Violence against children and adolescents by nursing staff: prevalence rates and implications for practice
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Child and Adolescent Psychiatry and Mental Health Open Access
RESEARCH ARTICLE
Violence against children and adolescents by nursing staff: prevalence rates and implications for practice Ulrike Hoffmann1*†, Vera Clemens1†, Elisa König1, Elmar Brähler2,3 and Jörg M. Fegert1
Abstract 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 sec‑ tor 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 inpa‑ tient 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. Keywords: Child maltreatment, Nursing, Medical institutions, Child protection, Child and adolescent psychiatry Introduction Child maltreatment is defined as “any act or series of acts of commission or omission by a parent or other caregiver that results in harm, potential for harm, or threat of harm to a child” [20] and can be distinguished into 5 subtypes: emotional, physical and sexual abuse and emotional and physical neglect. It can cause severe lifelong *Correspondence: ulrike.hoffmann@uniklinik‑ulm.de † Ulrike Hoffmann and Vera Clemens contributed equally to this manuscript 1 Department for Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Steinhövelstr. 5, 89073 Ulm, Germany Full list of author information is available at the end of the article
health impairment. Victims have an increased risk for cardiovascular and oncologic disorders [7], addiction and mental illnesses [28] as well as social problems such as criminal behavior in adulthood [16]. Often, affected
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