Awareness and knowledge of pediatric abusive head trauma among healthcare professionals in Taiwan

Abstract

Healthcare professionals’ awareness of pediatric abusive head trauma is essential for the early recognition and diagnosis of suspected cases. However, no previous study has evaluated pediatric abusive head trauma awareness among healthcare professionals in Taiwan. This cross-sectional study was conducted to understand pediatric abusive head trauma awareness among healthcare professionals in Taiwan. Convenience sampling was used to recruit nurses and physicians from the neonatal, pediatric, obstetric, or emergency departments from a medical center in southern Taiwan. The 81-item questionnaire was developed and validated in a previous study. This questionnaire was used to measure the healthcare professionals’ attitude toward childrearing, confidence in managing and reporting abusive head trauma, and their awareness/knowledge of abusive head trauma across four areas: infant crying (9 items), soothing skills (12 items), clinical manifestations and consequences (20 items), and risk factors (19 items). Professionals were asked to respond “true”, “false”, and “don’t know” on the items of the first three subscales. The subscale of risk factors of abusive head trauma was scored on a 5- point Likert scale. In total, 301 healthcare professionals completed the questionnaires (response rate: 86.5%). The mean scores were 7.5 (SD = 1.30) for infant crying (range = 3–9), 11.2 (SD = 1.22) for soothing skills (range = 4–12), and 14.8 (SD = 2.25) for AHT clinical manifestations and consequences (range = 4–20). Questions on the infant soothing skill subscale were the most likely to be answered correctly, with a correct response rate of 92.9%, followed by infant crying (correct response rate 83.2%) and AHT clinical manifestations and consequences (correct response rate 73.9%). Healthcare professionals considered the caregivers’ poor emotion control and substance abuse to be key risk factors for pediatric abusive head trauma. Healthcare professionals from pediatric units appeared to be more knowledgeable about the clinical manifestations and consequences of pediatric abusive head trauma items compared to those who worked in other departments. Discrepancies in knowledge on the different AHT subscales were found across professionals from different specialties. Specifically, physicians had more knowledge of soothing skills and clinical manifestations of AHT than nurses, while obstetricians had less knowledge of clinical manifestations of AHT than professionals in other specialties. Continuing education and training programs should be developed and emphasized, in accordance with the specific the needs of professionals from different specialties to increase their awareness of pediatric abusive head trauma to facilitate accurate diagnosis and intervention.