Child abuse and neglect reporting among nurses in Taiwan : professional knowledge, perceptions, attitudes, and self-efficacy

Lee, Pei-Yu (2008) Child abuse and neglect reporting among nurses in Taiwan : professional knowledge, perceptions, attitudes, and self-efficacy. PhD thesis, Queensland University of Technology.


According to the Children's Bureau of Taiwan (2007), the number of Taiwanese children abused and neglected sharply increased from 6,059 to 10,094 between 2000 and 2006. Reports of abused and neglected children also rose from 8,494 to 13,986 in that period. This followed enactment of the Children and Youth Welfare Law in 2003 imposing a range of health, education and social welfare professionals, including nurses, the statutory duty to report suspected child abuse and neglect. Previous studies in Taiwan have indicated that despite the legislation, a range of factors continue to act against nurses reporting child abuse and neglect (CAN) cases according to the law. Previous research had examined factors that influence CAN reporting by health, education, and welfare professionals including registered nurses in Taiwan. The study herein sought to extend knowledge of these factors by identifying and assessing nurses' self-efficacy as a prime factor influencing professional commitment to legal reporting of CAN. The aims of this research were to: (1) examine influencing factors of nurses' likelihood to report CAN in Taiwanese health care settings, and (2) develop and test a new instrument Child Abuse and Neglect Reporting Self Efficacy (CANRSE) to measure nurses' self-efficacy in CAN reporting. The research was conducted in two phases. Phase one investigated nurses' experience with CAN reporting and examined relationships between nurses' perceptions, attitudes, knowledge, and likelihood to report CAN cases. Two hundred and thirty-eight nurses from emergency departments, paediatric units and community centres in Taiwan completed a survey. The results showed that using a series of vignettes, a significant relationship existed between the likelihood to report CAN and perception, attitude, and knowledge. Notably, perception was the most significant variable in predicting nurses' likelihood to report CAN cases. Findings indicated nurses had poor perceptions of recognizing and reporting CAN and lacked faith in child protection services. Knowledge of Taiwanese CAN reporting laws was poor. In general, most nurses believed that they needed more training courses on the recognition and reporting of CAN. These findings, in particular the importance of perceptions of legal reporting behaviour, were worthy of further investigation. In Phase two, a measure of CANRSE was developed and tested. Data were collected from 496 nurses working in Taiwanese health care settings. Development of the CANRSE was guided by an extensive literature review, findings from Phase one of the study and by an expert panel. The CANRSE consisted of five sections: (1) demographic information, (2) efficacy-expectation for suspected cases, (3) efficacy-expectation for known cases, (4) outcome-expectation of CAN reporting, and (5) likelihood to report CAN. The influence of nurses' self-efficacy on their likelihood to report CAN cases was also analysed. Structure of the CANRSE was supported by structural equation modeling using AMOS 6.0. Additionally, correlation and regression analyses were applied to investigate the validity and reliability of the CANRSE. CANRSE met accepted psychometric standards for reliability and validity in this study. Nurses' CAN self-efficacy yielded strong prediction over personal characteristics, experience as a nurse, experience as a parent, and age. Thus, the research provides an important contribution to the literature relating to mandatory reporting by professional groups in particular nurses. It was the first research to successfully develop a new instrument to evaluate nurses' selfefficacy in CAN reporting. The findings provide a basis for understanding the influence of Taiwanese nurses' decision making for CAN reporting. Further research can extend the scope of CAN training programs and their evaluation.

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ID Code: 17800
Item Type: QUT Thesis (PhD)
Supervisor: Fraser, Jennifer, Dunne, Michael, & Chou, Fan
Keywords: child abuse, child neglect, mandatory reporting, professional behaviour, self-efficacy, Taiwanese nurses
Divisions: Current > Institutes > Institute of Health and Biomedical Innovation
Institution: Queensland University of Technology
Deposited On: 12 Feb 2009 04:28
Last Modified: 28 Oct 2011 19:52

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