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The role of paediatric nurse in prevention of the CAN syndrome
KROUŽKOVÁ, Aneta
Abstract Current state: CAN (Child Abuse and Neglect) syndrome can be characterized as physical and psychological abuse, sexual abuse and neglect of a child. The most common perpetrators of such treatment are parents or family members. Domestic violence and bullying are also part of CAN syndrome. The aim of the thesis was to evaluate trends in the number of reported cases of violence against children in the Czech Republic within the observed period of 2012-2021, to describe parents' knowledge of the abused and neglected child syndrome, to describe parents' knowledge of the Shaken Baby Syndrome, to describe the role of paediatric nurses in the prevention of the abused and neglected child syndrome and to describe the role of paediatric nurses in the prevention of the Shaken Baby Syndrome. Methodology: A combination of a qualitative-quantitative research strategy was chosen for the empirical part of the thesis. For the quantitative data collection, the method chosen was secondary analysis of documents from the Ministry of Labour and Social Affairs from the period 2012-2021. For the second part of the quantitative research, a questionnaire survey method was used using a non-standardized structured questionnaire. The data collection was partly carried out in the practitioners' offices for children and adolescents, and partly collected on the internet through forums for parents. A total of 212 questionnaires were collected. The method of semi-structured interviews was chosen for qualitative data collection. The research file consisted of six nurses working at practitioners' offices for children and adolescents. Results: In the period of 2012-2021, a total of 84 897 cases of abused and neglected children were reported to the register of the Ministry of Labour and Social Affairs (100%). Neglect was the most frequent form of CAN syndrome (72%). 11.2% children suffering from CAN syndrome were mentally abused, 10.2% were sexually abused including children in prostitution and children used for pornography, 7.6% were physically abused. The representation of girls and boys was almost equal, with 51.5% of girls and 48.5 % of boys. The most abused and neglected age group of children were children aged 6-15 (55%). Statistical testing did not confirm the hypothesis that the number of reported cases of violence against children increased significantly in the period of 2015-2021 (p<0.830). A total of 212 parents participated in the survey and 43.9% of the respondents had experienced some form of CAN syndrome. According to the parents surveyed, the most at-risk groups of people who are at higher risk of child abuse, neglect or exploitation include: alcohol addicts; substance abusers; or sexual deviants. According to the respondents, the most frequent perpetrators of sexual abuse were stepfathers (87.7%) or uncles (66.0%). According to the respondents, symptoms of physical abuse include: bruises of different ages, change in the child's behaviour , burns, fractures or stab wounds. According to respondents, symptoms of child sexual abuse include: anal injuries, genital bleeding, behavioural changes, increased anxiety or aggression. Parents were most likely to agree with the statement that shaking their infant resulted in brain injury (4.4 ? 0.9), brain haemorrhage, death of the infant, or retinal haemorrhage. Parents' knowledge of Abused, Abused and Neglected Child Syndrome and Shaken Baby Syndrome did not vary significantly with their education (p<277) or age (p<406). Based on the interviews with primary care nurses, it can be concluded that the role of nurses in the prevention of CAN syndrome is to seek out children at risk for CAN syndrome and educate parents about Shaken Baby Syndrome. On the basis of the theoretical and empirical part, an informative material was designed CAN "syndrome" for parents and nurses in general practitioners' offices for children and adolescents.
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