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Abuse And Neglect (abuse + and_neglect)
Selected AbstractsScreening for Abuse and Neglect of People with DementiaJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 3 2010Aileen Wiglesworth PhD OBJECTIVE: To investigate characteristics of people with dementia and their caregivers (CGs) that are associated with mistreatment in order to inform clinicians about screening for mistreatment. DESIGN: A convenience sample of CG,care recipient (CR) dyads were assessed for literature-supported factors associated with mistreatment, and evidence of mistreatment for the prior year was collected. An expert panel considered the evidence and decided on occurrences of psychological abuse, physical abuse, and neglect based on criteria adopted before data collection. SETTING: Participants' homes. PARTICIPANTS: One hundred twenty-nine persons with dementia and their CGs. MEASUREMENTS: CG and CR characteristics (demographic, health, and psychosocial variables), relationship characteristics, and three elder abuse and neglect detection instruments. RESULTS: Mistreatment was detected in 47.3%. Variables associated with different kinds and combinations of mistreatment types included the CG's anxiety, depressive symptoms, social contacts, perceived burden, emotional status, and role limitations due to emotional problems and the CR's psychological aggression and physical assault behaviors. The combination of CR's physical assault and psychological aggression provided the best sensitivity (75.4%) and specificity (70.6%) for elder mistreatment as defined by the expert panel. This finding has potential to be useful as a clinical screen for detecting mistreatment. CONCLUSIONS: The findings suggest important characteristics of older adults with dementia and their CGs that have potential for use in a clinical screening tool for elder mistreatment. Potential screening questions to be asked of CGs of people with dementia are suggested. [source] Verbal and Physical Abuse and Neglect as Manifestations of HIV/AIDS Stigma in Five African CountriesPUBLIC HEALTH NURSING, Issue 5 2007Priscilla S. Dlamini ABSTRACT Objective: To explore the experience of HIV/AIDS-related stigma for people living with HIV/AIDS (PLWA) in Lesotho, Malawi, South Africa, Swaziland, and Tanzania. Design and sample: Descriptive study using 43 focus groups (n=251 participants), which included male and female PLWA from both rural and urban areas and nurses working with PLWA. Methods: Participants were asked to relate incidents of HIV/AIDS-related stigma that they had experienced or observed. Focus group discussions were taped, and data were content analyzed to identify examples of abuse (verbal and physical abuse and neglect) related to HIV/AIDS stigma. Data analysis also explored targets of abuse, abusers, and consequences of abuse. Results: Participant reports documented extensive verbal and physical abuse and neglect or negating (disallowing of access to services and opportunities) experienced by PLWA and observed by nurses caring for them, and identified negative consequences experienced by PLWA whose HIV-positive status was disclosed to family, friends, or community members. Conclusions: Health care workers who encourage PLWA to disclose their HIV status must carefully consider the implications of encouraging disclosure in an environment with high levels of stigma, and must recognize the real possibility that PLWA may experience serious verbal and physical abuse as a consequence of disclosure. [source] Perceptions of Elderly Self-Neglect: A Look at Culture and CohortFAMILY & CONSUMER SCIENCES RESEARCH JOURNAL, Issue 3 2007Sylvia Marie San Filippo Abuse and neglect are issues of concern that face the elderly population. This study investigated differences in perception of self-neglect behaviors among four cohort and four cultural groups. Data were collected from students, staff, and faculty at a large state university, attendees at multiple senior centers, and people attending cultural fairs in Southern California. Using this convenience sample of 494 participants, age 18 years or older, researchers identified factors influencing self-neglect perceptions in the culture and cohort models. Significant variables identified in both models are: having a daily caloric intake of fewer than 1,000 calories, avoiding friends and social events, drinking three to four alcoholic drinks at social occasions, and working part-time. It is important for professionals working with self-neglecting elders to understand differences in perception by culture and cohort. Agreement on a definition of self-neglect is a step toward better addressing self-neglect in the elderly community. [source] Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implicationsACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2005J. Read Objective:, To review the research addressing the relationship of childhood