Assessment of Exposure to Family’s Abuse and Negligence among Minia Nursing Schools Students

Introduction

The terms child abuse and child maltreatment are often used interchangeably although some researchers make a distinction between them treating child maltreatment as an umbrella term to cover neglect, exploitation and trafficking. (Wise, Deborah ,2015).

In the United States the centers for disease control and prevention (CDC) uses the term child maltreatment to refer to both acts of commission and omission abuse which include words or overt actions that cause harm or potential harm. (World Health Organization, 2016).

The World Health Organization distinguishes four types of child maltreatment physical abuse, sexual abuse, emotional and psychological abuse, and neglect. (World Health Organization and International Society for Prevention of Child Abuse and Neglect, 2016).

The World Health Organization (WHO) and the international society for prevention of child abuse and neglect (ISPCAN) identify multiple factors at the level of the individual, their relationships, their local community and their society at large that combine to influence the occurrence of child maltreatment. At the individual level such factors include age, sex, and personal history while at the level of society factors contributing to child maltreatment include cultural norms encouraging harsh physical punishment of children, economic inequality and the lack of social safety nets. (World Health Organization and International Society for Prevention of Child Abuse and Neglect ,2016).

Unemployment and financial difficulties are associated with increased rates of child abuse. In 2015 CBS news reported that child abuse in the United States had increased during the economic recession. (Hughes, Sandra  2015).  

Significance of the Study

According to UNICEF statistics the study in Egypt found that most of the children aged 13-17 interviewed 61 percent in Cairo 65 percent in Alexandria and 67 percent in Assiut reported that they had been exposed to some physical violence in the past year with boys more likely to be exposed to physical violence than girls. (National Council for Childhood and Motherhood (NCCM) and UNICEF  2015).

According to national child abuse statistics 4.1 million child maltreatment referral reports received Child abuse reports involved 7.5 million children 3.2 million children received prevention & post response services 142,301 children received foster care services 74.9% of victims are neglected 18.3% of victims are physically abused 8.6% of victims are sexually abused 7.1% of victims are psychologically maltreated and highest rate of child abuse in children under age one 25.3% per 1,000. (May 2014).

Aim of the study:                                                                                                                 

The aim of this study is to assess pattern of family's abuse and negligence exposure among   nursing schools students.

Research Hypothesis:

• Pattern and types of family's abuse and negligence exposure among nursing   schools students.
• Family's abuse and negligence exposure among nursing schools students.
• Students’ knowledge about family abuse and negligence.
• A correlation between students' exposure regarding family's abuse and negligence with selected socio demographic variables.

Subjects and methods

Research design:

Descriptive exploratory research design was utilized to meet the aim of this study.

Setting:

The study was conducted in secondary nursing schools in Minia distric which includes the following schools secondary nursing school affiliated to ministry of health, secondary nursing school of health insurance, secondary university nursing school, and secondary school of nursing in zohra.

Sample:

The subjects of this study consisted of all students (499) in the selected secondary nursing school they were 90 female and 62 male students from school affiliated to the ministry of health, 129 female student from school of health insurance and 54 female and 114 male students from university school.

N.B: 12 students refused to participate in the study so the final number of the sample was 437 students.

Tools of data collection:

Structured interview questionnaire it was developed by the researcher in Arabic

Language after reviewing related literature it covers the following tools:-                                                       

• Tool (1):- socio demographic data which included students characteristic as sex, age, residence, birth order, number of sibling, socio economic scale…….etc.
• Tool (2):- part (1) assessment of students’ knowledge structured questionnaire sheet :-

It consist of 16 questions it included the related items of abuse and negligence such as types of family abuse, causes of each type and signs and symptoms of each type.

Each right answer was got two score with a total score 32, less than 20 score (60%) was considered unsatisfactory, 20 – 32 (60 – 100 %) was considered satisfactory.

Tool (2) part (2) :- child trauma questionnaire (Diavid P.Bernstein 1995 ) is a standardized scale for measuring abuse and negligence of childhood or adolescent it firstly began with 28 items and later on modified by researcher and measures four items: physical, emotional, sexual abuse and neglect the instruction asked how much of a problem occur it consisted finally from 39 items.

A five point likert scale is used (0=never, 1=almost never, 2= some times, 3= often, 4= always). A total scale score is 156 was divided into two class (1) abused=94 score (60%) and (2) not abused less than 94 score less than (60%).

