Educational Program's Impact on Nursing Students' Knowledge and Awareness of Child Abuse and Neglect

Child Abuse Clinical Trial

Official title:

The Impact of an Educational Program on Child Abuse and Neglect Knowledge and Awareness Levels Among Nursing Students: A Randomized Controlled Study

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05925387
• Other study ID #: YeditepeUniversity
• Status: Recruiting
• Phase: N/A
• Start date: May 20, 2023
• Est. completion date: July 30, 2023

Study information

• Verified date: June 2023
• Source: Yeditepe University
• Contact: Damla Ozcevik Subasi, PhD
• Phone: 05336038073
• Email: dozcevik17[@]ku.edu.tr
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Detecting and determining child abuse and neglect can be quite challenging and largely depends on the knowledge and skills of healthcare professionals. In a hospital setting, healthcare professionals frequently come across children who have experienced abuse and/or neglect. Nurses are often the first to encounter the child and their family, initiating the process of taking a medical history and establishing closer interactions during care and treatment. To accurately recognize the case and provide appropriate care using the right approach, nurses need to possess sufficient knowledge and skills related to child abuse and neglect. The lack of adequate education on child abuse and neglect, as well as insufficient research on the subject, can lead to a lack of information and cases being overlooked. To identify and report cases of child abuse and neglect, it is important for nurses, especially before starting their profession, to have a sufficient level of knowledge about the signs and risks of child abuse and neglect. This study aims to examine the impact of an educational program targeting nursing students on their knowledge and awareness levels regarding child abuse and neglect.

Description:

Detecting and identifying child abuse and neglect is quite challenging and relies heavily on the knowledge and skills of healthcare professionals (Child Welfare Information Gateway, 2019). In a hospital setting, healthcare professionals frequently encounter children who have experienced abuse and/or neglect. Nurses, who are often the first to interact with the child and their family, play a crucial role starting from the process of taking the medical history to provide care and treatment (Chen et al., 2022). Nurses who have frequent contact with children and their families are in a good position to protect children from abuse and neglect (Bahrami et al., 2021). Particularly in emergency departments, nurses often come across child abuse and neglect, including various types such as Munchausen by Proxy Syndrome, which is a form of physical abuse (Chen et al., 2022). Therefore, it is crucial, especially for nurses, to carefully observe children who may be victims of abuse and evaluate all children who come to the hospital for signs of abuse and neglect (Başdaş & Bozdağ, 2018). Nurses need to have sufficient knowledge and skills regarding child abuse and neglect to accurately identify cases and provide appropriate care (Jordan & Moore-Nadler, 2014). They should establish communication with the child and their family, attempt to recognize the signs and symptoms of abuse and neglect, and report the case from a forensic perspective (Chen et al., 2022). To fulfill these roles and responsibilities adequately, nurses need to receive education on child abuse and neglect (Topçu et al., 2022). Insufficient education on child abuse and neglect, as well as inadequate research on the subject, can lead to a lack of knowledge and cases being overlooked. For example, in Turkey, there are only a limited number of universities offering elective courses on child abuse and neglect within nursing curricula (Topçu et al., 2022). Similarly, a limited number of studies have shown that the level of awareness regarding child abuse and neglect is good when it is included in the pediatric nursing curriculum (Özçevik et al., 2018). However, studies conducted in Turkey involving nurses (Başdaş & Bozdağ, 2018; Burç & Güdücü Tüfekci, 2015) and particularly nursing students (Erkut et al., 2021; Ozbey et al., 2018; Seferoğlu et al., 2019; Tek & Karataş, 2021) have revealed that their knowledge levels regarding child abuse and neglect are insufficient, similar to countries like India (Poreddi et al., 2016). In order to identify cases of child abuse and neglect, it is essential for nurses, especially before entering the profession, to have sufficient knowledge about the signs and risks of child abuse and neglect. It has been emphasized that nursing students need to learn their legal responsibilities and receive education to enhance their knowledge and become more competent (Akcan & Demiralay, 2016; Bağ & Bozkurt, 2021; Kuşlu & Bulut, 2021; Seferoğlu et al., 2019).