trauma to psychosis and schizophrenia, and to discuss the theoretical and clinical implications. Method:, Relevant studies and previous review papers were identified via computer literature searches. Results:, Symptoms considered indicative of psychosis and schizophrenia, particularly hallucinations, are at least as strongly related to childhood abuse and neglect as many other mental health problems. Recent large-scale general population studies indicate the relationship is a causal one, with a dose-effect. Conclusion:, Several psychological and biological mechanisms by which childhood trauma increases risk for psychosis merit attention. Integration of these different levels of analysis may stimulate a more genuinely integrated bio-psycho-social model of psychosis than currently prevails. Clinical implications include the need for staff training in asking about abuse and the need to offer appropriate psychosocial treatments to patients who have been abused or neglected as children. Prevention issues are also identified. [source] Childhood Maltreatment and Migraine (Part II).HEADACHE, Issue 1 2010Emotional Abuse as a Risk Factor for Headache Chronification (Headache 2010;50:32-41) Objectives., To assess in a headache clinic population the relationship of childhood abuse and neglect with migraine characteristics, including type, frequency, disability, allodynia, and age of migraine onset. Background., Childhood maltreatment is highly prevalent and has been associated with recurrent headache. Maltreatment is associated with many of the same risk factors for migraine chronification, including depression and anxiety, female sex, substance abuse, and obesity. Methods., Electronic surveys were completed by patients seeking treatment in headache clinics at 11 centers across the United States and Canada. Physician-determined data for all participants included the primary headache diagnoses based on the International Classification of Headache Disorders-2 criteria, average monthly headache frequency, whether headaches transformed from episodic to chronic, and if headaches were continuous. Analysis includes all persons with migraine with aura, and migraine without aura. Questionnaire collected information on demographics, social history, age at onset of headaches, migraine-associated allodynic symptoms, headache-related disability (The Headache Impact Test-6), current depression (The Patient Health Questionnaire-9), and current anxiety (The Beck Anxiety Inventory). History and severity of childhood (<18 years) abuse (sexual, emotional, and physical) and neglect (emotional and physical) was gathered using the Childhood Trauma Questionnaire. Results., A total of 1348 migraineurs (88% women) were included (mean age 41 years). Diagnosis of migraine with aura was recorded in 40% and chronic headache (,15 days/month) was reported by 34%. Transformation from episodic to chronic was reported by 26%. Prevalence of current depression was 28% and anxiety was 56%. Childhood maltreatment was reported as follows: physical abuse 21%, sexual abuse 25%, emotional abuse 38%, physical neglect 22%, and emotional neglect 38%. In univariate analyses, physical abuse and emotional abuse and neglect were significantly associated with chronic migraine and transformed migraine. Emotional abuse was also associated with continuous daily headache, severe headache-related disability, and migraine-associated allodynia. After adjusting for sociodemographic factors and current depression and anxiety, there remained an association between emotional abuse in childhood and both chronic (odds ratio [OR] = 1.77, 95% confidence intervals [CI]: 1.19-2.62) and transformed migraine (OR = 1.89, 95% CI: 1.25-2.85). Childhood emotional abuse was also associated with younger median age of headache onset (16 years vs 19 years, P = .0002). Conclusion., Our findings suggest that physical abuse, emotional abuse, and emotional neglect may be risk factors for development of chronic headache, including transformed migraine. The association of maltreatment and headache frequency appears to be independent of depression and anxiety, which are related to both childhood abuse and chronic daily headache. The finding that emotional abuse was associated with an earlier age of migraine onset may have implications for the role of stress responses in migraine pathophysiology. [source] The infant protection system in France: How does it work?,INFANT MENTAL HEALTH JOURNAL, Issue 1 2008Antoine Guedeney The French system for protection of infants and toddlers relies on the collaboration of several different partners for preventing, screening, assessing, intervening in, and treating cases of infant abuse and neglect. This article first provides a brief historic overview and some data about the protection of infants in France, with data focused on the Parisian area. We then describe the tasks and interconnections of these different agencies and