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What do GPs’ experiences teach us about the components of their intervention in non-urgent cases of suspected child abuse?

Par : Contributeur(s) : Type de matériel : TexteTexteLangue : français Détails de publication : 2021. Sujet(s) : Ressources en ligne : Abrégé : Non-urgent cases of suspected child abuse engage general practitioners (GPs) in a particularly complex process. Despite their important role in preventing such abuse, GPs still detect and report too few cases of child abuse. The barriers explaining this under-reporting are explored in the scientific literature, but there is little research analyzing GPs’ engagement with situations of abuse. This study attempts to determine the components of GPs’ intervention in non-urgent cases of suspected child abuse in order to better understand their decision-making process and identify levers for action. To answer this question, semi-structured interviews were conducted with 6 GPs practicing in the Wallonia-Brussels Federation. The data from the interviews were analyzed using the grounded theory method. This research highlights four categories that illustrate the components of GPs’ intervention when faced with non-urgent cases of suspected child abuse. These categories are presented by progressively broadening our focus from the GP to the healthcare network in which the practitioner is involved. They are then arranged in a chart that allows the modeling of the decision-making process undertaken by these GPs. The analysis of this decision-making process makes it possible to understand the limits of theoretical knowledge and why suspicion of a situation of abuse is not enough to intervene. Appropriate training programs could adequately support GPs in the complexity of these situations by integrating the specificities of their interventions highlighted by qualitative studies. An example of a pedagogical activity developed on the basis of the results of this research is discussed at the end of the article. More than a simple acquisition of knowledge and skills, such training could contribute to the development of a reflexive posture among GPs, i.e., an awareness of the difficult decision-making process they have to undertake.
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Non-urgent cases of suspected child abuse engage general practitioners (GPs) in a particularly complex process. Despite their important role in preventing such abuse, GPs still detect and report too few cases of child abuse. The barriers explaining this under-reporting are explored in the scientific literature, but there is little research analyzing GPs’ engagement with situations of abuse. This study attempts to determine the components of GPs’ intervention in non-urgent cases of suspected child abuse in order to better understand their decision-making process and identify levers for action. To answer this question, semi-structured interviews were conducted with 6 GPs practicing in the Wallonia-Brussels Federation. The data from the interviews were analyzed using the grounded theory method. This research highlights four categories that illustrate the components of GPs’ intervention when faced with non-urgent cases of suspected child abuse. These categories are presented by progressively broadening our focus from the GP to the healthcare network in which the practitioner is involved. They are then arranged in a chart that allows the modeling of the decision-making process undertaken by these GPs. The analysis of this decision-making process makes it possible to understand the limits of theoretical knowledge and why suspicion of a situation of abuse is not enough to intervene. Appropriate training programs could adequately support GPs in the complexity of these situations by integrating the specificities of their interventions highlighted by qualitative studies. An example of a pedagogical activity developed on the basis of the results of this research is discussed at the end of the article. More than a simple acquisition of knowledge and skills, such training could contribute to the development of a reflexive posture among GPs, i.e., an awareness of the difficult decision-making process they have to undertake.

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