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 75
• Est. completion date: July 30, 2023
• Est. primary completion date: June 30, 2023
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years to 30 Years

Eligibility

Inclusion Criteria:

• 1st, 2nd, 3rd, and 4th Grade Undergraduate Nursing Students between the ages of 18-30.
• Being a volunteer,
• Not having any disability,
• Being Turkish literate,
• Having Internet access and a Google account,
• Signing the informed consent form

Exclusion Criteria:

• Being outside the age range,
• Being a prep class student, being illiterate in Turkish

Related Conditions & MeSH terms

• Child Abuse
• Child Neglect

Intervention

Other:
• CANAP Education
The volunteer group included in the research consists of Yeditepe University Nursing Students. All nursing students over the age of 18, at all levels of the nursing program, will be included in the study based on voluntary participation, in accordance with the sample size. The purpose and design of the research will be explained to the 1st, 2nd, 3rd, and 4th-year nursing students. The announcement of the study will be made through Yeditepe University Nursing's social media accounts, and a consent link provided. Participants who sign the document in the consent link and upload it to the shared Google Drive received the pre-test link. Participants who complete all the procedures are provided with a participant certificate prepared by the researchers as an incentive.

Locations

Country	Name	City	State
Turkey	Yeditepe University	Istanbul	Atasehir

Sponsors (1)

Lead Sponsor	Collaborator
Yeditepe University

Country where clinical trial is conducted

Turkey, 

References & Publications (27)

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Altan, H. (2015). Üniversite Ögrencisi Gençlere Çocuk Istismari Ve Ihmali Konusunda Yapilan Egitimin Bilgi Ve Farkindaliklarina Etkisi [Doktora, Gazi Üniversitesi].

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Bag, Ö. F., & Bozkurt, G. (2021). Hemsirelerin Çocuk Ihmal Ve Istismarina Iliskin Farkindaliklarini Etkileyen Faktörlerin Incelenmesi. Anadolu Hemsirelik Ve Saglik Bilimleri Dergisi, 24(1), 17-24.

Bahrami N, Tork-Torabi M, Sotoudeh R, Namnabati M. Perceived Child Abuse and Neglect in Hospitalized Children with Special Health Care Needs in Iran. Iran J Nurs Midwifery Res. 2021 Oct 22;26(6):526-530. doi: 10.4103/ijnmr.IJNMR_296_19. eCollection 2021 Nov-Dec. — View Citation

Bakir, E., & Kapucu, S. (2017). Çocuk ihmali ve istismarinin Türkiye'de yapilan arastirmalara yansimasi: Bir literatür incelemesi. Hacettepe Üniversitesi Hemsirelik Fakültesi Dergisi, 4(2), 13-24.

Basdas, Ö., & Bozdag, F. (2018). Hemsirelerin çocuk istismari ve ihmalinin belirti ve risklerini tanilama durumlarinin belirlenmesi. Mersin Üniversitesi Saglik Bilimleri Dergisi, 11(3), 267-275.

Burç, A., & Güdücü Tüfekci, F. (2015). Hemsirelerin çocuk istismari ve ihmalinin belirti ve risklerini tanilama düzeyleri.

Chen CJ, Chen YW, Chang HY, Feng JY. Screening Tools for Child Abuse Used by Healthcare Providers: A Systematic Review. J Nurs Res. 2022 Feb 1;30(1):e193. doi: 10.1097/JNR.0000000000000475. — View Citation

Child Welfare Information Gateway. (2004). Risk and Protective Factors for Child Abuse and Neglect. U.S. Department of Health and Human Services, Administration for Children and Families, Children's Bureau. . https://www.childwelfare.gov/pubpdfs/riskprotectivefactors.pdf

Child Welfare Information Gateway. (2019). What is child abuse and neglect? Recognizing the signs and symptoms. Washington, DC: U.S. Department of Health and Human Services, Children's Bureau.

Cicchetti D. Socioemotional, Personality, and Biological Development: Illustrations from a Multilevel Developmental Psychopathology Perspective on Child Maltreatment. Annu Rev Psychol. 2016;67:187-211. doi: 10.1146/annurev-psych-122414-033259. — View Citation

Conrad-Hiebner A, Byram E. The Temporal Impact of Economic Insecurity on Child Maltreatment: A Systematic Review. Trauma Violence Abuse. 2020 Jan;21(1):157-178. doi: 10.1177/1524838018756122. Epub 2018 Feb 4. — View Citation

Erkut, Z., Gözen, D., & Besirik, S. (2021). Hemsirelik Bölümü Son Sinif Ögrencilerinin Çocuk Istismari ve Ihmalinin Belirti ve Risklerini Tanilamaya Yönelik Bilgi Düzeyleri ve Sosyodemografik Faktörlerle Iliskisi. Journal Education and Research in Nursing, 18(2), 231-240.

