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Emergence of child abuse diagnostic education in emergency care: a common concern
Author(s)
Maritz, Roxanne Tamlyn
Date Issued
2020
Type
Thesis
Publisher
Cape Peninsula University of Technology
Abstract
Child abuse prevalence in South Africa is high. Despite this the pedagogy of child abuse
education of emergency care practitioners is deficient. This thesis, conducted in the field of
emergency medical care, intended to elucidate the emergence of child abuse diagnostic
education in emergency care as a common concern. In order to achieve this, the treatment of
child abuse victims needs to be understood within an out-of-hospital setting as well as from an
emergency medical care student’s perspective.
The research paradigm is that of critical pragmatism. A concurrent mixed-methods approach
was followed. Retrospective archival data (1 323 pediatric cases) was retrieved from 12 365
pre-hospital medical records. The researcher established a pre-training workshop survey,
followed by a training workshop intervention to inform participants on law and ethics as well as
a screening tool for child abuse. A post-training workshop survey was conducted. The
quantitative data analysis was conducted using ‘R’ Statistical software. The researcher used
FreeMind® to synthesis and construct themes from the focus group qualitative data. The
quantitative and qualitative data were contrasted and associations between child abuse
knowledge (mediated by training) and self-reported diagnostic practices were identified.
The probable historical “missed” case detection for pre-hospital presentation of child abuse
and neglect is an alarming 19%. The study found that all participants demonstrated knowledge
of antecedent factors for child abuse such as what constitutes risk and vulnerability for abuse.
However, the knowledge of conceptual definitions from the Children’s Act was lacking. There
was also statistical significance showing that collectively, the training workshop intervention
had a positive impact on those who attended. In addition to this, the study also found that the
policies and emergency care training of child abuse and neglect are deficient. This study’s
theoretical contribution is that it validates Archer’s Morphogenesis as an analytical frame for
child abuse diagnostics in emergency care. Socio-cultural actions such as clinical practice,
diagnostic training, activism, learner engagement and reflective practice all have the latency
for improved child abuse diagnostics, but if not sustained, prioritized and mainstreamed,
‘morphostasis’ rather than ‘morphogenesis’ is likely to prevail. It is recommended that future research concerning the topic of child abuse diagnostics is
conducted to reduce the gap in the emergency care knowledge. Higher education institutions
offering emergency care qualifications are encouraged to incorporate ‘child abuse and neglect’
into their existing curricula for the ‘common good’.
education of emergency care practitioners is deficient. This thesis, conducted in the field of
emergency medical care, intended to elucidate the emergence of child abuse diagnostic
education in emergency care as a common concern. In order to achieve this, the treatment of
child abuse victims needs to be understood within an out-of-hospital setting as well as from an
emergency medical care student’s perspective.
The research paradigm is that of critical pragmatism. A concurrent mixed-methods approach
was followed. Retrospective archival data (1 323 pediatric cases) was retrieved from 12 365
pre-hospital medical records. The researcher established a pre-training workshop survey,
followed by a training workshop intervention to inform participants on law and ethics as well as
a screening tool for child abuse. A post-training workshop survey was conducted. The
quantitative data analysis was conducted using ‘R’ Statistical software. The researcher used
FreeMind® to synthesis and construct themes from the focus group qualitative data. The
quantitative and qualitative data were contrasted and associations between child abuse
knowledge (mediated by training) and self-reported diagnostic practices were identified.
The probable historical “missed” case detection for pre-hospital presentation of child abuse
and neglect is an alarming 19%. The study found that all participants demonstrated knowledge
of antecedent factors for child abuse such as what constitutes risk and vulnerability for abuse.
However, the knowledge of conceptual definitions from the Children’s Act was lacking. There
was also statistical significance showing that collectively, the training workshop intervention
had a positive impact on those who attended. In addition to this, the study also found that the
policies and emergency care training of child abuse and neglect are deficient. This study’s
theoretical contribution is that it validates Archer’s Morphogenesis as an analytical frame for
child abuse diagnostics in emergency care. Socio-cultural actions such as clinical practice,
diagnostic training, activism, learner engagement and reflective practice all have the latency
for improved child abuse diagnostics, but if not sustained, prioritized and mainstreamed,
‘morphostasis’ rather than ‘morphogenesis’ is likely to prevail. It is recommended that future research concerning the topic of child abuse diagnostics is
conducted to reduce the gap in the emergency care knowledge. Higher education institutions
offering emergency care qualifications are encouraged to incorporate ‘child abuse and neglect’
into their existing curricula for the ‘common good’.
Additional information
Thesis (Master of Emergency Medical Care)--Cape Peninsula University of Technology, 2020
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