JGZ-richtlijn Kindermishandeling

Vink, R.; Wolff, Michelle; Kamphuis, M.

doi:10.1007/s12452-017-0109-7

Cited by 11 publications

(23 citation statements)

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“…The ambiguous stance towards intuition indicates that it can be a helpful practice in decision-making, but also highlights the need for guidance on how to use it and to avoid the pitfalls mentioned by interviewees. Currently, Dutch guidelines on child abuse reflect this ambiguity and lack of guidance: it states that "good intuition" is useful, but that decision-making based on intuition is "dangerous", it fails to provide any further explanation [4]. As guidelines in health care are aimed at improving quality of care and supporting decision-making, it is important to not only mention intuition, but also to guide practitioners in using intuition not just as a feeling, but also as good care.…”

Section: Discussionmentioning

confidence: 99%

“…In the investigation of suspected cases of child abuse, CYHC-practitioners are guided by evidencebased guidelines (EBM), which aim to improve the quality of care and prevention [14,15]. These guidelines emphasise the importance of collecting factual evidence, on which CYHC-professionals ought to base their decisions [4]. Yet, in order to work with problems as unstructured, complex and broad as child abuse, professionals cannot solely rely on analytical rationality; they are in need of other strategies and subjective ways of knowing [16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

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Navigating complexity through intuition and evidence-based guidelines: a mix-methods study among child and youth healthcare practitioners

Erisman

Sabbata

Zuiderent‐Jerak

et al. 2019

Preprint

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Background: Dutch child and youth health care (CYHC) practitioners monitor and assess the well-being of all children. One of their main concerns is identifying cases of child abuse, which is an arduous and sensitive task. They use both evidence-based guidelines aimed at increasing the quality of care through rationalised decision-making and intuition. These two practices are seen as being at odds with each other, yet empirical research has shown that both are needed in healthcare. This study aims to understand how Dutch CYHC-practitioners perceive the role of intuition in their work and in relation to evidence-based medicine, in the case of child abuse.Methods: A sequential exploratory mixed-methods design. In-depth semi-structured interviews with CYHC-practitioners focused on perceptions on intuition, which was followed by a survey amongst CYHC-professionals on the recognition and use of the concept.Results: The majority of CYHC-practitioners and professionals recognise and use intuition in their daily work, stating that it is necessary in their profession. CYHC-practitioners use intuition: 1) to sense that something is off, 2) to differentiate between ‘normal’ and ‘abnormal’, 3) to assess risks, 4) to weigh secondary information and 5) to communicate with parents. At the same time, they warn for its dangers as it may lead to tunnel vision and false accusations. Their ways of working with intuition show parallels to the practices that evidence-based guidelines try to support.Conclusion: Intuition is experienced as an integral part of the work of CYHC-practitioners. It is stated to be particularly useful in the case of child abuse, which is inherently complex as signs and evidence of abuse are hidden, subtle and unique in each case. CYHC-practitioners use intuition to manage and navigate this complexity. As there is a lack of guidance on how to practice intuition, there is a need for support through guidelines.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Navigating complexity through intuition and evidence-based guidelines: a mix-methods study among child and youth healthcare practitioners

Erisman

Sabbata

Zuiderent‐Jerak

et al. 2019

Preprint

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“…Randvoorwaarden voor een goede samenwerking zijn dat de huisartsen in het werkgebied de JGZ professionals kunnen bereiken, en dat er afspraken zijn gemaakt over verwijzing, terugkoppeling, gegevensuitwisseling en zorgcoördinatie (LESA, 2010;Rutte, Pijpers & Timmermans, 2013;NCJ, 2008;2016). In bepaalde situaties is het van belang dat de JGZ professional rechtstreeks contact opneemt met huisartsen: -Bij verwijzing naar een medische professional zoals jeugd ggz, jeugdhulp, maatschappelijk werk of andere hulp zoals schulphulpverlening ; -Bij (vermoedens van) kindermishandeling in een gezin of bij een jeugdige (Zie verder JGZ Richtlijn Kindermishandeling (Vink et al, 2016) ; -Indien ouders/jeugdige nooit verschijnen dan wel weigeren deel te nemen aan JGZ-programma en er is aanleiding voor (een vermoeden van) zorgen over de veiligheid van het kind.…”

