Assessment of Knowledge and Attitudes of Teachers about Child Abuse in Selected Primary Schools at Minia City

Introduction

Childhood is a golden and enjoyable period of life so Protection of a child during this period is the responsibility of the professionals who care for the child. Beside the parents, teachers and physicians play a very important role. Child abuse and child neglect have negative psychological effect on children (Alsaleem et al., 2019). WHO define child abuse as “All types of physical and/or emotional illtreatment, sexual abuse, neglect, negligence and commercial or other exploitation, which results in actual or potential harm to the child’s health, survival, development or dignity in the context of a relationship of responsibility, trust or power Exposure to intimate partner violence is also sometimes included as a form of child maltreatment” (WHO, 2014).

Child abuse continues to be one of the primary threats to the child’s emotional and social well-being globally affects children of all ages, gender, races, ethnicities, in varied socio economic classes and is in the forefront in the line of widespread social issues and economic problems(Hynniewta et al., 2017). The World Health Organization (WHO) estimates that 40 million children aged below 15 years fall victim to violence each year. The ensuing traumas vary according to the gravity of the violence and the child's personal experience and can have medical and psychosocial consequences in the long run. (A jilian Abbasi et al., 2015)

Hynniewta, 2017 selected thatKnowledge and attitudes of teachers influence the perception of abuse and consequently reporting cases. There are many factors that may potentially be influenced by their attitude and perception that may affect the quality of decision making and reporting of child abuse that teachers need to take into consideration. The lack of adequate knowledge and information indicate a gap in the crucial role of teachers in identification and early assistance of an abused child. (Hynniewta et al., 2017). In the same context (Choo, 2013) reported thatSocial and cultural values of communities may also influence the personal attitudes of teachers regarding what constitutes unacceptable behavior towards children and may affect their reporting behavior (Choo et al., 2013). Due to their coverage of children, primary school teachers and public child healthcare workersplay a pivotal role in the prevention and identification of child abuse among children most at risk. To reduce the prevalence of child abuse and its related costs and human suffering, different preventive strategies can be used, from primary to secondary to tertiary prevention (Devore, 2013).

While preventing child abuse is recognized as a national and international priority, nurses are in a perfect position to intervene in child abuse and neglect at primary, secondary and tertiary levels as they interact with children in a variety of hospital- and community-based settings(Poreddi et al., 2016).The individual nurses must know their responsibilities and accept responsibility. Nurses have both an ethical and a legal responsibility towards maltreated children, which they cannot escape; this is at the ethical core of nursing care (Skarsaune et al., 2015).

All stakeholders, especially those in close contact with the child (for example teachers, doctors) need to be adequately trained to detect, manage and report any cases of maltreatment .If the child does not disclose the abuse, a teacher can detect abuse through observation of a child. This is the most likely situation to occur because of the stigma attached to child abuse. A child may be waiting for an adult to notice what’s going on or may even be trying to hide the situation to protect a parent or guardian. Every child is different, which will cause each one to react differently to the abuse, but with each type of abuse there are some typical signs that a teacher would be able to notice (Wilson, 2012).

Significance of the study:

Children are suffering from a hidden epidemic of child abuse and neglect. It’s a widespread war against our children that we have the power to stop, and understanding the issue is the first step. It is well known that the childhood period is the fundamental stages for providing children with knowledge and skills that enable them to face life and its requirements. So, the seriousness of child abuse phenomenon is that it has negative impact on children growth, development and personality which reflect negatively on the lives of child, family and society as a whole (National Center for Injury Prevention and Control, 2016)

School staff must be the first to become aware that a child may be a victim of abuse and is struggling because of adverse events occurring in his or her life (Feeser, 2017). Teachers are one of the important groups that in addition to teaching the students can have a role in control and identification of child maltreatment and violence in schools (Boroumandfar et al., 2015). Add to that, various researches findings that teachers are lacking in the areas of specific knowledge and attitude regarding child abuse that required effective guidance and supportive direction in relation to early detection and reporting of cases so different preventive strategies can be taken ( Hynniewta et al., 2017).

Aim of this study:

To assess the knowledge and attitudes of teachers about child abuse in selected primary schools at Minia city.

Research Questions:

1. what is level of teacher`s knowledge about child abuse?

2. What are the teacher attitudes about child abuse?

3. Is there relation between teacher knowledge and attitudes regarding child abuse and socio-demographic characteristics of the teachers?

Research design:

A descriptive design was used in this study.

Setting:

The study was conducted in (8) urban and rural public primary schools at Minia city included : 6 October, Taha Hussein, El Shaheed, Kafr El Mansoura,  El sheik Essa, Damshir 1, Tala Girls 2 and Al Borgaya Boys2.

Sampling:

Previous schools sample selected by using multi-stage sample. A purposive sample of 274 teachers was selected, which represented all male and female teachers who have equal or more than five years of experience working in eight pre mentioned urban and rural primary schools. The study of sample 145 from urban schools and 129 from rural schools distributed as follows:  25 from 6 October school, 27 from Taha Hussein school, 42 from El Shaheed school, 51from Kafr El Mansoura school, 34 from El sheik Essa, 25 from Damshir 1school, 32 from Tala Girls 2 School  and 38 from Al Borgaya Boys School.

