Utility of the "Cycle Model" of Child Abuse Prevention Using PACAP and USDT

Wednesday, 24 July 2013: 1:50 PM

Reiko Ueda, RN, PHN, MLitt, DMSci1
Chieko Yoshikawa, RN, PHN, BA2
Tomoko Nishihira, RN, MSN.2
Kiyoko Tamashiro, RN, DNS2
Junko Miyazawa, RN, CNM, PHN, DNS3
(1)Graduate School of Health and Nursing, Okinawa Prefectural College of Nursing, Naha, Japan
(2)Okinawa Prefectural College of Nursing, Naha, Japan
(3)Faculty of Nursing, Josai International University, Togane, CHIBA, Japan

Learning Objective 1: The learner will be able to get acquainted with PACAP and USDT, innovative pre-assessment tools for population and risk strategies for child abuse prevention.

Learning Objective 2: The learner will be able to get acquainted with the “cycle model”, a positive approach to child abuse prevention in communities with limited personal resources.

Purpose: To confirm the utility of “cycle model” of child abuse prevention by an action research using PACAP (Pre-assessment tool for child abuse prevention) and USDT (Ueda’s simplified developmental test) developed by us.

Methods: All pre-school children and their parents in Island K, Japan, and multiple health-related professionals in direct contact with them participated in the action research. PACAP, a semi-structured questionnaire with 18 items in four areas, was administered to the parents.  USDT was administered to those children who were suspected of maltreatment by the results of PACAP. To the non-respondents PACAP was administered by public health nurses on home visits. 

Results: 1) A total of 447 of 538 cases (83.1%) responded.Among 447, 16 (3.6%) true risk cases, 38 (8.5%) false positive cases and 393 (87.9%) normal cases were confirmed. The better identification of the false positives and reduction of waste of time and energy by it were possible by the newly introduced “adaptive score” method of PACAP. 2) Out of 16 true risk cases, only four (25.0%) seeked professional support while 12 (75.0%) did not, thus indicating great “covert needs”. 3) The follow-up of 16 cases after 3-6 months showed that “the risk score” lowered or remained the same but did not become higher, while “adaptive score” became higher except for one case. 

Conclusion: 1) The true risk cases were identified in 3.6% by PACAP and USDT. It is important that newly introduced “adaptive score” was effective in reducing false positive cases. 2) The positive approach of “cycle model” of child abuse prevention was effective from both the standpoints of population strategy as well as risk strategy. 3) Assessment and intervention for the primary prevention of child abuse would be possible even in communities of limited professional resources like Island K using PACAP and USDT.