Working with multidiscipline group of professionals and local welfare commissioner in case management for preventing child abuse and neglect

BACKGROUND : In Japan, the number of child abuse cases is increasing. In multidisciplinary teams, public health nurses (PHNs) are expected to prevent child abuse and neglect via case management. However, the problem concerning difficulties related to working in multidisciplinary teams remains to be resolved. PURPOSE : The purpose of this study was to explore how PHNs work with multidisciplinary groups of professionals and local residents in case management for potential cases of child abuse and neglect. METHOD : An exploratory descriptive design was used. Semi-structured interviews were conducted for 31 PHNs from 22 municipalities in Japan. Each PHN selected one case of suspected child abuse and neglect among their clients. The case management processes of each case were recorded during the interview. Data was analyzed using the constant comparison methods. RESULTS: Four categories with eight subcategories were identified: assessment of overall family situation, establishment of a link between the family and professionals,sharing of child rearing-related tasks between the family and multidisciplinary team, and maintenance of links within the community. In most cases, multiple problems were observed, such as mentally ill parents, lack of social support, and low income. The PHNs coordinated with both the multidisciplinary groups of professionals and local residents, depending on the case situation. The situation of the families improved as the number of professionals and local residents in the team increased. CONCLUSION : Our findings suggest that continuous support and constant links within the community are essential to prevent child abuse and neglect via case management.