Improving child protection: a systematic review of training and procedural interventions
Improving child protection: a systematic review of training and procedural interventions
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DOI：
10.1136/adc.2005.092007
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发表时间：
2006-09-01
影响因子：
5.2
通讯作者：
Barlow, J.
中科院分区：
文献类型：
--
作者：
Carter, Y. H.;Bannon, M. J.;Barlow, J.
目的：综合已发表的关于旨在改善卫生专业人员对虐待和忽视儿童的识别和管理的培训和程序干预的有效性的证据。方法：系统回顾1994-2005年间评估儿童保护培训和程序干预的研究。主要观察指标为学习成绩、态度改变和临床行为。结果：7篇检查程序性干预措施有效性的文章和15篇评估培训计划的文章符合纳入标准。批判性评价表明，对干预措施的评价总体上很差。研究发现，某些程序性干预措施(如使用核对表和结构化表格)可以改进重要临床信息的记录，还可以提醒临床工作人员注意滥用的可能性。虽然确定了各种创新的培训方案，但缺乏对其影响的严格评估。然而，少数一个小组的事前和事后研究表明，成功参与儿童保护进程所需的一系列态度有所改善。结论：目前的证据支持使用程序改革，以改进对涉嫌虐待儿童的记录，并提高专业意识。执行儿童保护培训缺乏循证办法，可能会限制所有保健专业人员在儿童保护进程中发挥作用的能力。迫切需要对提供这一培训的各种模式进行正式评价，并随后传播结果，突出那些被认为最有效的模式。
Aim: To synthesise published evidence regarding the effectiveness of training and procedural interventions aimed at improving the identification and management of child abuse and neglect by health professionals.Methods: Systematic review for the period 1994 to 2005 of studies that evaluated child protection training and procedural interventions. Main outcome measures were learning achievement, attitudinal change, and clinical behaviour.Results: Seven papers that examined the effectiveness of procedural interventions and 15 papers that evaluated training programmes met the inclusion criteria. Critical appraisal showed that evaluation of interventions was on the whole poor. It was found that certain procedural interventions ( such as the use of checklists and structured forms) can result in improved recording of important clinical information and may also alert clinical staff to the possibility of abuse. While a variety of innovative training programmes were identified, there was an absence of rigorous evaluation of their impact. However a small number of one-group pre- and post-studies suggest improvements in a range of attitudes necessary for successful engagement in the child protection process.Conclusion: Current evidence supports the use of procedural changes that improve the documentation of suspected child maltreatment and that enhance professional awareness. The lack of an evidence based approach to the implementation of child protection training may restrict the ability of all health professionals to fulfil their role in the child protection process. Formal evaluation of a variety of models for the delivery of this training is urgently needed with subsequent dissemination of results that highlight those found to be most effective.