önskar distriktssköterskorna att samarbetet mellan parterna förbättras för att minska de faktorer som försvårar. Distriktssköterskorna ser yrkeserfarenhet som en underlättande faktor. I studien framkommer också svårigheten i att både vara professionell och samtidigt människa som påverkas känslomässigt i svåra situationer. Samtliga faktorer diskuteras i relation till varandra och i relation till studiens syfte. Resultatet kan användas för att öka distriktssköterskans medvetenhet om vad som kan påverka ett beslut om en anmälan kring utsatta barn vilket i sin tur bidrar till bättre förutsättningar för barn i det fortsatta livet. / Program: Specialistsjuksköterskeutbildning med inriktning mot distriktssköterska

Background: Child maltreatment has since 1979 been a punishable crime according to Swedish law but is still occurring in society today. All sorts of physical, psychological, sexual violence, neglect and exploitation of an individual under 18 years old was qualified as child maltreatment. Previous research has found an insecurity among nurses when they met children exposed to maltreatment. Nurses can encounter these children and are obligated through duty to notify and report when they suspect child maltreatment. Aim: The aim of this study was to illustrate nurses´ experiences of suspected child maltreatment or child maltreatment. Method: A literature review was conducted with a qualitative approach. Ten qualitative studies from Cinahl and Pubmed was reviewed for quality assurance and analyzed by Friberg's five-step analysis. Result: The analyze of the study resulted in three themes and eight subthemes. The first theme, Complex meetings, was about experiences in being a professional and challenges in the meeting. The second theme, Complicated assignments, described how nurse's experienced to assess the child's situation, to make a report and the cooperation with authorities. The third and last theme, Inhibitory and promotional activities, exposed the nurse's view on receiving support and education and the support for children and parents. Conclusion: Nurses experienced that it was important to be available and to build a relation with the child so the child could feel safe to tell about the mistreatment. It has also been shown that the nurse experienced complex emotions in the meeting with both the child and the parents and that it was not always clear to the nurse when to report child maltreatment. There was a need for more information and education for the nurse within the topic of child maltreatment. Also, the nurse experienced a need for better cooperation with the authorities that oversees cases of child maltreatment. / Att komma i kontakt med barn som far illa är något som alla sjuksköterskor kan komma att göra. Detta är en litteraturbaserad studie med analys av kvalitativa artiklar som visar att det utifrån flera perspektiv är både svårt och komplext. Denna studies resultat visar att sjuksköterskor upplever att det finns både viktiga och svåra delar i mötet och att det kan vara svårt att vara professionell, även om det eftersträvas. Det upplevs som att det finns faktorer som både kan underlätta och försvåra en bedömning och likaså som påverkar om sjuksköterskan utfärdar en anmälan. Att göra en anmälan har en känslomässig påverkan på sjuksköterskan och samverkan med myndigheter upplevs som svår och bristande. Sjuksköterskan har erfarenheter av att stödet är otillräckligt och upplever att de vill ha mer support från både kollegor och professionellt stöd. För att kunna känna sig mer trygga inför dessa situationer önskar de få mer utbildning kring barn som far illa. Sjuksköterskan ser också att det finns ett stödbehov hos familjerna och barnen. Att kunna ge stöd upplevs viktigt men ibland svårt om familjen inte vill ta emot det eller när åtgärder riskerade att bryta barnets förtroende för sjuksköterskan. Verksamheter och supportgrupper upplevs vara ett bra stöd och att samarbete med skola kan underlätta för barnet.

