Knowledge on Medico-legal and Ethical Duties Related to Child Abuse among Paediatric Nursing Officers: A Descriptive Cross-sectional Study

Abstract

Background: Child abuse is common in Sri Lankan context. Nurse is a member of the healthcare team who manages the victimized children admitted to paediatric wards. Therefore, nurses should have adequate knowledge on child abuse, medico-legal and ethical duties towards an abused child and it is important for better management and care. However, this aspect has not been explored adequately worldwide. Objectives: To identify the knowledge on child abuse, medico-legal duties on child abuse and ethical duties on abused children among paediatric nurses in a major children’s hospital in Sri Lanka. Methods: A descriptive cross-sectional study was conducted using randomly selected sample of registered nursing officers (n=392) from Lady Ridgeway Hospital (LRH), Colombo. The data were collected using a self-prepared, pre-tested, self-administered questionnaire. Data were analysed using the descriptive statistics and Chi-square test with SPSS version 25.0. Knowledge scores including the knowledge on child abuse, medico-legal duties and ethical duties on child abuse and the overall score were calculated. Overall score was divided into three categories of knowledge as low (0-20), moderate (21-40) and high (41-61). Results: Majority of paediatric nursing officers were Sinhalese (99.7%) and Buddhist (97.4%). Of the participants, 41.3% were below thirty years of age. Mean (SD) overall knowledge score was 37.23 (±6.96). Further, knowledge on child abuse, knowledge on medico-legal duties and ethical duties were 12.76 (±2.90), 16.49 (±4.14) and 7.98 (±1.77), respectively. Majority (59.7%, n=234) of nurses had high level of knowledge while 37.5% (n=147) had moderate level of knowledge. Prior training on medico-legal and ethical duties towards child abuse (p=0.038) and gender (p=0.034) had significant associations with the overall knowledge on child abuse. Conclusions: Most of the pediatric nursing officers in LRH had moderate level of knowledge on child abuse, related medico-legal and ethical duties on child abuse. The level of knowledge was associated with the prior training and gender. All the nurses should have high level of knowledge to enhance the care and rehabilitation of abused child. Therefore, further continuous training is recommended.