Attitude of pediatricians toward suspected cases of child sexual abuse (CSA) in Saudi Arabia

Abstract

Objective: To assess the attitudes of pediatricians working at the Ministry of National Guard-Health Affairs (MNGHA) to report cases of child sexual abuse (CSA) and to determine the association between the demographic, cultural characteristics, and the attitude toward reporting. Participants and Settings: The participants included all pediatricians, from consultants to residents, employed at the Pediatric Department of the King Abdulaziz Medical City and King Abdullah Specialist Children's Hospital, Riyadh. Additional inclusion criteria were females and males, Saudis and non-Saudis, and age 20—60 years. Methods: A self-administered, hard copy questionnaire was distributed to 277 pediatricians, and the response rate was 58.48%. The sensitivity/specificity emphasis mean score was calculated. Categorical variables were tested against the sensitivity/specificity emphasis mean score using an ANOVA and an independent sample t-test. The reliability of the questionnaire was measured with Cronbach's alpha. Results: In total, 153 completed questionnaires were analyzed. The responses were inclined toward balanced (indecisive toward reporting) and high specificity (favors the decision not to report suspected CSA). No significant difference was found in the sensitivity/specificity mean score between the different levels of professionals, experience, age, gender, and number of prior child abuse-related courses. The skepticism scale showed, for the different professional levels, that the staff physician/resident believed the 3- to 5-year-old girls and boys to be genuine. The consultants/associate consultants believed 6- to 12- year and 13- to 17-year-old girls and boys to be true most of the time. Nearly half of the participants indicated that their reporting decision was affected by the possible consequences of reporting suspected CSA for the children's families and the social perceptions of sexually abused children as adults. Conclusion: The results highlight the low reporting rates of CSA cases. The findings suggest a lack of training and experience of the professionals in this area of assessing, detecting, and reporting CSA cases.

“Today, I Say It’s Mine!”: Professional Identity Construction among Jewish and Arab School Counselors Coping with CSA Disclosure in Israel

“…The additional discovery made by the current study, which differs from these earlier findings, was the trend of outright denial of CSA among Arab educators in the early stages of their careers, driven by the belief that such incidents were impossible within their culture. A previous study on professionals in Saudi Arabia managing CSA cases similarly revealed a high degree of skepticism towards child disclosures, attributed to insufficient training on CSA and various cultural and religious factors [81,82]. Yet, the outright denial of the existence of CSA within their cultural context, as identified by the Arab educators in this study, represents a unique finding.…”

“…Past research on the cultural challenges faced by Arab professionals worldwide in managing CSA cases is limited and tends to focus on diverse professionals rather than specifically on educators. These studies primarily address reporting dilemmas and difficulties stemming from socio-cultural factors, such as fears of tarnishing the family's reputation, community denial, the importance of a girl's chastity in Arab Muslim culture, and the enduring stigma of sexual abuse [80][81][82]. The present study, along with other past qualitative research conducted by the authors in the Israeli context (e.g., [10,13,50,51,61]), echoes these findings in relation to Arab educators and further highlights the emotional consequences of the conflict between personal beliefs and professional responsibilities.…”