Perceptions of caregivers and adolescents of the use of telemedicine for the child sexual abuse examination

Stavas, Natalie; Shea, Judy A.; Keddem, Shimrit; Wood, Joanne N.; Orji, Whitney; Cullen, Catherine; Scribano, Philip V.

doi:10.1016/j.chiabu.2018.08.009

Cited by 10 publications

(5 citation statements)

References 39 publications

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“…Less has been published with regards to the attitudes of adolescents. Stavas conducted semistructured interviews similar to us among 10 adolescents and 17 caregivers in the setting of child sexual abuse [ 17 ]. Stavas found an overwhelming positive response to telemedicine despite of the sensitive subject matter.…”

Section: Discussionmentioning

confidence: 99%

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Adolescent and caregiver attitudes towards telemedicine use in pediatric nephrology

Qiu

McIntyre

Wile

et al. 2021

BMC Health Serv Res

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Background Telemedicine is increasingly utilized as an alternative to in person consultation. Current pandemic conditions are providing additional impetus to virtual care delivery. We compared both adolescent and caregiver (parent or guardian) attitudes towards telemedicine (here as tertiary center to remote health care location) as a crucial determinant of longer-term effectiveness. Methods This qualitative research study analyzed transcribed structured telephone interviews with both 11–18 year-old pediatric nephrology patients and their caregivers and performed a quantitative analysis of patient demographics, disease factors and distance to tertiary center vs. telemedicine center. Results The study was conducted in a medium-sized tertiary pediatric nephrology centre with a large catchment area of over 0.5 million square kilometers and 629,000 children and adolescents under 18 years of age. Eleven dyads of adolescents and caregivers were enrolled. Five adolescents were male. The mean age of the adolescents was 14.4 ± 2.5 years (range 11.2–18.0). The median distance to our tertiary center was 191 km (range 110–1378 km). Four adolescents lived more than 500 km from our tertiary center. The 11 adolescents had a total of 334 in person visits (mean 30 ± 25) and 86 telemedicine visits (mean 8 ± 7). A ratio of 2:1 telemedicine to in-person visits was favored; with caregivers more in favor of remote care than adolescents. Qualitative analysis found that experiences with telemedicine were distinguished by consultation-specific factors and contextual factors. Contextual factors (travel/cost savings) were valued for telemedicine by adolescents and caregivers. Consultation-specific factors, such as the ability to show the doctor physical symptoms, were more valued during in-person consultations, especially by adolescents. The overall visit type preference was related to the nature of the consultation. For regular check-ups, and for adolescents with less complex needs, participants felt that telemedicine offered a comparable experience to in-person visits. Adolescents with more complex conditions preferred in-person visits. Conclusions Indiscriminate transfer to chronic care predicated on mainly telemedicine approach is not compatible with user expressed attitudes (especially among adolescents). Accurately mapping models of care to these attitudes is an essential determinant of effective management and longer-term engagement with potentially life-long health challenges.

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Section: Discussionmentioning

confidence: 99%

“…Stavas found an overwhelming positive response to telemedicine despite of the sensitive subject matter. While the adolescents felt scared, unprepared and nervous, they all expressed relief after the telemedicine visit [ 17 ]. We are unaware of additional studies that directly involved the adolescents.…”

Section: Discussionmentioning

confidence: 99%

Adolescent and caregiver attitudes towards telemedicine use in pediatric nephrology

Qiu

McIntyre

Wile

et al. 2021

BMC Health Serv Res

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“…It involves the exchange of medical information between a clinician and patient using video conferencing software as well as educate the families and cater the needs of CSA victims and adolescents. (Stavas et al, 2018) Moreover, an approach should be adopted to offer emotional support, crisis intervention, education, and advocacy to children and their caregivers. Coordination across disciplines and agencies in society and across jurisdictions in some instances is crucial to simultaneously address the health, legal, safety, and support goals.…”