Section: De Huisartsunclassified

JGZ-richtlijn Psychosociale problemen

Wolff

Theunissen

Rooijen

2017

Tijdschr Jeugdgezondheidsz

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De richtlijn is bedoeld voor artsen en verpleegkundig(en)(specialist) werkzaam in de JGZ, in deze richtlijn de JGZ-professionals. Daar waar jeugdarts staat kan ook verpleegkundig specialist gelezen worden. Daar waar ouders staat, kan ook verzorgers of naasten worden gelezen. Taken van de JeugdgezondheidszorgGestart wordt met een korte schets van de taken van de jeugdgezondheidszorg en welke plaats het opsporen van psychosociale problemen heeft binnen het takenpakket.Aandacht voor gezond opgroeien en opvoeden Sinds 1 januari 2015 is het Basispakket JGZ ingevoerd; dit Basispakket stelt vaccinaties, screeningen, monitoring en signalering actief ter beschikking. Hoewel dergelijke activiteiten er voor alle jeugdigen moeten zijn, kan de uitvoering ervan per kind of jongere variëren. Dit is 5 afhankelijk van de specifieke behoefte en situatie van kind, gezin en omgeving. Waar nodig wordt voorlichting, advies, begeleiding en toeleiding naar zorg gegeven. Met uitleg en advies (ontwikkelingsgerichte informatie) kan de JGZ zorgen wegnemen en de situatie normaliseren, en zo bijdragen aan het versterken van eigen kracht en onnodige medicalisering helpen tegengaan. Hiermee wordt voorkomen dat alledaagse problemen ten onrechte bij zware, specialistische zorg terechtkomen, maar ook dat problemen ten onrechte niet behandeld worden, waardoor in een later stadium juist een extra beroep op gespecialiseerde zorg nodig zou zijn. Voorkomen van risico's en psychosociale problemenEen onderdeel van de taken van de JGZ is het volgen van de (psychosociale) ontwikkeling van kinderen en jeugdigen tussen 0 en 18 jaar. In de JGZ staat de lichamelijke, psychosociale en cognitieve ontwikkeling in samenhang met de omgeving (gezin, onderwijs en vrije tijd) centraal. Hierbij past een brede integrale benadering van kinderen en jeugdigen, vanuit een biopsychosociaal perspectief . Volgens deze benadering zijn zowel biologische (denk aan aanleg en erfelijkheid), psychologische (persoonlijkheid) als sociale aspecten (omgeving, gezin, opvoedsituatie) van invloed op het ontstaan en beloop van problemen. Vaak zijn er meerdere factoren die hierbij een rol spelen, bovendien kunnen factoren elkaars effect versterken. Wanneer een biologisch-genetische kwetsbaarheid aanwezig is, kan onder invloed van omgevingsfactoren een preklinische of prodromale fase ontstaan. In die fase zijn er nog geen signalen waarneembaar. Als de ongunstige interactieprocessen doorgaan, kunnen de eerste symptomen of problemen ontstaan. Preventie van gevolgen van opkomende problemen is vooral van belang in de fase dat klachten, problemen, symptomen (nog) niet zijn uitgekristalliseerd tot een classificeerbare diagnose. Immers, er kan ook al sprake zijn van (beginnende) lijdensdruk dan wel een stagnerende ontwikkeling nog vóórdat er een formele diagnose gesteld kan worden. De JGZ biedt een uniek kader om deze beginnende problemen positief te beïnvloeden in een vroeg stadium. Instrumenten en klinische blikInstrumenten zoals vragenlijsten en protocollen kunnen een goed hulpmiddel zijn in de ...