Background: The number of children abused in Sweden has increased in last years. All children have the right to live a safe life and receive a good development during their upbringing. It is important that the child's basic needs are met for the child to have a good development. Being a victim of child abuse can lead to enormous consequences in the future for the child's physical and mental health. Aim: This study aimed to illuminate the nurse's experiences in suspected child maltreatment Method: A literature study based on analysis of qualitative studies according to Friberg´s five step model. Results: The results of the studies showed that responding and helping children who live in child abuse was a difficult task for the nurses to perform. The nurses were aware of their obligation to maintain the child's safety. The nurses described the basis of their experience that they encountered personal and work-related obstacles to be able to identify, remedy and report when children were suspected of being abused. The result is presented under three themes. The first theme highlights how nurses are emotionally affected. The second theme is about experiences about collaboration with other authorities. The third theme describes the nurses' need for professional development. Conclusion: The nurses should be able to give the child the right care to ensure the safety of the child and be able to give advice to the child's family. A prerequisite for providing adequate nursing needs nurses have good health science knowledge. / Antalet barn som far illa i Sverige ökar. Sjuksköterskor har skyldighet att anmäla vid misstanke om barn som far illa. Forskning visar att barn som far illa väljer att inte berätta för en vuxen eller en professionell person om misshandeln. Forskning visar även att sjuksköterskans beteende kan hindra eller stimulera patientens delaktighet samt att vårdkultur kan bidra till ett vårdlidande. Konsekvensen av att leva med utsatthet som barn kan resultera i fysisk och psykisk ohälsa senare i livet. Resultat av denna litteraturstudie baseras på sammanställning av nio kvalitativa studier. Resultatet visar att sjuksköterskornas emotionella påverkan har sin inflytande på arbetet. Sjuksköterskorna förstår sitt ansvar att reagera och hjälpa det utsatta barnet, för att sjuksköterskorna ska kunna utöva sitt ansvar krävs det en fungerande samverkan med andra verksamheter. Sjuksköterskorna upplever frustration över bristande samverkan med andra vårdenheter och myndigheter. Sjuksköterskorna uttrycker även ett behov av mer kunskap och professionell utveckling samt tydliga rutiner för att kunna upptäcka varningstecken och därefter kunna vidta relevanta åtgärder i syfte att barnets säkerhet säkerställas i god tid. Slutsatsen av detta examensarbete är att sjuksköterskorna stöter på hinder under processen att hjälpa barn och deras familj. För att sjuksköterskorna ska kunna tidigt upptäcka och vidta rätta åtgärder vid misstanke om barn som far illa krävs det förutsättningar för sjuksköterskorna att utveckla sin kunskap, en fungerande samverkan med alla berörda, samt rätt stöd för att bearbeta den emotionella påverkan som uppstår.

