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Woodman J, Simon A, Hauari H, Gilbert R. A scoping review of 'think-family' approaches in healthcare settings. J Public Health (Oxf) 2021; 42:21-37. [PMID: 30668870 DOI: 10.1093/pubmed/fdy210] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 09/27/2018] [Accepted: 11/06/2018] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND 'Think-family' child health approaches treat child and parent/carer health as inter-related. They are promoted within health policy internationally (also called 'family paediatrics' or 'whole-family', 'family-centred' approaches or 'child-centred' approaches within adult services). METHODS We reviewed publications of think-family interventions. We developed a typology of these interventions using thematic analysis of data extracted from the included studies. RESULTS We included 62 studies (60% USA and 18% UK); 45/62 (73%) treated the parent as patient, helping the child by addressing parental mental health, substance and alcohol misuse and/or domestic violence. Our typology details three common mechanisms of change in relevant interventions: screening, health promotion and developing relationships (inter-professional and parent-professional). CONCLUSIONS Policy-makers, practitioners and researchers can use our typology to develop and evaluate think-family approaches within healthcare. Strong relationships between parents and professionals are key in think-family approaches and should be considered in service design. Although helping the child through the parent may be a good place to start for service development, care is needed to ensure parental need does not eclipse child need. Strategies that reach out to the parent behind the child (child as patient) and which work simultaneously with parent and child warrant attention.
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Affiliation(s)
- Jenny Woodman
- UCL-Institute of Education, Thomas Coram Research Unit, 27/8 Woburn Square, London, UK
| | - Antonia Simon
- UCL-Institute of Education, Social Science Research Unit, 27/8 Woburn Square, London, UK
| | - Hanan Hauari
- UCL-Institute of Education, Thomas Coram Research Unit, 27/8 Woburn Square, London, UK
| | - Ruth Gilbert
- UCL-GOS- Institute of Child Health, 30 Guilford Street, London, UK
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Systematic Literature Review of Attempted Suicide and Offspring. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15050937. [PMID: 29738447 PMCID: PMC5981976 DOI: 10.3390/ijerph15050937] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 04/20/2018] [Accepted: 05/03/2018] [Indexed: 11/27/2022]
Abstract
Background: Exposure to parental suicide attempt is associated with higher risks of adverse outcomes like lower educational performance, drug abuse and delinquent behavior. When a patient is hospitalized after a suicide attempt, this presents a unique opportunity to identify whether the patient has children, and thereby provide adequate follow-up for both the parent/patient and their children. The objective of this paper was to review the existing literature on follow-up measures for children subjected to parental suicide attempt. Methods: In line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, we conducted a systematic literature search. Results: The search resulted in a total of 1275 article titles, of which all abstracts were screened. Out of these, 72 full text papers were read, and a final four articles were included. Three of the included papers described parts of the same study from an emergency department in The Hague, where a protocol was implemented for monitoring and referring children of parents attempting suicide. The fourth article described the association between maternal attempted suicide and risk of abuse or neglect of their children. Conclusions: The lack of research in this particular area is striking. The circumstances surrounding a parent’s suicide attempt call for appropriate familial care.
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Hoytema van Konijnenburg EMM, Gigengack M, Teeuw AH, Sieswerda-Hoogendoorn T, Brilleslijper-Kater SN, Flapper BC, Lindauer RJL, van Goudoever JB, van der Lee JH. Follow-up protocol was useful for children whose parents attended emergency departments after partner violence, substance abuse or a suicide attempt. Acta Paediatr 2018; 107:110-120. [PMID: 28929523 DOI: 10.1111/apa.14082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 04/11/2017] [Accepted: 09/15/2017] [Indexed: 11/30/2022]
Abstract
AIM This was a one-year follow-up of families referred to support services after the parents visited the emergency department due to intimate partner violence, substance abuse or a suicide attempt. Its aim was to evaluate the well-being of any children. METHODS Data on families identified a year earlier by the Amsterdam protocol were gathered from child protective services and parent and child self-reports in two Dutch regions from 2012-2015. RESULTS We included 399 children (52%) boys with a median age of eight years (range 1-18) in the study using child protective services data. Of the 101 families who participated in the first measurement, 67 responded one year after the parent's emergency department visit. The results showed that 20% of the children had no or minor problems, voluntary support services were involved in 60% of cases and child protective services were involved in 20%. Compared to their first assessment a year earlier, the children's psychosocial problems had not increased, but this could have been an underestimation due to selective responses. CONCLUSION The Amsterdam protocol was valuable in referring families to voluntary support services, but given the ongoing problems in some families, professionals need to carefully monitor whether support services are sufficiently effective.
