Children Witnessed Violence Evaluated in a Pediatric ED

Prevalence of Children Witnessed Violence Evaluated in a Pediatric Emergency Department

Witnessed violence is a form of child abuse with detrimental effects on child wellbeing and development, whose recognition relies on the assessment of their mother exposure to intimate partner violence (IPV). The aim of this cross-sectional study is to assess the frequency of witnessed violence in a population of children attending a pediatric emergency department (ED) in Italy, by searching for IPV in their mother, and to define the characteristics of the mother-child dyads.

Study Overview

• Status: Completed
• Conditions: Violence, Domestic; Intimate Partner Violence

Detailed Description

Witnessed violence is a form of child abuse, consisting of the child experience of any kind of maltreatment against his/her parents/caregivers/family members, and can be either direct (if the maltreatment takes place in the child presence) or indirect (if the child is aware of the maltreatment and perceives its acute/chronic, physical/psychological effects). The recognition of children witnessed violence requires the previous assessment of their mothers' exposure to intimate partner violence (IPV), defined by the World Health Organization (WHO) as a "behavior within an intimate relationship that causes physical, sexual, or psychological harm, including acts of physical aggression, sexual coercion, psychological abuse and controlling behaviors" committed by a current or former partner. According to the WHO reports, one in three women is subjected to IPV, and it has been estimated that among children living in households where IPV takes place, 85% are direct witnesses to violence, and up to one half undergo direct forms of abuse, mostly by the father or any other male family member. Exposure to IPV not only has deleterious effects on the child wellbeing, and cognitive and socio-emotional development, but it also negatively affects behaviors and relationships into adulthood: boys and girls who experience household violence against their mother are at increased risk of perpetuating aggressive behaviors and being victims of domestic violence later in their own lives, respectively, engaging in the so-called intergenerational perpetuation of violence. While the WHO currently recommends screening for IPV during pregnancy, no agreement exists on the appropriateness of routine assessments of postpartum IPV. Nevertheless, on the ground of the detrimental effects of IPV on children, the American Academy of Pediatrics advocated for IPV screening in pediatric settings, endorsing the abuse of women as a pediatric issue. Healthcare professionals are generally in a privileged position to investigate IPV; the emergency department (ED) represents an ideal setting to detect abuse and take actions against it, providing a unique opportunity to involve the mother-child dyads in research surveys, in accordance with the international guidelines on research on violence against women and children. The aim of this study is to assess the frequency of witnessed violence in a population of children attending a pediatric emergency department (ED) in Italy, by searching for IPV in their mother, and to define the characteristics of the mother-child dyads.

• Study Type: Observational
• Enrollment (Actual): 212

Contacts and Locations

Study Locations

• Italy
  • Trieste, Italy, 34137
    • IRCCS Burlo Garofolo

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: No older than 17 years (Child)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Mother-child dyads attending a pediatric Emergency Department in Italy

Description

Inclusion Criteria:

• children aged 0 to 17 years
• attending the pediatric ED (undergoing clinical observation within the ED and/or admission to the ward )
• presence of their mothers

Exclusion Criteria:

• inability of the mother to fill in the questionnaire (due to either language barrier or inability to leave the child behind for a while)
• impossibility to take the mother aside from her partner

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
To evaluate the prevalence of children witnessed violence	Mothers of children attending a pediatric ED will receive a questionnaire, which will include the validate italian version of Woman Abuse Screening Tool (WAST), a questionnaire assessing women's physical, psychological, and sexual abuse by their partner in the last 12 months. It comprises eight questions, each with three possible answers, graded from 0 (never) to 2 (often): an overall score of 4 or above suggests women abuse by their partner.	Within 6 hours of ED admission

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
To define the demographical and clinical characteristics of the mother-child dyads enrolled	Mothers of children attending a pediatric ED will receive a questionnaire which will include questions about their baseline data and health.	Within 6 hours of ED admission

Collaborators and Investigators

• Sponsor: IRCCS Burlo Garofolo
• Investigators: Principal Investigator: Claudio Germani, MD, IRCCS Materno Infantile Burlo Garofolo

Study record dates

Study Major Dates

• Study Start (Actual): February 1, 2020
• Primary Completion (Actual): May 31, 2022
• Study Completion (Actual): May 31, 2022

Study Registration Dates

• First Submitted: March 24, 2023
• First Submitted That Met QC Criteria: April 6, 2023
• First Posted (Actual): April 7, 2023

Study Record Updates

• Last Update Posted (Actual): April 7, 2023
• Last Update Submitted That Met QC Criteria: April 6, 2023
• Last Verified: April 1, 2023

More Information

Terms related to this study

• Keywords: Intimate partner violence; Pediatric emergency department; Witnessed violence; Woman Abusive Screening Tool
• Other Study ID Numbers: RC 14/19

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No