Submitted by PPG Medicina e Ci?ncias da Sa?de (medicina-pg@pucrs.br) on 2018-12-04T19:14:23Z No. of bitstreams: 1 RAFAEL_MORENO_FERRO_DE_ARAUJO.pdf: 2490432 bytes, checksum: 00a75e2fcaf58b1136209930cfb617bf (MD5) / Approved for entry into archive by Sheila Dias (sheila.dias@pucrs.br) on 2018-12-06T11:50:19Z (GMT) No. of bitstreams: 1 RAFAEL_MORENO_FERRO_DE_ARAUJO.pdf: 2490432 bytes, checksum: 00a75e2fcaf58b1136209930cfb617bf (MD5) / Made available in DSpace on 2018-12-06T11:56:09Z (GMT). No. of bitstreams: 1 RAFAEL_MORENO_FERRO_DE_ARAUJO.pdf: 2490432 bytes, checksum: 00a75e2fcaf58b1136209930cfb617bf (MD5) Previous issue date: 2018-08-07 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Os maus-tratos infantis (abuso e neglig?ncia) s?o considerados como problemas de sa?de p?blica globais, com graves consequ?ncias para a sa?de mental de quem sofre. A maioria dos estudos sobre abuso n?o faz distin??o entre os diferentes tipos de puni??o f?sica (abuso f?sico, palmadas), a intera??o com os outros tipos de abuso (emocional e sexual), se a crian?a sabia sobre o motivo por estarem sendo punidas, ou o impacto subjetivo a longo prazo na vida de quem sofreu algum tipo de abuso. O objetivo deste estudo ? descrever o impacto subjetivo na idade adulta do abuso ocorrido na inf?ncia e/ou na adolesc?ncia, analisar a associa??o de experi?ncias abusivas na inf?ncia e/o na adolesc?ncia com o uso de medica??es psicotr?picas ao longo da vida. Para este fim, analisamos os dados de uma grande pesquisa an?nima on-line (BRAINSTEP, Brazilian Internet Study on Temperament and Psychopathology). Para avaliar a hist?ria de abuso sexual, f?sico e emocional na inf?ncia e/ou adolesc?ncia, utilizamos o QUESI (Question?rio Sobre Traumas na Inf?ncia). Para aqueles que n?o sofreram abusos f?sicos com objetos, perguntamos sobre frequ?ncia de palmadas. Al?m disso, para aqueles que reportaram algum tipo de puni??o f?sica (com objetos ou palmadas), avaliamos se ele sabia o motivo da puni??o. O impacto subjetivo foi avaliado em todos os participantes que sofreram algum tipo de abuso. O desfecho foi avaliado, o uso de medica??es psicotr?picas ao longo da vida. Encontramos que o abuso emocional e sexual estava associado a um impacto subjetivo negativo, independentemente da intensidade. Por sua vez, a puni??o f?sica nem sempre esteve associada a um impacto subjetivo negativo, sendo que foi maior para aqueles indiv?duos que n?o sabiam o motivo da puni??o. O abuso emocional mostrou a maior associa??o com o uso de medica??es psiqui?tricas ao longo da vida. Os participantes que reportaram um impacto subjetivo positivo da puni??o f?sica utilizaram menos frequentemente medica??es psiqui?tricas ao longo da vida. Esses achados sugerem que os mecanismos, que associam abuso a consequ?ncias negativas, s?o mais complexos do que os descritos anteriormente; seu impacto subjetivo e a coocorr?ncia de abuso emocional tamb?m devem ser levados em considera??o. / Child maltreatment (abuse and neglect) is a global public health problem, with serious consequences to the mental health of those who suffer it. Most studies on abuse have not accounted for the different types of physical punishment (physical abuse, spanking), the interaction between different types of abuse (emotional and sexual), awareness of the children on the motivation for being punished, or their long-term subjective impact in the life of those abused. This study aim is to describe the subjective impact in adulthood of abuse occurred in childhood and adolescence, and to analyze the association of abuse experiences in childhood and adolescence, and the use of psychoactive medication as adults. We analyzed data from a large and anonymous online survey (BRAINSTEP). To assess the history of childhood sexual, physical and emotional abuse, we used the CTQ (Childhood Trauma Questionnaire). For those who did not suffer physical abuse from objects, we asked about spanking frequency. Also, for those with any physical punishment history, we assessed if he/she knew the reason for being punished. The subjective impact was assessed in all participants that suffered any abuse. The outcome was assessed, inquiring on their lifetime psychiatric medication use. We found that emotional and sexual abuse were associated with a negative subjective impact, regardless of intensity. In turn, physical punishment not always was associated with a negative subjective impact, and this was greater for those individuals that did not know the reason for being punished. Emotional abuse showed the highest association with increased psychiatric medication use. Subjects that stated a positive subjective impact from physical punishment used less psychiatric medication. These findings suggest that the mechanisms, which associate abuse to negative consequences, are more complex than previously described; its subjective impact and the simultaneous occurrence of emotional abuse must also be taken into consideration.

Book Summary: This volume offers an overview of the latest research on perinatal adaptation among women who have faced trauma, loss and/or adversity, both in childhood and/or as an adult, and describes the varied trajectories of adaptive and maladaptive coping that follow. The range of outcomes considered span from health-limiting (e.g. mental illness, substance use, unhealthy life style behaviours) to health-promoting (e.g. resilience and posttraumatic growth). These outcomes are examined both in relation to mothers’ experience of motherhood and parenting, and with regard to their children’s lives. Interpersonal trauma, experienced in childhood and/or or adulthood, can have a profound effect on how women experience the transition into motherhood – from pregnancy, to childbirth, and postpartum caregiving. Women across the globe are exposed to high rates of interpersonal violence, and face the physical and emotional consequences of such events. The shift into motherhood is an emotionally evocative period in a woman’s life, entailing not only challenges, but also the potential for healing and growth. Individual chapters will present state-of-the-art research, and will also highlight the voices of women who have personally experienced trauma, illustrating the effects on their experiences as mothers. Throughout the book, the consistent emphasis is on clinical implications and on ways that providers can create a context for healing and growth with the help of current evidence-based and promising treatment methods.