administrations, and offer some reflections on the actual functioning of the system. Finally, some suggestions for changes are provided. Discussion should begin on a theoretical level regarding whether we should continue with institutionalization of infants for long periods of time, as is still the case in Paris. Discussion also should take place regarding which is the higher priority when infants and children are in situations of danger, abuse, and/or neglect of infants: (a) the hope of reestablishing parental rights or (b) the need of the infant for a secure and stable attachment relationship. The process of evaluating parental caregiving skills would benefit from more clinical observation as well as structured methods of assessment. [source] Laws and policies to support the wellbeing of children: an international comparative analysisINTERNATIONAL JOURNAL OF SOCIAL WELFARE, Issue 1 2010Emily J. Nicklett Nicklett EJ, Perron BE. Laws and policies to support the wellbeing of children: an international comparative analysis Int J Soc Welfare 2010: 3,7 © 2009 The Author(s), Journal compilation © 2009 Blackwell Publishing Ltd and the International Journal of Social Welfare. The international community has raised concerns regarding the extent to which countries have implemented laws and policies to support the rights and wellbeing of children. This study evaluates the progress of least-developed countries (LDCs) and middle-income countries (MICs) in developing such legislation. Surveys were sent to 131 UNICEF country offices. Items included efforts to promote family preservation and family ties, family-based care over institutionalization, and child participation in placement decisions. A total of 68 surveys were returned, reflecting a 52 percent response rate (LDC, n= 25; MIC, n= 43). Legislation that addressed abuse and neglect of children, maternity leave, removal of children from the family, family care, adoption, and guardianship was widespread. Chi-square tests indicated that MICs had a substantially higher number of laws and policies related to child allowances, school feeding programs, maternity leave, and day care. [source] Health education for nurses in Japan to combat child abuseNURSING & HEALTH SCIENCES, Issue 3 2003Beverly M. Henry phd, hondsc Abstract A health education program for nurses was conducted to address the complex problem of child abuse, which has reached epidemic proportions. In Japan, the number of consultations has risen 23-fold over the past 11 years. Maltreatment of children is a public health problem as perilous as any contagious disease. The International Council of Nurses asks for nurses' leadership to strengthen measures to combat abuse throughout the world. The Japanese Nursing Association has published statements for prevention, detection and support. Yet, few community-based education programs with a multidisciplinary perspective have been reported that focus on nurses, the largest group of health providers. More than 200 nurse educators, clinicians and managers met for a one-day program designed to improve understanding of the nurses' role in combating the abuse and neglect of children and to formulate action plans. This significant health problem is addressed in the context of a health education program's needs, objectives, content and evaluation. [source] Verbal and Physical Abuse and Neglect as Manifestations of HIV/AIDS Stigma in Five African CountriesPUBLIC HEALTH NURSING, Issue 5 2007Priscilla S. Dlamini ABSTRACT Objective: To explore the experience of HIV/AIDS-related stigma for people living with HIV/AIDS (PLWA) in Lesotho, Malawi, South Africa, Swaziland, and Tanzania. Design and sample: Descriptive study using 43 focus groups (n=251 participants), which included male and female PLWA from both rural and urban areas and nurses working with PLWA. Methods: Participants were asked to relate incidents of HIV/AIDS-related stigma that they had experienced or observed. Focus group discussions were taped, and data were content analyzed to identify examples of abuse (verbal and physical abuse and neglect) related to HIV/AIDS stigma. Data analysis also explored targets of abuse, abusers, and consequences of abuse. Results: Participant reports documented extensive verbal and physical abuse and neglect or negating (disallowing of access to services and opportunities) experienced by PLWA and observed by nurses caring for them, and identified negative consequences experienced by PLWA whose HIV-positive status was disclosed to family, friends, or community members. Conclusions: Health care workers who encourage PLWA to disclose their HIV status must carefully consider the implications of encouraging disclosure in an environment with high levels of stigma, and must recognize the real possibility that PLWA may experience serious verbal and physical abuse as a consequence of disclosure. [source] The Vulnerability and sexual abuse of people