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Affiliation(s)
| | - Maj Gigengack
- Department of Child and Adolescent Psychiatry; Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
- The Bascule, Academic Center for Child and Adolescent Psychiatry; Amsterdam The Netherlands
| | - Arianne H. Teeuw
- Department of Paediatrics; Emma Children's Hospital; Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
| | - Tessa Sieswerda-Hoogendoorn
- Department of Paediatrics; Emma Children's Hospital; Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
| | - Sonja N. Brilleslijper-Kater
- Department of Paediatrics; Emma Children's Hospital; Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
| | - Boudien C. Flapper
- Department of Paediatrics; University Medical Centre Groningen; University of Groningen; Groningen The Netherlands
| | - Ramón J. L. Lindauer
- Department of Child and Adolescent Psychiatry; Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
- The Bascule, Academic Center for Child and Adolescent Psychiatry; Amsterdam The Netherlands
| | - Johannes B. van Goudoever
- Department of Paediatrics; Emma Children's Hospital; Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
- Department of Paediatrics; VU University Medical Center; VU University; Amsterdam The Netherlands
| | - Johanna H. van der Lee
- Paediatric Clinical Research Office; Woman-Child Center; Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
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McTavish JR, Kimber M, Devries K, Colombini M, MacGregor JCD, Wathen CN, Agarwal A, MacMillan HL. Mandated reporters' experiences with reporting child maltreatment: a meta-synthesis of qualitative studies. BMJ Open 2017; 7:e013942. [PMID: 29042370 PMCID: PMC5652515 DOI: 10.1136/bmjopen-2016-013942] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To systematically search for research about the effectiveness of mandatory reporting of child maltreatment and to synthesise qualitative research that explores mandated reporters' (MRs) experiences with reporting. DESIGN As no studies assessing the effectiveness of mandatory reporting were retrieved from our systematic search, we conducted a meta-synthesis of retrieved qualitative research. Searches in Medline (Ovid), Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Sociological Abstracts, Education Resources Information Center, Criminal Justice Abstracts and Cochrane Library yielded over 6000 citations, which were deduplicated and then screened by two independent reviewers. English-language, primary qualitative studies that investigated MRs' experiences with reporting of child maltreatment were included. Critical appraisal involved a modified checklist from the Critical Appraisal Skills Programme and qualitative meta-synthesis was used to combine results from the primary studies. SETTING All healthcare and social-service settings implicated by mandatory reporting laws were included. Included studies crossed nine high-income countries (USA, Australia, Sweden, Taiwan, Canada, Norway, Finland, Israel and Cyprus) and three middle-income countries (South Africa, Brazil and El Salvador). PARTICIPANTS The studies represent the views of 1088 MRs. OUTCOMES Factors that influence MRs' decision to report and MRs' views towards and experiences with mandatory reporting of child maltreatment. RESULTS Forty-four articles reporting 42 studies were included. Findings indicate that MRs struggle to identify and respond to less overt forms of child maltreatment. While some articles (14%) described positive experiences MRs had with the reporting process, negative experiences were reported in 73% of articles and included accounts of harm to therapeutic relationships and child death following removal from their family of origin. CONCLUSIONS The findings of this meta-synthesis suggest that there are many potentially harmful experiences associated with mandatory reporting and that research on the effectiveness of this process is urgently needed.