After pilot sample was done the researcher found that must be put tool specify with students’ knowledge about abuse and negligence.

Procedure

Data of the current study were done by researcher from October 2016 to April 2017 once official permissions were obtained the 437 nursing students who included

Into the present study while 12 students refused to participation in the study. The students were interviewed per day 9:00 AM to 1:00 PM in two days each week within average of 15 minutes for each student the researcher met the students when they were available in the class they were assured on the issue of confidentiality and all students were requested to fill out the questionnaires anonymously. The questionnaire was read aloud to students.

Pilot Study

A pilot study was carried out on 10% of nursing students in the nursing secondary schools who fulfilled the inclusion criteria for testing the clarity, completeness and to determine the time involvement according to the results of pilot, the pilot group was included in the study.

Ethical considerations

A written initial approval was obtained from the researcher ethical committee of the faculty of nursing Minia University and written informed consent was obtained from directors of nursing secondary school which students participate in the study. Each assessment sheet was coded and students name was not appeared on the sheets for the purpose of anonymity and confidentiality. The students were assured that they could withdraw at any time from the study. Administrative approvals were obtained from the dean of faculty of nursing Minia University to directors of nursing secondary school before implementation of the study. Meeting with head master and teacher to explain the nature and purpose of the study, the purpose and nature of the study were explained by the researcher through direct personal communication prior starting to their participation in the study to the students oral consent was obtained from students. These data were confidential between students and the researcher and were used for the purpose of the research only.

Statistical Analysis

Data entry was done using compatible personal computer IBM. The statistical analysis was done using SPSS-12 statistical software package and excel for figures. The content of each tool analyzed, categorized. Data were presented using descriptive statistics in the form of frequencies and percentages for qualitative variables mean and standard deviations for quantities variable. Quantitative continuous data were compared by using student’s t-test. Qualitative variable were compared using chi-square test. Statistical significance was considered at p- value <0.05.

Results   

Table (1) Percentage Distribution of socio demographic characteristics of nursing students’ (n= 437).

Table (1) Shows percentage distribution of socio demographic characteristics of nursing students’. It revealed that more than half (55.1%) of students were females and their ages between 17-18 years were (41.9%) with a mean and SD 16.6 ± 0.93.      It was found that two third of students from rural area (70.5%) and had three sibling and more were (80.6%). Also it was observed that most of them had owned house (92.9%). Also it was shown (46%) had two person per room.

Table (2) percentage distribution of socio-demographic data of the nursing students’ parents (n =437).

Table (2) percentage distribution of socio-demographic data of the nursing students’ parents. It was observed that mother and father education with secondary school (35.5% and 44.4%) respectively. Two third of their mother were house wife (70.35).  Also it was illustrated that (45.3%) of their father were employee and half of them was salary between 1000-2000 (51.7%).

Figure (1) Percentage Distribution of students’ total score of knowledge about family abuse and negligence (n= 437).

Figure (1) shows Percentage Distribution of students’ total score of knowledge about family abuse and negligence. It revealed that (66%) of the students have satisfied knowledge about family abuse and one third percentage (34%) had unsatisfied knowledge about family abuse and negligence.

Figure (2) Percentage Distribution of total score of child trauma questioner (n=437).

Figure (2) presents Percentage Distribution of total score of child trauma questioner. It revealed that more than half (66%) of the students’ had exposed to abuse and neglect from their families.

The relationship between socio demographic of nursing schools students’ and types of abuse.

Table (3) relationship between socio-demographic characteristics of nursing schools students’ and Physical, psychological abuse (n=437)

Table (3) shows relationship between socio-demographic characteristics of nursing schools students’ and Physical, psychological abuse. It was illustrated that there is no a statistical significant between total physical, psychological abuse and gender, Residence, and Birth order. It was illustrated that there is a statistical significant between age & psychological abuse (p = 0.02) and Also between number of sibling and physical abuse (p=0.04) It was found that more than half (55.8%, 54.5% respectively) of students were females had exposed to physical and psychological abuse while (44.2%) of males exposed to physical abuse. Also it noticed that two third of students (71.7%) from rural area and (82.7%) with three siblings and more exposed to physical abuse.

Table (4) relationship between socio-demographic data of nursing students’ parents and Physical abuse (n=437).

