Management of Suspicions of Child Maltreatment at Child and Family Clinics: A Mixed-Methods Study

Abstract This study investigated Norwegian public health nurses working in child and family health clinics’ decision-making practices concerning child maltreatment. A one-phase convergent mixed-method design was utilized, with quantitative and qualitative data concurrently collected and separately analyzed from a questionnaire that included patient vignettes. These vignettes described three potential child maltreatment scenarios to assess public health nurses’ competence and clinical decision-making processes. A total of 554 public health nurses participated in the study conducted from October 24 to December 31, 2022. Findings reveal a high level of recognition of child maltreatment among public health nurses. However, despite their self-perceived confidence, the qualitative data underscore the complexity and uncertainty inherent in their assessment process. The most supported management approaches involved further exploration of the situation. Few public health nurses would file a report of concerns to Child Protective Services or report the police despite their level of concerns. The findings underscore the necessity for additional training and support to enhance public health nurses’ confidence and competence in reporting suspected child maltreatment cases, as well as the need for increased information exchange regarding the procedures and services provided by the child if Child Protective Service is involved.