There were no studies found in the literature that primarily focused on threatened harm as type of maltreatment. This study utilized Florida's child welfare administrative data to explore threatened harm as a type of maltreatment, particularly as a predictor of recurrence of maltreatment within six and 12 months for children who had a verified report of maltreatment in FY2005-2006. Threatened harm was examined in three ways; when it was reported as the only maltreatment, the initial maltreatment, and in situations where there was a prior report. The most prevalent acts of threatened harm were examined separately. It was examined as a predictor of recurrence of any maltreatment and also as a predictor of recurrence of a different type of maltreatment. The results of bivariate and multivariate Cox regression analysis indicated that children who experienced threatened harm were at increased odds for recurrence of maltreatment overall. The odds were found to be greater within 12 months, for children who had a prior report and for children who experienced a substance related threatened harm. Children with a prior report were also found to be more likely to experience recurrence of a different type of maltreatment. Implications of these findings are discussed.

Child abuse is a pressing national issue that affects thousands of children every year in the United States. The lifelong implications of child abuse been well documented in the literature, which identifies psychopathology, interpersonal violence and suicide risk, and substance abuse as a prominent triad of the negative sequelae of child abuse. Parents abused as children represent a subgroup that introduces additional domains of clinical interest and unique needs, including parenting stress and perceived parenting competence. These complex clusters of needs are clinically significant, and the beliefs licensed clinical social workers (LCSWs) hold about parents abused as children can significantly affect the assessment process. This study sought to assess LCSW beliefs about assessing parents abused as children through qualitative interviews with 10 LCSWs with clinical experience that could have included this population. This study found that LCSWs emphasize the three domains of psychopathology, interpersonal violence and suicide risk, and substance abuse in their assessment processes, thus reflecting LCSW beliefs about the saliency of these issues. The exploration of strengths and resources also emerged as a significant area of assessment and case conceptualization, which demonstrates congruence with core social work values. Culture, parental stress and client-perceived competence were not, however, emphasized in the participant responses. Overall, this study points to the strong congruence between the expressed LCSW beliefs about assessing this population and the domains emphasized in the literature, as well as core social work values.

Youth who have experienced maltreatment and the dysfunction of multiple placements are at risk of engaging in delinquent behaviors. Studies from various professionals found specific risk and protective factors that affect youth from being involved in the juvenile justice system. The current study adds significantly literature by identifying the risk and protective factors that affect foster youth in the child welfare and juvenile justice system based on social workers perspectives. The results indicate almost 93% of the participants agreed that multiple placements, 74% agreed that physical abuse, 61% agreed that group homes, and 67% agreed that sexual abuse serve as risk factors for foster youth. Foster youth who have encountered risks factors such as psychical abuse, sexual abuse, severe general neglect, mental health issues, multiple placements, group home placements, substance abuse, and negative support systems are at risk of being involved with the juvenile justice system. In addition, approximately 99% of the participants agreed that a mentor, 98% agreed that after school activities, 91% agreed that early parent bonding, 90% agreed that monitoring youths behaviors, and 73% agreed that contact with birth parents serves as protective factors that prevent youth from being involved from the juvenile justice system. The results identify factors such as early parent child bonding, school activities, contact with birth family, parents or caregivers monitoring their behavior, a mentor or role model, school involvement, and involvement with religious and spiritual activities serve as protective factors in preventing youth involvement in the juvenile justice system.