Child Abuse: Nurse Identification of At-Risk Children   

Abstract
“Child abuse is a problem for children, for families and for society as a whole, as the abused child may have life-long emotional and behavioural problems” (Murray, Baker & Lewin, 2000, p. 47). The nurse, often the first health care professional to see the abused child, must be alert to the physical, emotional and behavioural signs of abuse and know how to intervene.  Risk assessment should be standard practice for Registered Nurses offering paediatric health care. There is a triad of factors that serve as predictors of increased risk of abuse. To further aid New Zealand health care professionals where child and/or partner abuse is suspected, identification and response strategies are outlined in the Family Violence Intervention Guidelines (Ministry of Health, 2002).  Nurses have an opportunity to assess children for abuse through the nursing observation, physical examination and history taking. The nurse’s actions to promote the hauora/wellbeing of each child in her/his practice may be the crucial determinant in the identification of and intervention for the abused child.   

Keywords
Child, abuse, family, nurse   

Introduction
New Zealand has “…levels of child maltreatment deaths that are four to six times higher than the average for the leading (Organisation for Economic Co-operation and Development) countries” (UNICEF, 2003, p. 2). Maltreatment is the “Physical, sexual or psychological abuse or neglect of a child by any person” (Ministry of Health, 2001b, p. 9). The same document continues  with assertions that “Physical abuse  includes acts of violence that may  result in pain, injury, impairment or  disease… (and) …may include  under/over medication”, and  “Psychological/emotional abuse  includes any behaviour that causes  anguish or fear…and…exposing the  child to the…abuse of another  person”.  Legislative policy in New Zealand is reflecting the changing social and cultural mores, as evidenced by the Care of Children Bill (2003). This bill recognises the diversity of family Evans, S. (2003). Child abuse: Nurse identification of at-risk children. Nursing Praxis in New Zealand, 19(3), 22-28.  Nursing Praxis in New Zealand Vol. 19 No. 3 2003 Page 23 arrangements in Aotearoa, and also emphasises parental “responsibilities” to provide daily care, whereas the previous terminology was parental “rights”.