with learning disabilitiesBRITISH JOURNAL OF LEARNING DISABILITIES, Issue 2 2007Nicholas Guy Peckham Accessible summary ,,People with learning disabilities are more likely to experience sexual things happening to them when they do not want them to. This is called sexual abuse. ,,A group was started to help some women who have been sexually abused. ,,Women who wanted to attend the group were given information about it and asked on three separate occasions if they wanted to attend. Their carers helped them and went to a different group upstairs in the same building. ,,We found that the group helped the women feel less scared and depressed and helped the women's carers understand them better. ,,This research matters because it helped the women move on with their lives and will help others who want to start a group. Summary In his capacity as a Clinical Psychologist the author provides psychological support to people with learning disabilities living in hospital and in the community. Frequently, the problem behaviour highlighted in referral letters (such as sexualized behaviour, anger management or self-harm) is formulated as relating to a past history of abuse and neglect which they had experienced. In view of increasing client referrals and a limited research literature the author established a small team, developed and then piloted a survivors' group for women with a learning disability. The pilot achieved ethical approval and the survivors' group ran concurrently with an educational support group for their carers. For more details about this pilot study see Peckham (2005)Developing, delivering and evaluating a survivors group pilot in Northumberland for women with significant learning disabilities who have been sexually abused. Unpublished DClinPsych Thesis, University of Newcastle, Newcastle upon Tyne; and Peckham et al. (2007). These articles summarize the research literature in the area of sexual abuse and describe, in detail, the problem of delivering and evaluating a survivors' group for women with learning disabilities. [source] Mothering and child protection practice: rethinking risk assessmentCHILD & FAMILY SOCIAL WORK, Issue 1 2000Krane In recent years, across North America and the UK, child protective service agencies have increasingly begun to rely on bureaucratic, technocratic, and regulatory mechanisms for detecting and managing abuse and neglect. Coupled with a shift from concern for the general social welfare of children to a heightened preoccupation with risk or dangerousness to children, risk assessment systems are becoming integral to child protection practice. Though risk assessment systems aim to enhance the effectiveness of child protection investigations and service provision, as well as filter out high risk cases from the rest, such systems may foster and reproduce often concealed relations of gender, race, and class. This paper presents a review of the risk assessment trend in child welfare, its general objectives, and some criticisms raised to date. Through a feminist analysis of the social construction of mothering, we re-examine risk assessment. We argue that the risk assessment trend has the potential to entrench oppressive relations of gender, race, and class in child welfare practice with mothers. We suggest that an approach to risk assessment which incorporates a ,mothering narrative' might offer a more thorough evaluation of the conditions that shape the context within which risk to children emerges. [source] The role of communities in safeguarding children and young people,CHILD ABUSE REVIEW, Issue 2 2010Gordon Jack Abstract Historically, children's safeguarding policy and practice in the UK have focused on individual and family-level explanations of abuse and neglect, with relatively little attention given to children's overall well-being or the role played by neighbourhood conditions in shaping it. As a result, community-oriented practice, designed to improve the neighbourhood conditions in which many of the families who come to the attention of child welfare agencies live, has largely remained on the margins of mainstream provision for safeguarding children and young people. However, more recent policy developments, including Every Child Matters and the Children's Plan, do highlight the influence of children's wider circumstances on their well-being, providing the foundations for more holistic approaches to service provision. Nevertheless, it is argued that these policy developments are unlikely to be successful unless they are accompanied by fundamental changes within the culture of many agencies and professions. Using a combination of ecological theory and practice examples, some of the main strands of the changes required (developing a culture of listening to children and adults; recognising and supporting the safeguarding activities of local people; and promoting partnership approaches to extending local provision) are critically