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“…The insights from this thesis have contributed to the revision of the guideline on the prevention of child abuse and neglect in preventive child healthcare, which came available in 2016 [50]. The outcomes of the determinant analysis provide directions for individual organisations concerning which activities need attention and which strategies can be used to improve guideline adherence.…”

Section: Recommendations For Policy and Practicementioning

confidence: 98%

“…the Mandatory Reporting Code Act, new scientific insights and consensus discussions among content experts [50].…”

Section: Risk Assessment Based On Protective and Risk Factors;mentioning

confidence: 99%

Fragile, please handle with care : understanding and supporting professionals' response to suspicions of child abuse and neglect

Konijnendijk¹

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Understanding and supporting professionals' response to suspicions of child abuse and neglect FRAGILE, PLEASE HANDLE WITH CARE UNDERSTANDING AND SUPPORTING PROFESSIONALS' RESPONSE TO SUSPICIONS OF CHILD ABUSE AND NEGLECTReferences 181 Summary 193Samenvatting 201 Dankwoord (Acknowledgements) 209 Curriculum Vitae 217Publications and other contributions 221 CHAPTER 1General introduction Child maltreatment traumatises millions of children across the globe [4]. A meta-analysis that included articles published between 1980 and 2008 on the prevalence of child abuse and neglect reported the following overall estimated rates for self-report studies that mainly assessed lifetime prevalence rates: 12.7% for sexual abuse, 22.6% for physical abuse, 36.3% for emotional abuse, 16.3% for physical neglect and 18.4% for emotional neglect. For studies using informants that mainly assessed one-year prevalence rates, the estimated prevalence rates were 0,4% for sexual abuse, and 0,3% for both physical and emotional abuse [4]. Child abuse and neglect in the NetherlandsChild abuse and neglect remains a major societal problem in high-income countries, as a considerable number of children continue to be maltreated and exploited [5]. In the Netherlands, the following definition of child abuse and neglect is currently in use, officially documented in the Kindermishandeling, Veilig Thuis since 2015) on child abuse and neglect reports, and self-reports of students in secondary school. In 2016, the nation-wide prevalence study was limited to self-reports of secondary school students. In 2010, the overall estimated one-year prevalence was 3.4% based on the results of the informants study and the official registration of Veilig Thuis [7]. This prevalence rate is 0.4% higher than found in 2005 [8]. In 2003, the yearly report of the Dutch Advice and Reporting Centre [9] showed the organisation was consulted 47,000 times, and investigated 20,000 suspected cases (0.6% of all Dutch children in 2013 [10]). One-year prevalence rates based on self-report study alone remained stable between 2005 and 2010, 9.9% of students between eleven and seventeen years old reported to have experienced child abuse and neglect [7,8]. The self-report study among secondary school students (in one of the first four years of secondary schools) performed in 2016 (6.5%) showed a decline of the one-year prevalence rate compared to 2005 and 2010 [11].In 2010, the most prevalent types of child maltreatment were physical, emotional and educational neglect, i.e. not attending to children's academic needs. Furthermore, the study concluded that almost a quarter of victims underwent sexual and/or physical abuse in 2010. Compared to 2005, emotional neglect (including being a witness of domestic violence) and educational neglect were reported more often, while sexual abuse and physical neglect were reported less often [7]. Causes and consequencesIn the last two decades, research has increased public knowledge about risk factors and protective factors of child abuse and neglect. It b...

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JGZ-richtlijn Kindermishandeling

Cited by 11 publications

References 5 publications

Navigating complexity through intuition and evidence-based guidelines: a mix-methods study among child and youth healthcare practitioners

Navigating complexity through intuition and evidence-based guidelines: a mix-methods study among child and youth healthcare practitioners

JGZ-richtlijn Psychosociale problemen

Fragile, please handle with care : understanding and supporting professionals' response to suspicions of child abuse and neglect

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