Gonzalez D, Bethencourt Mirabal A, McCall JD. Child Abuse and Neglect. 2022 Jul 4. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from http://www.ncbi.nlm.nih.gov/books/NBK459146/ — View Citation

Gubbels J, van der Put CE, Stams GJM, Assink M. Effective Components of School-Based Prevention Programs for Child Abuse: A Meta-Analytic Review. Clin Child Fam Psychol Rev. 2021 Sep;24(3):553-578. doi: 10.1007/s10567-021-00353-5. Epub 2021 Jun 4. — View Citation

Jordan KS, Moore-Nadler M. Children at risk of maltreatment: identification and intervention in the emergency department. Adv Emerg Nurs J. 2014 Jan-Mar;36(1):97-106. doi: 10.1097/TME.0000000000000011. — View Citation

Külcü, D. P., & Karatas, H. (2016). Çocuk kliniklerinde çalisan hemsirelerin çocuk istismari ve ihmali konusunda bilgi düzeylerinin incelenmesi. Ege Üniversitesi Hemsirelik Fakültesi Dergisi, 32(1), 48-58.

Kuslu, S., & Bulut, A. (2021). Çocuk Istismari ve Ihmaline Yönelik Hemsirelerin Bilgi, Tutum ve Davranislari: Literatür Taramasi. Disiplinlerarasi Çocuk Haklari Arastirmalari Dergisi, 1(2), 73-84.

Ozbey, H., Ozcelep, G. A., Gul, U., & Kahriman, I. (2018). Knowledge and awareness of nursing students about child abuse and neglect. J Nurs Res Pract, 2(3), 21-25.

Özçevik, D., Günes, Ö. D., & OCAKÇI, A. F. (2018). Hemsirelik ögrencilerinin sosyo-kültürel ve demografik özelliklerinin çocuk istismari ve ihmali farkindaligi ile iliskisi. Ankara Saglik Hizmetleri Dergisi, 17(2), 16-27.

Poreddi V, Pashapu DR, Kathyayani BV, Gandhi S, El-Arousy W, Math SB. Nursing students' knowledge of child abuse and neglect in India. Br J Nurs. 2016 Mar 10-23;25(5):264-8. doi: 10.12968/bjon.2016.25.5.264. — View Citation

Seferoglu, E. G., Sezici, E., & Yigit, D. (2019). Hemsirelik ögrencilerinin çocuk istismari ve ihmalinin belirti ve risklerini tanilama düzeyleri. OPUS International Journal of Society Researches, 10(17), 257-276.

Tek, S., & Karatas, G. (2021). Awareness Levels of Child Neglect and Abuse in Nursing Students. OPUS International Journal of Society Researches, 18(43), 6162-6176.

Topçu, T. E., Erek Kazan, E., Küçük, S., Murat, Y., Alpaslan, B., Molozoglu, H., & Özkan, B. (2022). Hemsirelik Ögrencilerinin Çocuk Istismari ve Ihmalinin Belirti ve Risklerini Tanilamaya Iliskin Bilgi Düzeyleri. Journal of Higher Education & Science/Yüksekögretim ve Bilim Dergisi, 12(2), 264-273.

TUIK. (2021). Güvenlik Birimine Gelen veya Getirilen Çocuk Istatistikleri, 2020. Erisim adresi: https://data.tuik.gov.tr/Bulten/Index?p=Guvenlik-Birimine-Gelen-veya-Getirilen-Cocuk-Istatistikleri-2020-37200

Yüksel, H., & Yüksel, M. (2014). Çocuk ihmali ve istismari baglaminda Türkiye'de çocuk gelinler gerçegi. Çankiri Karatekin Üniversitesi Sosyal Bilimler Enstitüsü Dergisi, 5(2), 1-24.

