Child maltreatment by nursing staff and caregivers in German institutions: A population-representative analysis

Clemens, Vera; Hoffmann, Ulrich; König, Elisa; Sachser, Cedric; Brähler, Elmar; Fegert, Jörg M.

doi:10.1016/j.chiabu.2019.104046

Cited by 18 publications

(23 citation statements)

References 19 publications

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“…In a previous analysis of the German population, 0.8% of those who were treated in hospitals or rehabilitation centres during childhood or adolescence experienced sexual abuse by nursing staff during their stay (Clemens et al ., 2019 ). The present study confirms a high proportion of minors who experience sexual abuse during treatment.…”

Section: Discussionmentioning

confidence: 99%

#patientstoo – Professional sexual misconduct by healthcare professionals towards patients: a representative study

Clemens

Brähler

Fegert

2021

Epidemiol Psychiatr Sci

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Aims Sexual border violations are a severe problem in the healthcare system. Studies using non-probability samples indicate a high prevalence of professional sexual misconduct (PSM) towards patients. However, valid prevalence rates are lacking. Methods We did a cross-sectional, observational study in Germany from February to April 2020. By different sampling steps, a probability sample of the German population above the age of 14 was generated. The final sample consisted 2503 persons (50.2% female, mean age: 49.5 years). Participants were asked about sexual contacts with and sexual harassment by healthcare professionals. Using descriptive statistics, prevalence rates of PSM were estimated. Results PSM was reported by 56 (4.5%) female and 17 (1.4%) male participants. In detail, 28 (2.2%) female and 10 (0.8%) male participants reported sexual contacts with healthcare professionals. One third of these sexual contacts took place before the age of 18 and one third against the will of the patients. 40 (3.2%) female and 8 (0.6%) male participants reported unnecessary physical examinations, 31 (2.5%) female and 7 (0.6%) male participants reported sexual harassment. The majority of perpetrators were male. Conclusions Our data provide an important first insight into the prevalence of PSM by healthcare professionals towards patients in a representative sample. Results suggest a high prevalence of PSM in the general population of Germany. Preventive measures to increase awareness of PSM and concepts for protection of patients are needed.

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Section: Discussionmentioning

confidence: 99%

#patientstoo – Professional sexual misconduct by healthcare professionals towards patients: a representative study

Clemens

Brähler

Fegert

2021

Epidemiol Psychiatr Sci

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“…Our results suggest, that application of coercive measures and physical abuse in general decreased in the course of reforms in psychiatric care initiated by the “Psychiatrie-Enquête”, but due to low number of cases, no clear conclusions could be drawn. However, this interpretation is underlined by a previous analysis that included subjects in all assessed kind of hospitals without sub stratification for psychiatry, showing that oldest participants reported highest rates of maltreatment [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…In the—to the best of our knowledge—first population-representative study that analyzed the prevalence of child maltreatment by caregivers in several institutions including schools and hospitals, maltreatment specifically by nursing staff in the clinical setting was assessed. 2.2% of the sample indicated to have experienced physical abuse, 2.1% emotional abuse, 0.2% sexual abuse and 2.6% neglect by nursing staff in medical institutions [ 6 ]. Using the same population-representative dataset than in the study from Clemens et al [ 6 ], this study takes a detailed look on child maltreatment by nursing staff specifically during inpatient stays in child and adolescent psychiatry.…”

Section: Introductionmentioning

confidence: 99%

“…2.2% of the sample indicated to have experienced physical abuse, 2.1% emotional abuse, 0.2% sexual abuse and 2.6% neglect by nursing staff in medical institutions [ 6 ]. Using the same population-representative dataset than in the study from Clemens et al [ 6 ], this study takes a detailed look on child maltreatment by nursing staff specifically during inpatient stays in child and adolescent psychiatry. Data are compared to rates in general or pediatric hospitals.…”

Section: Introductionmentioning

confidence: 99%

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Violence against children and adolescents by nursing staff: prevalence rates and implications for practice