examined. Copyright © 2009 John Wiley & Sons, Ltd. [source] Prevention of child abuse and neglect and improvements in child developmentCHILD ABUSE REVIEW, Issue 1 2009Mogens Nygaard Christoffersen Abstract The aim of the study was to evaluate the implementation of a section in the Danish Social Assistance Act which encourages local authorities to offer families services in order to support children at risk of child maltreatment. The specific purpose of the present paper is to answer the question: Will the socio-psychological development of children known to social services be improved when abuse and neglect are reduced? A sample of 1,138 children was drawn at random from new social services cases starting in 1998. Subsequently, about 80 per cent were evaluated by local caseworkers on the basis of a standardised questionnaire covering a period of four years. The most damaging family conditions seemed to be psychological maltreatment, physical/sexual abuse and neglect. Maltreated children were more often in a depressed state, unhappy, socially isolated, or they had an eating disorder, inadequate or under-nutrition, suicidal tendencies, lack of concentration, or disturbed behaviour, compared to those children who were not exposed to abuse and neglect. If parental behaviour improved, effects on children's well-being were also observed and positive changes in children's socio-psychological development were identified. The questionnaire explored the impact of various interventions, including services geared to strengthen the child's network, but results indicated that the child displayed reduced risk of reactive symptoms only when parental behaviour improved and abuse and neglect were reduced. Copyright © 2009 John Wiley & Sons, Ltd. [source] The preoccupation with thresholds in cases of child death or serious injury through abuse and neglectCHILD ABUSE REVIEW, Issue 5 2008Marian Brandon Abstract Thresholds into and between services emerged as a significant theme in the biennial analysis of cases of child death and serious injury through abuse and neglect ,serious case reviews' carried out in England for the (then) Department for Education and Skills between 2003,05. The preoccupation with thresholds was one of a number of interacting risk factors and many children's cases were on the boundary of services and levels of intervention. In most cases child protection did not come ,labelled as such' which reinforces the need for all practitioners, including those working with adults to be alert to the risks of significant harm. Policy makers should acknowledge that staff working in early intervention are working within the safeguarding continuum and not in a separate sphere of activity. The emotional impact of working with hostility from violent parents and working with resistance from older adolescents impeded engagement, judgement and safeguarding action. In the long term neglect cases that were reviewed, the threshold for formal child protection services was rarely met and some agencies and practitioners coped with feelings of helplessness by adopting the ,start again syndrome'. Adequate resources are essential but not sufficient to redress the problems. Effective and accessible supervision is crucial to help staff to put into practice the critical thinking required to understand cases holistically, complete analytical assessments, and weigh up interacting risk and protective factors. Copyright © 2008 John Wiley & Sons, Ltd. [source] Milk Teeth and Jet Planes: Kin Relations in Families of Sri Lanka's Transnational Domestic ServantsCITY & SOCIETY, Issue 1 2008MICHELE R. GAMBURD Abstract This essay examines the confluence of local and global dynamics, exploring how transnational migration affects and is affected by gender roles, kinship relations, intergenerational obligations, and ideologies of parenthood. Journeying to the Middle East repeated on two-year labor contracts, many of Sri Lanka's migrant housemaids leave behind their husbands and children. Women's long-term absences reorganize and disrupt widely accepted gendered attributions of parenting roles, with fathers and female relatives taking over household tasks. Migrants say that economic difficulties prompt migration, and assess commitment to kin in financial terms. The government also benefits from remittances. Nevertheless, stakeholders (villagers, politicians, and the national media) worry about the social costs born by children. Drawing on interviews with the adult children of migrant mothers in four extended families in the Sri Lankan coastal village of Naeaegama, I examine the long-term effects of transnational labor migration on local households. The case studies do not support media claims that children suffer abuse and neglect in their mothers' absence, but do in part support survey information on reduced education, shifting marriage patterns, and paternal alcohol consumption. [source] | |||||||||||||