Child abuse: perception and knowledge by Public Health Dentistry teams in Brazil

Abstract Aim: To evaluate the experience, knowledge and attitudes of dentists and oral health technicians (OHTs) who work in Basic Health Units in the city of Curitiba, PR, Brazil, regarding cases of abuse against children and adolescents. Methods: In this observational study, three hundred eighty-three questionnaires (validated for Brazilian Portuguese) were sent to dentists and OHTs who work in public health units. The response rate was 38.12% (n = 146) for dentists and 40% (n = 77) for OHTs. Results: The mean age of the dentists was 40±8.29 years, and 53.43% treated more than 10 children per week. The OHTs' mean age was 45.39±9.71 years, and 62.35% attended to more than 10 children per week. Although the dentists perceived 185 suspected cases of maltreatment, only 35.67% were reported to authorities. In the OHT group, 22.08% were reported to authorities. Sixty-eight dentists (47%) and 11 OHTs (14.28%) reported having treated at least one case of orofacial trauma in the previous 6 months, totalizing 166 orofacial traumas. About the mechanism for reporting suspected cases, 83% of the respondents knew how to report. Over 50% of the responses concerning why the professionals did not report cases of physical violence against children included fear of retaliation and difficulties in diagnosis. Conclusions: Suspected cases of maltreatment against children and adolescents are underreported. More information is required to recognize suspected maltreatment cases and notify authorities.

Child abuse: validation of a questionnaire translated into Brazilian Portuguese

This study sought to validate the Portuguese translation of a questionnaire on maltreatment of children and adolescents, developed by Russell et al. and to test its psychometric properties for use in Brazil. The original questionnaire was translated into Portuguese using a standardized forward-backward linguistic translation method. Both face and content validity were tested in a small pilot study (n = 8). In the main study, a convenience sample of 80 graduate dentistry students with different specialties, from Curitiba, PR, Brazil, were invited to complete the final Brazilian version of the questionnaire. Discriminant validity was assessed by comparing the results obtained from the questionnaire for different specialties (pediatric dentistry, for example). The respondents completed the questionnaire again after 4 weeks to evaluate test-retest reliability. The comparison of test versus retest questionnaire answers showed good agreement (kappa > 0.53, intraclass correlation > 0.84) for most questions. In regard to discriminant validity, a statistically significant difference was observed only in the experience and interest domains, in which pediatric dentists showed more experience with and interest in child abuse compared with dentists of other specialties (Mann-Whitney test, p < 0.05). The Brazilian version of the questionnaire was valid and reliable for assessing knowledge regarding child abuse by Portuguese-speaking dentists.

O conhecimento do aluno de Odontologia sobre maus tratos na infância antes e após o recebimento de uma cartilha informativa / Dental student’s knowledge about child abuse before and after receiving an informative booklet

Objetivo: avaliar o conhecimento dos alunos do curso de Odontologia sobre a violência contra a criança e o adolescente. Metodologia: é um estudo descritivo e transversal, desenvolvido com 96 graduandos em Odontologia. Para a coleta de dados, utilizou-se um questionário com questões estruturadas e semiestruturadas que foi aplicado em dois momentos, antese após a entrega da cartilha “Enfrentamento dos maus tratos contra a criança e o adolescente” elaborada pelo Hospital Pequeno Príncipe, Curitiba, PR, Brasil. Resultados: apenas 25% dos alunos julgaram-se capazes de identificar os casos suspeitos de maus tratos, e, após a entrega da cartilha, houve um aumento para 36%.Em relação à instituição correta que deveriam notificar os casos suspeitos houve um aumento de 10%. Os sinais mais citados para o diagnóstico de maus tratos foram hematomas e mudança de comportamento. Todos os alunos afirmaram que é importante o conhecimento do assunto na graduação, apesar de apenas 36% deles afirmarem que leram ou participaram de palestras ou cursos relacionados ao tema. Conclusão: somente a entrega da cartilha não foi suficiente para despertar totalmente o interesse do grupo pelo assunto.

Aim: to evaluate the students' knowledge of the dentistry course on child abuse against children and adolescents. Methodology: this is a descriptive study, developed with 96 graduates in dentistry. For data collection, it was used a questionnaire with structured and semi-structured questions wich was applied in two moments, before and after distribution of the booklet "Combating of abuse against children and adolescents" prepared by the Hospital Pequeno Príncipe, Curitiba, PR, Brazil. Results: only 25% of students found themselves able to identify suspected cases of child abuse, and after distribution of the booklet, there was an increase to 36%. In relation to the institution that should properly notify suspected cases increased by 10%. The signs most often cited for the diagnosis of child abuse were bruises and behavior change before and after distribution of the booklet. All students said that it is important to examine the subjetc at graduation, although only 36% said they have read or attended a lecture or course related topic. Conclusion: only the distribution of the booklet was not enough to fully awaken the group's interest in the subject.