Paediatricians must be better prepared to examine abused children

As primary contact persons for health issues, paediatricians play a key role in detecting child abuse. However, they are often extremely emotionally stressed and subsequently unsure when they notice the first signs of abuse. It is striking that this phenomenon occurs in both young and experienced doctors.

Louisa Thiekötter is herself a paediatrician and adolescent doctor in training at the Vestische Kinder- und Jugendklinik in Datteln, a partner hospital of Witten/Herdecke University (UW/H). In her doctoral thesis, she collected data on how stressed paediatricians are when they examine children or adolescents who may have been abused. "The level of stress reported by the doctors surveyed clearly exceeds classic emergency situations in primary care. This is a sign that there is a need for improvement in training, but also in the provision of resources," says Thiekötter, summarising the results. "Although doctors are generally familiar with the child protection guidelines, the signs of child endangerment cannot always be clearly classified as such," adds Prof Dr Oliver Fricke, co-author of the resulting publication. "Communication with parents or authorities also often lacks concrete, practical processes and information on how to implement the discussions. In addition, there is room for improvement in professional and interdisciplinary exchange - for example in the closely neighbouring field of child and adolescent psychiatry and psychotherapy."

Initiating improvements in dealing with child protection stressors

The study was supported by the Professional Association of Paediatricians. The results now available should be used to initiate the necessary improvements in dealing with stressors in child protection and thereby further develop professional care in this area. In particular, changes in the training of paediatricians and adolescent doctors initiated by health policy could be strengthened so that they are better trained for such stressful situations. The existing laws and guidelines could then also be more effective.

All results have been published in open access in the international journal "Children": https://www.mdpi.com/1892938