Child abuse and neglect: a concept analysis

Abstract

Purpose
The purpose of this study was to summarize the attributes, antecedents and consequences of the concept of child abuse and neglect, which could then serve as the bases for the development of a child abuse and neglect screening tool to guide the prevention of child abuse and neglect during the perinatal period.
Method
Literature was identified from nine databases: Ichushi-Web, CiNii, MEDLINE, CINAHL, PsycINFO, SocINDEX, Minds, National Guideline Clearinghouse, and TRIP database using the keywords child abuse, pregnant women, postnatal, and child care. Relevant findings of 26 articles in English, 32 articles in Japanese and the 2014 Japanese Guide for Medical Treatment of Child Abuse and Neglect were analyzed using Rodgers's 2000 concept analysis model.
Findings
Five attributes were identified: 1) one-sided controlling relation to the abused child, 2) caregivers either unaware or aware of own behavior, 3) child's experience, 4) harm to the child's well-being and 5) failure to protect child's well-being. Five antecedents were identified: 1) caregiver factors, 2) child factors, 3) socioeconomic factors, 4) the overlapping of multiple factors and 5) a lack of appropriate intervention. Five consequences were identified: 1) child's security, 2) caregiver denial and isolation, 3) effects on the prospective health of survivors, 4) distress of surviving mothers and 5) intergenerational diffusion of abuse. Lastly, one surrogate term, child maltreatment, and three related concepts, (discipline, shaken baby syndrome, Munchhausen syndrome by proxy) were found. Based on this analysis, the concept of child abuse and neglect was defined as: the child's experience of crisis with or without the caregiver's awareness, including harm to the child's well-being and a lack of action to guard the child's well-being based on the one-sided controlling relationship of the child's caregiver.
Conclusion
This analysis summarizes the current concept of child abuse and neglect, which could provide a basis upon which to develop a child abuse and neglect screening tool. The analysis clearly demonstrated the possibility of long-term harm to abused children, repeating child abuse and neglect and the importance of appropriate preventive interventions during the gestational period, especially, the importance of appropriate interventions for grown-up survivors to prevent their repetition of child abuse and neglect. Moreover, effective prevention entails recognizing interventions are required not only for pregnant women but also for their partners and children and must include improved instrumental support and other multiple factors.