Table (4) present relationship between socio-demographic data of nursing students’ parents and Physical abuse. It was illustrated that there is a statistical significant between father salary and physical abuse (p = 0.01), it found that more than one third of mother and nearly half of father education secondary school (39.4%, 47.3% respectively) exposed to abuse. It was noticed that two third (74.4%) of mother’ students were house wife not exposed to abuse, while (46.5%) of father’ students were employee exposed to abuse.

Table (5) relationship between socio-demographic data of the nursing students’ parents and psychological abuse (n=437).

Table (5)presents relationship between socio-demographic data of the nursing students’ parents and psychological abuse. It was illustrated that there is no a statistical significant between psychological abuse and parents education, occupation and salary. It was noticed that more than one third of mother and father education is secondary school (40.4%, 44.2% respectively) exposed to abuse. It was found that two third (71.7%) of mother’ students were house wife, while (45.5%) of father’ students were employee not exposed to abuse. It noticed that two third (71.9%) of mother’ students hadn’t income, while (52.5%) of father income from 1000 to 2000 didn’t exposed to abuse.

Table (6) relationship between socio-demographic characteristics of the nursing schools students’ and sexual, emotional abuse (n=437).

Table (6)presents relationship between socio-demographic characteristics of the nursing schools students’ and sexual, emotional abuse. It was illustrated that there is a statistical significant between age & sexual, emotional abuse (p = 0.002) (p = 0.008), gender & sexual abuse (p = 0.04), it was found that more than half (55.8%) of students was females and two third (70.6%) of them from rural area had not exposed to sexual abuse. It was found that   more than half (53.8%) of students was females and (71%) from rural area had exposed to emotional abuse.

Table (7) relationship between socio-demographic data of the nursing students’ parents and sexual abuse (n=437).

Table (7)present relationship between socio-demographic data of the nursing students’ parents and sexual abuse. It was illustrated that there is no a statistical significant between sexual abuse and parents education, occupation, and salary. It was noticed that more than one third of students’ mother and father had secondary school (35.7%, 45.1% respectively) not exposed to abuse. Also found two third (70%) of mother’ students were house wife, while (45.3%) of father’ students was employee didn’t exposed to abuse.

Table (8) relationship between socio-demographic data of the nursing students parents and emotional abuse (n=437).              

Table (8) relationship between socio-demographic data of the nursing student’s parents and emotional abuse. It showed that there is a statistical significant between Father Education & emotional abuse (p = 0.03). It was noticed that two third (69.6%) of mother’ students hadn’t income, while (51.3%) of father income from 1000 to 2000 exposed to abuse.

Table (9) relationship between socio-demographic characteristics of the nursing schools students’ and neglect (n=437).

Table (9) present relationship between socio-demographic characteristics of the nursing schools students’ and neglect. It was illustrated that there is a statistical significant between age, number of sibling & negligence   (p = 0.004 and p=0.07). It was found that more than half (53.6%) of students’ was females, two third of them (71.1%) from rural area and (80%) had three sibling and more was neglected.

Table (10) relationship between socio-demographic characteristics of the nursing schools students’ parents and neglect (n=437).

Table (10) relationship between socio-demographic characteristics of the nursing schools students’ parents and neglect. It was illustrated that there is a statistical significant between father education and neglect (p= 1.01). It was noticed that two third (69.4%) of mother’ students was no income while half (51.1%) of father’ students has income from 1000 to 2000 was neglected.

Table (13) relationship between socio-demographic data of the nursing students’ environments and physical, psychological and sexual abuse (n=437)

         Table (13) presents relationship between characteristics of the nursing students’ environments and physical, psychological and sexual abuse. It was illustrated that there is no a statistical significant between total physical, psychological, sexual abuse and environment characteristics. It showed that high percentage of students had exposed to physical, psychological and sexual abuse had owned house (95.1%, 90.4%, and 100% respectively). It was found that (48.2%, 55.6% respectively) of students’ was exposed to physical, sexual abuse had two person per room.

Table (14) relationship between characteristic of the nursing students’ environments and emotional abuse, neglect (n=437).

Table (14) presents relationship between characteristic of the nursing students’ environments and emotional abuse, neglect. It was illustrated that there is a statistical significant between environmental characteristic and both emotional abuse, neglect. It was found that high percentage (95%, 94.7% respectively) of students’ had owned house. Also more than one third of them (46.2%, 45.8% respectively) had two persons per room was exposed to emotional abuse and neglect