Hoffmann

Clemens

König

et al. 2020

Child Adolesc Psychiatry Ment Health

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Background International studies show that child maltreatment is a widespread but often underestimated problem that causes high individual, social and economic costs. Child maltreatment is an important topic for the medical sector as well. On the one hand, affected persons often seek support and help from healthcare professionals, but on the other hand, assaults can also occur in medical institutions by healthcare professionals. Surprisingly, there is hardly any data on the frequency of child maltreatment by healthcare professionals in general and particularly by nursing staff. Methods Therefore, in a large representative survey of the German population of 2,516 subjects aged between 14 and 91, the experience of child maltreatment in medical institutions by nursing staff was assessed retrospectively. Results Of the 46 subjects who had an inpatient stay in a child and adolescent psychiatry before the age of 18, 33.3% reported to have experienced maltreatment by nursing staff, while 17.3% of the 474 persons who had an inpatient stay in general or pediatric hospitals experienced maltreatment by nursing staff. All forms of maltreatment were significantly more frequent in psychiatric compared to general and pediatric hospitals. Conclusions The results of our representative retrospective survey demonstrate that maltreatment by nursing staff are not rare individual cases, but that medical facilities bear systemic risks for assault. Therefore, it is necessary that all medical institutions, in particular psychiatric hospitals, address this issue. In order to reduce the risk for assaults, it is important not only to implement structural measures but also to develop an attitude that emphasizes zero tolerance for violence against children and adolescents.

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“…In addition, particularly in medical institutions, there are often steep hierarchies which make it more difficult to deal with cases of child maltreatment adequately. Several studies showed that medical institutions can act as crime scenes in which professionals misuse structures and treatment situations to abuse their patients [ 12 ]. This perspective is often neglected in the self-image of medical institutions as it contradicts the self-perception of medical institutions as places where people get help and treatment.…”

Section: Discussionmentioning

confidence: 99%

Development and randomized controlled trial evaluation of E-learning trainings for professionals

et al. 2020

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Background Child maltreatment and consequently child protection are highly relevant and current issues in our society. Medical institutions are widely regarded as places of healing, care and support. But they also hold risk factors to promote child maltreatment. Efforts have to be taken in order to offer help to victims by medical institutions and to reduce risk factors for child maltreatment. Therefore, health professionals in the field of child protection must be trained and sensitized for these two purposes. The Department of Child and Adolescent Psychiatry / Psychotherapy at the University Hospital of Ulm in Germany is developing E-Learning courses directed to health professionals in order to create flexible advanced training courses for dealing with child abuse, and to increase competences in child protection. Due to their specific role in (institutional) child protection, three courses and their evaluation will be presented in this article. The aim of the studies is to examine if those online-courses are increasing knowledge and skills in child protection and how satisfied participants are with course quality. Methods Randomised Controlled Trials (RCT) were conducted with one wait-list control group and one group participating in the course (= intervention group). The RCTs took place from October 2016 to March 2017 for two courses, and from May 2017 to September 2017 for the other course. Data were analysed with mixed design ANOVA. For evaluation of user satisfaction, descriptive statistics are reported. Results For all three courses, knowledge and practical capacities on the topic of the intervention group raised significantly in comparison to the values of the control group. Furthermore, participants of the course for managers felt better prepared to meet their responsibilities in regard to institutional child protection and came up with ideas on how to implement safeguarding standards in their institution. Overall, participants were very satisfied with the structure and the content of the courses. Conclusions The article shows that the online-courses are an effective and well-accepted approach to train professionals in topics regarding (institutional) child protection by contributing to the participants´ abilities to create medical facilities into a place of competence and protection.

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Child maltreatment by nursing staff and caregivers in German institutions: A population-representative analysis

Cited by 18 publications

References 19 publications

#patientstoo – Professional sexual misconduct by healthcare professionals towards patients: a representative study

#patientstoo – Professional sexual misconduct by healthcare professionals towards patients: a representative study

Violence against children and adolescents by nursing staff: prevalence rates and implications for practice

Development and randomized controlled trial evaluation of E-learning trainings for professionals

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