Experiences of Family Physicians Who Encountered with Cases of Child Abuse/Neglect in Turkey

Kübra Celen, Pemra C. Unalan, Irem Gelgec, Cigdem Apaydin Kaya

Keywords: family physicain, child abuse, neglect, primary care

Background:
Family physicians play a pivotal role in the detection and reporting of child abuse. However, there is not enough research on their experiences in this issue in literature.

Research questions:
What are the experiences of family physicians who encountered with cases of child abuse/neglect, and needs in this regard?

Method:
A qualitative study was conducted in 2021 with family physicians (FPs) worked in primary health centers in Turkey. Semi-structured interviews were used to understand the experiences of FPs' worked in primary health centers in Turkey who were recruited by purposive and snowball sampling and through the annoncements of FPs ascociations. Deep interviews with the voluntary physicians took place via online meetings or face to face. In those interviews covered topics were such as participants’ opinions and experiences about reporting child abuse, barriers or facilitators encountered when reporting and participants’ suggestions to improve the opinions on the current reporting system. All interviews were conducted by the first author and took an average of 30-45 minutes. Interviews were recorded with prior consent and transcribed verbatim. Interviews were thematically analysed using an inductive approach, first by descriptive coding, then categorising common codes into subthemes and themes , by three wo authors. To ensure rigor, the coding framework was reviewed and agreed by the all authors. Ethics approval was obtained from the Marmara University School of Medicine Non-interventional Clinical Practices Ethics Committee.

Results:
Seventeen FPs (fifteen female, two male) participated, with an average age of 40years and 15years of practice in medicine. Four main themes were identified: “Case reporting and management process”, “Judgments and emotions”, "Self-assessment”, “Traces on the physician and recommendations”. Physicians reported the difficulties in; recognizing child abuse, deciding to report, managing the interfamily relations and self safety after reporting the case to the officials.

Conclusions:
The family physicians need support about reporting and managing child abuse.

Points for discussion:
Is there any similarity with your experience?

Do you experienced any helping factor that makes the primary care physicians to manage child abuse/neglect cases better?