Child neglect: injuries of omission

Child neglect is the most common form of child maltreatment in the United States. Researchers have indicated that child neglect is strongly correlated with poverty, single-parent caretakers, unemployment, and multifaceted family problems. When neglect is present, it is usually pervasive in the lives of all family members, with both parents and children often perceiving themselves to be powerless and viewing attempts at goal achievement to be futile. Treatment for neglectful families requires multidisciplinary efforts to improve family functioning and promote a safe and supportive environment. Nurses have a variety of roles in the assessment of and primary, secondary, and tertiary prevention interventions for child neglect, with child safety and optimal family functioning as the desired outcomes. Early identification and intervention has the potential for reducing or preventing the developmental consequences associated with the deprivations of neglect. The nurse's role as child/family advocate is often the critical determinant of whether "at-risk" families are identified and receive the therapeutic interventions and tangible services they need. Additionally, nurses often have direct responsibilities for monitoring and remediating parenting patterns that have placed the child in hazardous conditions.     

Child abuse and neglect

The professional who must deal with child abuse has to resist the urge to punish the offenders and concentrate instead on seeking the best solution for the child. Guidelines for distinguishing child abuse from accidental injury are presented and management of the sexually abused child is detailed.     

Unilateral neglect: mechanisms and nursing care.

Unilateral neglect is frequently observed in brain-damaged persons, most commonly in conjunction with right-sided brain damage. Manifest as failure to attend to one-half of the body or extrapersonal space, unilateral neglect is caused by an attentional arousal deficit. Patients with unilateral neglect may present with a variety of behaviors. An understanding of causal mechanisms facilitates implementation of appropriate interventions to assist the patient and caregivers to cope with neglect and improve ability to perform activities of daily living.     

Safety: when infants and parents are research subjects

Patient safety is a central concern in nursing. Unlike other areas of patient safety, safety in research is particularly important because research is not part of standard care and participation is voluntary. Issues related to safety in research are especially pertinent to high-risk infants, because of the nature of parental (or legal guardian) consent and because children are considered a vulnerable group requiring special protection from research risks. Nurses must be aware of safety in research whether independently conducting research, employed by a research project, or caring for patients who are research subjects. This article reviews safety issues and policies, processes, and ethical guidelines designed to protect infants and children who are research subjects.     

Child abuse and neglect. The role of the primary care physician in recognition, treatment, and prevention

The present state of knowledge in the field of child abuse and neglect is reviewed, and the role of the primary care physician in the recognition, management, treatment, and prevention of child abuse is discussed.     

Working conditions and cultural competence when interacting with children and parents of foreign origin--Primary Child Health Nurses' opinions

BACKGROUND: Interaction with children and parents of foreign origin is an important part of Primary Child Health Care (PCHC) services. Cultural competence among Primary Child Health Nurses' (PCHNurses') must therefore be regarded as essential. Cultural competence has been described as a process with different steps through which an individual must proceed. AIM: The present study investigates PCHNurses' opinions regarding their working conditions and cultural competence. The focus will be placed on their interaction with children and parents of foreign origin. METHODS: A total of 270 PCHNurses working in the PCHC services in Stockholm County responded to a questionnaire (response rate 70%). The association between experiences of difficulties and nine explanatory variables were analysed with logistic regression. RESULTS: Many of the PCHNurses reported inadequate working conditions and dissatisfaction with the quality of their healthcare work and said that they lacked written guidelines, support and help. A majority (84%) experienced difficulties in their interactions with children and parents of foreign origin, although to different degrees. The odds of experiencing difficulties were increased when nurses were responsible for a high proportion of children of foreign origin, when nurses had long professional experience and when they worked more than 50% on child-health-services assignments. Many nurses had no formal training in cultural competence and the majority felt that their formal and clinical cultural competence was insufficient. CONCLUSIONS: Deficiencies were found regarding the PCHNurses' working conditions and cultural competence when interacting with children and parents of foreign origin. Improvements are needed to facilitate the nurses' healthcare work and to enable high quality health care on equal terms for all children and parents visiting the PCHC services.