Tools of The Study:

Two tools were used to collect the necessary data include:

First Tool:

An interviewing questionnaire: It was developed by the investigator based on reviewing the related literatures and considering the experts opinions, it comprised of two parts to assess the following:

Part 1:

Socio demographic characteristics includes: (8) questions such as (age, gender, marital status, place of residence, educational level, monthly income, number of children, years of experience(

Part 2:

Knowledge of teachers regarding child abuse includes: question about (types of abuse, Signs of physical abuse, behavioral signs of physical abuse, types of emotional abuse, … etc).

Scoring system each correct answer scored as one point and each incorrect answer scored as zero. The total score for all question related to knowledge was 103 point (100%), and categorized into three level as following:

• Poor       (0->60%)
• Average (≥60-74%)
• Good     (≥75%)

Second Tool: It was developed by  (Mekheimar, 2011) an Attitude Rating Scale for assessment of teacher attitude toward Child Abuse: it was modified by jury, it composed of 23 items using rating scale of two level (agree, and disagree)

The score ranged from one to two, disagree=1, agree=2, total score of the scale equal 46 points, which represents 100%.

• Positive attitude  ≥ 24degree 50%
• Negative attitude  ≤ 22degree 50%

Validity:

To establish validity, the questionnaire was piloted on panel of five experts of community nursing staff, who was reviewed the instruments for clarity, relevance comprehensiveness, understanding, applicability and easiness.

Reliability

The internal consistency of the questionnaire was calculated using cronbach's alpha coefficient, test retest was used.  The cronbach's alpha it was alpha of the questionnaire were 0.509 and 0.741 respectively.

Pilot study:        

Pilot study was conducted on 10% from the total number of study which equal 30 teachers to test the study process and to evaluate the efficiency and clarity of tools that were used in the study. It also was help in the estimation of the time needed to fill the form.

Ethical Consideration:

Approval was sought from the provincial and district ethical committee befor under taking the research. Written informed consent was obtained from each participating teachers after explaining the nature and benefits of the study. The participant was informed that their participation in the study was completely voluntary and there was no harm if they not participate in the study. Privacy was considered during collection of data. Participants was assure that all their data are highly confidential

Study Procedure:

An official letter of the study approval was obtained from the dean of the faculty of nursing at Minia University to the Directorate of Education and the request was transferred to primary education and one school was selected from each sector in mina city to carry out the study. This letter was included brief explanation of the aim of the study and permission was requested from each manager to carry out the study. Data was collected two days per week; Data was collected on Sunday and Monday per week at school time. It was lasted for three months years of 2018; the interviewers explained the questions of the questionnaire to the teachers. Tools were introduced to teachers to be filled and each interview consisted of five teachers and last for half an hour, ten minute to explain the questionnaire and a third of an hour to fill out the questionnaire

Data statistical analysis:

Data were collected tabulated and analyzed by computer using” the statistical package for social science “(SPSS) version 20, descriptive data were expressed as number and percentage. Questionnaire data were presented by mean and standard deviation. Correlation was calculated between knowledge and attitude about child abuse using person correlation test. Probability (p-value)                Equal to or less than 0.05 was considered significant in test of relationships.

Results

Table (1): Distribution of the studying teachers according to their demographic characters (No- 274)

Table)1(:Illustrating that their age is ranged from 27-58 with a mean of 39±6.8. As well as more half of gender were females, also 62.8% of total teacher residences in urban area, as well as 80.3% of total teachers were university education. In addition there are statistically significant differences between rural and urban schools in age, gender, residence and educational level at p value (0.008, 0.008, 0.001, 0.004) respectively.

Table (2): Teachers knowledge about notification of child abuse (No- 274)

Table (2) showing that 32.5% of teachers say notification of child abuse to psychiatric moreover there is statistically significant difference between urban and rural school teacher.

Figure 1 knowledge of teachers about child abuse

P V=0.6

Figure (1): Showing that more than two third of teachers had poor knowledge about child abuse

Figure 2 Attitude of teachers regarding child abuse

P V=0.6

Figure (2): Showing that 62%of teachers had negative attitude regarding child abuse

Table (3): Relation socio demographic characters of teachers and their knowledge about child abuse (No- 274).

Table (3): Illustrating that present 60.6% of teachers who their experience more than 20 years of teachers who have good knowledge about child abuse. As well as 100% of teachers with university education of teachers who have good knowledge. In addition, there are statistically significant differences between years of experience and educational level with their knowledge at p value (0.001, 0.006) respectively.

Table (4): Relation socio demographic characters of teachers and their attitude about child abuse (No- 274).

Table)4(: Illustrating that present teachers with age mean ±SD 40.7±7.2 have positive attitude, as well as 84.6% of teachers who have positive attitude from married teachers, also 67.6% of teachers who have negative attitude from teachers urban area, 49.4% of teachers who have negative attitude whose years of experience 5-<10 and 86.5% who had positive attitude from university education.  In addition there are statistically highly significance differences between marital status, residence, years of experience as well as educational level at p value(0.001, 0.004, 0.03, 0.01, 0.04) respectively.