* Note: There are 27 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Child Abuse and Neglect Awareness Scale (CANA-S)	CANA-S has 4 sub-dimensions: physical abuse, sexual abuse, emotional abuse and neglect. It consists of 20 items in total, 11 of which are reverse scored (1,2,3,5,7,10,12,13,16,17,18). It is a 5-point Likert-type scale (ranging from 1 to 5 (between "strongly disagree" and "strongly agree"). The highest score to be obtained from the scale is 100 and the lowest score is 20. Each of the subscales is 25 points. As the scores obtained from the scale increase, the level of awareness of child abuse and neglect increases; As the scores decrease, the level of awareness of child abuse and neglect decreases. In the internal consistency analysis for reliability, the Cronbach alpha value of CANA-S was found to be 0.768.	Pretest
Primary	Child Abuse and Neglect Awareness Scale (CANA-S)	CANA-S has 4 sub-dimensions: physical abuse, sexual abuse, emotional abuse and neglect. It consists of 20 items in total, 11 of which are reverse scored (1,2,3,5,7,10,12,13,16,17,18). It is a 5-point Likert-type scale (ranging from 1 to 5 (between "strongly disagree" and "strongly agree"). The highest score to be obtained from the scale is 100 and the lowest score is 20. Each of the subscales is 25 points. As the scores obtained from the scale increase, the level of awareness of child abuse and neglect increases; As the scores decrease, the level of awareness of child abuse and neglect decreases. In the internal consistency analysis for reliability, the Cronbach alpha value of CANA-S was found to be 0.768.	Immediately after the intervention
Primary	Child Abuse and Neglect Awareness Scale (CANA-S)	CANA-S has 4 sub-dimensions: physical abuse, sexual abuse, emotional abuse and neglect. It consists of 20 items in total, 11 of which are reverse scored (1,2,3,5,7,10,12,13,16,17,18). It is a 5-point Likert-type scale (ranging from 1 to 5 (between "strongly disagree" and "strongly agree"). The highest score to be obtained from the scale is 100 and the lowest score is 20. Each of the subscales is 25 points. As the scores obtained from the scale increase, the level of awareness of child abuse and neglect increases; As the scores decrease, the level of awareness of child abuse and neglect decreases. In the internal consistency analysis for reliability, the Cronbach alpha value of CANA-S was found to be 0.768.	1 month after the intervention
Secondary	1. Scale for Identification to the Symptom and Risks of Child Abuse and Neglect (SISRCAN)	This scale, consisting of 67 items in total, was developed to measure the knowledge levels of nurses and midwives about child abuse and neglect. This scale is a 5-point Likert type. The scale has 6 sub-dimensions. There are reverse scored items in the scale. The participant who answers all the items in the scale correctly is expected to get 335 full points. Each sub-dimension of the scale is evaluated by calculating the average score out of 5. The fact that the average score of the participants is close to 5 indicates that they answered the questions "correctly", and the closer to 1 indicates that they answered the questions "wrong". In the internal consistency analysis for reliability, the Cronbach alpha value was found to be 0.92.	Pretest
Secondary	1. Scale for Identification to the Symptom and Risks of Child Abuse and Neglect (SISRCAN)	This scale, consisting of 67 items in total, was developed to measure the knowledge levels of nurses and midwives about child abuse and neglect. This scale is a 5-point Likert type. The scale has 6 sub-dimensions. There are reverse scored items in the scale. The participant who answers all the items in the scale correctly is expected to get 335 full points. Each sub-dimension of the scale is evaluated by calculating the average score out of 5. The fact that the average score of the participants is close to 5 indicates that they answered the questions "correctly", and the closer to 1 indicates that they answered the questions "wrong". In the internal consistency analysis for reliability, the Cronbach alpha value was found to be 0.92.	Immediately after the intervention
Secondary	1. Scale for Identification to the Symptom and Risks of Child Abuse and Neglect (SISRCAN)	This scale, consisting of 67 items in total, was developed to measure the knowledge levels of nurses and midwives about child abuse and neglect. This scale is a 5-point Likert type. The scale has 6 sub-dimensions. There are reverse scored items in the scale. The participant who answers all the items in the scale correctly is expected to get 335 full points. Each sub-dimension of the scale is evaluated by calculating the average score out of 5. The fact that the average score of the participants is close to 5 indicates that they answered the questions "correctly", and the closer to 1 indicates that they answered the questions "wrong". In the internal consistency analysis for reliability, the Cronbach alpha value was found to be 0.92.	1 month after the intervention