PhD defence F. (Féline) Hoedeman

Below is a brief summary of the dissertation:

Child maltreatment is a large public health problem, with long-lasting effects on both the individual and future generations because of intergenerational trauma effects, and society. It is therefore of the utmost importance to increase early recognition and adequate management of (possible) child maltreatment. Studies have shown systematic screening for child maltreatment at the emergency department is effective in improving its detection rate. This thesis is centered on defining areas of improvement and outlining strategies to achieve a positive change in recognition and management of child maltreatment.

Based on survey research, the variation in screening and policy regarding child maltreatment across European emergency departments (EDs) is described, highlighting the need for standardized screening tools and training. The development and validation of the Screening instrument for Child Abuse & Neglect (SCAN), an early detection tool, is discussed. The implementation of a child abuse toolkit (including the screening tool, training, and hospital policy) is further explored, with an examination of the barriers and facilitators to implementation through surveys amongst healthcare professionals in European EDs. The findings from the surveys are translated into a protocol for practical implementation at EDs of the Child Abuse & Neglect Readiness Package (CAN-Ready), which includes a screening tool and implementation strategies such as training and hospital policy. A standardized approach for the evaluation of sexual abuse in children is also presented.