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Affiliation(s)
- Jill R McTavish
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Melissa Kimber
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Karen Devries
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Manuela Colombini
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | | | - C Nadine Wathen
- Faculty of Information and Media Studies, Western University, London, Ontario, Canada
| | - Arnav Agarwal
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Harriet L MacMillan
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
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Hoytema van Konijnenburg EMM, van der Lee JH, Teeuw AH, Lindeboom R, Brilleslijper-Kater SN, Sieswerda-Hoogendoorn T, van Goudoever JB, Lindauer RJL. Psychosocial problems of children whose parents visit the emergency department due to intimate partner violence, substance abuse or a suicide attempt. Child Care Health Dev 2017; 43:369-384. [PMID: 27774638 DOI: 10.1111/cch.12419] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 09/05/2016] [Accepted: 09/12/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND High levels of maltreatment are found in children who are identified because their parents visit the emergency department due to partner violence, substance abuse or suicide attempt. However, it is unknown if these children experience psychosocial problems. This study aims to assess their levels of post-traumatic stress, anxiety, depression, behavioural problems and health-related quality of life. METHODS A cross-sectional study was conducted in six hospitals. All consecutive families of which a parent visited the emergency department due to partner violence, substance abuse or suicide attempt between 1 July 2012 and 1 March 2014 with children aged 1.5-17 years were approached for participation. Parents and children aged 8 years and older filled out questionnaires measuring post-traumatic stress [13-item version of Children's Revised Impact of Event Scale (CRIES-13)], anxiety, depression (Revised Child Anxiety and Depression Scale), behavioural problems [Child Behavior Checklist (CBCL) and Youth Self-Report (YSR)] and health-related quality of life (PedsQL). Scores of participants were compared with reference data obtained in children in similar age ranges from representative Dutch community samples (CRIES-13, Revised Child Anxiety and Depression Scale, PedsQL and CBCL) and to a normed cutoff score (CRIES-13). RESULTS Of 195 eligible families, 89 (46%) participated in the study. Participating children did not score different from community children, both on child-reported and parent-reported instruments. Standardized mean differences of total sum scores were 0 (CRIES-13 and CBCL 1.5-5), 0.1 (YSR), 0.2 (CBCL 6-18) and -0.3 (PedsQL) and not statistically different from community children. Thirty-five percent of the participating children scored above the cutoff score on the CRIES-13, indicating post-traumatic stress disorder, but this difference was not statistically significant from community children (mean difference 8%; 95% CI -4-22%). CONCLUSIONS We found no differences in psychosocial problems between children whose parents visited the emergency department due to partner violence, substance abuse or suicide attempt and children from community samples. Because 35% of the children scored in the range of post-traumatic stress disorder, we advise healthcare providers to pay attention to post-traumatic stress symptoms.
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Affiliation(s)
- E M M Hoytema van Konijnenburg
- Department of Pediatrics, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - J H van der Lee
- Pediatric Clinical Research Office, Woman-Child Center, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - A H Teeuw
- Department of Pediatrics, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - R Lindeboom
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - S N Brilleslijper-Kater
- Department of Pediatrics, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - T Sieswerda-Hoogendoorn
- Department of Pediatrics, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - J B van Goudoever
- Department of Pediatrics, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.,Department of Pediatrics, VU University Medical Center, VU University, Amsterdam, the Netherlands
| | - R J L Lindauer
- Department of Child and Adolescent Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.,The Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, the Netherlands.,Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Amsterdam, the Netherlands
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Hoytema van Konijnenburg EMM, Diderich HM, Teeuw AH, Klein Velderman M, Oudesluys-Murphy AM, van der Lee JH. Comparing policies for children of parents attending hospital emergency departments after intimate partner violence, substance abuse or suicide attempt. CHILD ABUSE & NEGLECT 2016; 53:81-94. [PMID: 26718263 DOI: 10.1016/j.chiabu.2015.11.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Revised: 10/25/2015] [Accepted: 11/18/2015] [Indexed: 06/05/2023]
Abstract
To improve identification of child maltreatment, a new policy ('Hague protocol') was implemented in hospitals in The Netherlands, stating that adults attending the hospital emergency department after intimate partner violence, substance abuse or a suicide attempt should be asked whether they care for children. If so, these children are referred to the Reporting Center for Child Abuse and Neglect (RCCAN), for assessment and referrals to support services. An adapted, hospital-based version of this protocol ('Amsterdam protocol') was implemented in another region. Children are identified in the same manner, but, instead of a RCCAN referral, they are referred to the pediatric outpatient department for an assessment, including a physical examination, and referrals to services. We compared results of both protocols to assess how differences between the protocols affect the outcomes on implementation, detection of child maltreatment and referrals to services. Furthermore, we assessed social validity and results of a screening physical examination. We included 212 families from the Amsterdam protocol (cohort study with reports by pediatric staff and parents) and 565 families from the Hague protocol (study of RCCAN records and telephone interviews with parents). We found that the RCCAN identified more maltreatment than pediatric staff (98% versus at least 51%), but referrals to services were similar (82% versus 80% of the total sample) and parents were positive about both interventions. Physical examination revealed signs of maltreatment in 5%. We conclude that, despite the differences, both procedures can serve as suitable methods to identify and refer children at risk for maltreatment.
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Affiliation(s)
- Eva M M Hoytema van Konijnenburg
- Department of Pediatrics, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Hester M Diderich
- Emergency Department, Medical Centre Haaglanden, Lijnbaan 32, 2501 CK Den-Haag, The Netherlands
| | - Arianne H Teeuw
- Department of Pediatrics, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | | | - Anne Marie Oudesluys-Murphy
- Social Pediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Johanna H van der Lee
- Pediatric Clinical Research Office, Woman-Child Center, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
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