Section: Discussionmentioning

confidence: 99%

Medico-legal evidence collection in child sexual assault cases: a forensic significance

Kaur

Rawat

2021

Egypt J Forensic Sci

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Background Every year, millions of children face sexual exploitation worldwide. In India, 109 children (National Crime Records Bureau2018) were sexually abused everyday (22% jump from the previous year). Even with advanced DNA techniques, the conviction rate remains low. The methods used for forensic DNA evidence analysis vary around the world, but the primary step of biological evidence collection plays the most vital role. Proper and timely evidence collection from the victim by a trained medical professional is important. Main body Dynamics of child sexual assault being massively different from an adult rape demands altogether different approach of evidence collection. A standard sexual kit employed for evidence collection needs urgent modifications considering genital development of pre- and post-pubertal victims. In the present study, parameters including systemic collection and evaluation of forensic evidences, medico-legal examination, and developmental consequences of sexual assault on pre-pubertal victims were assessed. Further suggestions for separate evidence collection kit during medico-legal examination were given for pre-pubertal victims and alleged accused in sexual assault cases in order to streamline and for better evaluation of DNA analysis in forensic laboratories. Conclusion The importance of expert medical practitioners plays a significant role in collection of appropriate information and evidences from the victim of sexual assault. General guidelines for evidence collection in sexual assault cases are not well suited for pre-pubertal victims. Appropriate reforms pertaining to the age and genital development of victims are required. Securing clothing as forensic evidence is essential in most cases as it turned out to be the exclusive evidence bearing material. The purpose of this article is to bring awareness about the thorough medical examination and modified sexual assault kit for pre-pubertal victims and alleged accused for a better approach in evidence collection and conviction rate.

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“…In addition, not all cases of abuse are marked by pain, leading to confused feelings that run from pleasure and affection to fear of the abuser 48 . Depending on the frequency of abuse, when this mix of sensations last, the victim can end up falling in love with the abuser 49 .…”

Section: Sexual Impactsmentioning

confidence: 99%

Repercussões do abuso sexual vivenciado na infância e adolescência: revisão integrativa

Cruz

Gomes

Campos

et al. 2021

Ciênc. saúde coletiva

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Resumo O objetivo deste artigo é identificar as repercussões do abuso sexual experienciado na infância e na adolescência. Trata-se de uma revisão integrativa de literatura realizada no mês de setembro de 2018, a partir da base de dados da Biblioteca Virtual em Saúde. Para busca, associou-se os seguintes descritores: Abuso Sexual de Crianças e Adolescentes and (Adultos Sobreviventes de Abuso Sexual or Desenvolvimento Infantil), considerando como critérios de inclusão: artigos originais; disponíveis completos; publicados no período de 2013 a setembro de 2018; nos idiomas português, inglês e espanhol. Após a leitura dos títulos e dos resumos, selecionou-se 16 artigos, os quais foram lidos na íntegra e organizados através de uma tabela. Os estudos evidenciaram que pessoas que experienciam abuso sexual na infância e na adolescência apresentam repercussões de ordem psicológica, física, sexual e social, as quais perduram por toda vida. O estudo oferece subsídios para alertar profissionais de saúde quanto à necessidade de investigarem sinais e sintomas sugestivos de abuso sexual, visto que experienciar tal agravo traz inúmeras repercussões para vida das vítimas.

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Perceptions of caregivers and adolescents of the use of telemedicine for the child sexual abuse examination

Abstract: Telemedicine was widely accepted by adolescents and caregivers when used for the child sexual abuse examination.

Cited by 10 publications

References 39 publications

Adolescent and caregiver attitudes towards telemedicine use in pediatric nephrology

Adolescent and caregiver attitudes towards telemedicine use in pediatric nephrology

Medico-legal evidence collection in child sexual assault cases: a forensic significance

Repercussões do abuso sexual vivenciado na infância e adolescência: revisão integrativa

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