Case management by public health nurses in an effort to prevent child abuse and neglect in Japan: Providing support to mothers and children

Background: In Japan, public health nurses (PHNs) working for local governments play an important role in preventing child abuse and neglect. PHNs meet with almost all children in the community through maternal and child health projects such as health check-ups and home visits, and can identify high-risk families. Case management is especially necessary to prevent child abuse and neglect in high-risk families. Our objective was to describe the support provided by PHNs to mothers and their children in case management for preventing child abuse and neglect.

Methods: Unstructured interviews of five PHNs working for three local governments in Japan were conducted. PHNs were asked about the support they provide to high-risk mothers and their children for preventing child abuse and neglect. Data were audiorecorded and analyzed. The qualitative descriptive research method was used.

Results: Three categories of support provided by PHNs to mothers and children were identified: 1) Assessment of the situations of mothers and their children and consulting with the mothers, 2) Referring mothers to services, making arrangements for enrollment in nursery school, and checking the mothers' mental status, physical condition and parenting skills, 3) Collaborating with organizations and professionals by sharing the mothers' hopes, the physical or mental condition of mothers and their children, and family situation. Each category consisted of 2 or 3 subcategories.

Conclusions: In case management of high-risk mothers and children, PHNs established a relationship of trust with mothers by understanding and sharing the mothers' hopes and situation with other organizations and professionals.