A Look at Physical Child Abuse During COVID-19: A Systematic Review

Abstract

Objective: This systematic review aims to examine the frequency, risk factors, types of abuse, as well as the early detection, prevention, and intervention roles of nurses in physical child abuse during the COVID-19 pandemic. Materials and Methods: The review was conducted following PRISMA guidelines. Searches were performed in PubMed, CINAHL, Cochrane, ClinicalKey/Elsevier, ScienceDirect, and Ulakbim databases between April 1 and December 31, 2021, using keywords "COVID-19, abuse, physical abuse, child, child abuse" and their Turkish equivalents. The search, limited to 2020-2021, focused on descriptive, cross-sectional, retrospective, and prevalence studies. Of 1817 studies initially identified, 10 were included after removing duplicates and applying eligibility criteria. Findings: Studies indicate that social isolation, economic hardships, job losses, parental psychological issues, and increased stress during the pandemic heightened the risk of physical child abuse. Behaviors such as hitting, shaking, pushing, slapping, and choking increased significantly. Reporting rates varied by country, with some showing increases and others decreases due to pandemic challenges. Conclusion: Cases of physical child abuse have increased during the pandemic, but reporting has decreased due to school closures and limited access to healthcare. Strengthening physical child abuse screening and intervention protocols by nurses in healthcare facilities, systematizing case detection, early referral, and preventive education efforts are critical to protecting children’s safety during pandemics and similar crises. Keywords: Abuse, child, child abuse, COVID-19, nurse, physical abuse.

Keywords

• Abuse
• child
• child abuse
• COVID-19
• nurse
• physical abuse

COVID-19 Döneminde Fiziksel Çocuk İstismarına Bakış: Sistematik Bir İnceleme

Abstract

Amaç: Bu sistematik derlemenin amacı, COVID-19 salgını süresince fiziksel çocuk istismarı vakalarının sıklığı, risk faktörleri, istismar türlerinin yanı sıra hemşirelerin erken tespit, önleme ve müdahale rollerini incelemektir. Gereç ve Yöntem: Derleme, PRISMA yönergelerine uygun olarak yürütülmüştür. 1 Nisan – 31 Aralık 2021 tarihleri arasında PubMed, CINAHL, Cochrane, ClinicalKey/Elsevier, ScienceDirect ve Ulakbim veri tabanlarında, "COVID-19, abuse, physical abuse, child, child abuse" ve bu terimlerin Türkçe karşılıkları kullanılarak taramalar yapılmıştır. 2020-2021 yıllarıyla sınırlı tutulan arama; tanımlayıcı, kesitsel, retrospektif ve prevalans çalışmalarına odaklanmıştır. Başlangıçta belirlenen 1817 çalışmadan, tekrarlar ve uygunluk kriterlerine göre eleme yapıldıktan sonra 10 çalışma derlemeye dahil edilmiştir. Bulgular: Çalışmalar, pandemi sürecinde sosyal izolasyon, ekonomik zorluklar, iş kayıpları, ebeveynlerdeki psikolojik sorunlar ve artan stresin fiziksel çocuk istismarı riskini artırdığını göstermektedir. Vurma, sarsma, itme, tokat atma ve boğma gibi davranışlarda anlamlı artış gözlemlenmiştir. Vakaların bildirilme oranları ülkelere göre farklılık göstermiş; bazı ülkelerde artış yaşanırken, bazılarında ise pandemi koşulları nedeniyle azalma olmuştur. Sonuç: Fiziksel çocuk istismarı vakaları pandemi sırasında artmıştır, ancak okulların kapanması ve sağlık hizmetlerine erişimin sınırlı olması nedeniyle bildirimler azalmıştır. Sağlık kuruluşlarında hemşirelerin fiziksel çocuk istismarı tarama ve müdahale protokollerini güçlendirmeleri; vaka tespiti, erken yönlendirme ve koruyucu eğitim çalışmalarını sistematik hale getirmeleri, pandemi ve benzeri kriz dönemlerinde çocukların güvenliğini korumada kritik öneme sahiptir. Anahtar Kelimeler: İstismar, çocuk, çocuk istismarı, COVID-19, hemşire, fiziksel istismar.

Keywords

• İstismar
• çocuk
• çocuk istismarı
• COVID-19
• hemşire
• fiziksel istismar

References

1. 1. Louis SAM, Johnson EJ. How mothers perceive their own domestic violence victimization and how it impacts their children. Journal of Child Custody. 2017; 14(1): 34-48.
2. 2. Hungerford A, Wait SK, Fritz AM, Clements CM. Exposure to intimate partner violence and children's psychological adjustment, cognitive functioning, and social competence: A review. Aggression and Violent Behavior. 2012; 17(4): 373-82.
3. 3. Baron EJ, Goldstein EG, Wallace CT. Suffering in silence: How covid-19 school closures inhibit the reporting of child maltreatment. Journal of Public Economics. 2020; 190, 104258.
4. 4. Lawson M, Piel MH, Simon M. Child maltreatment during the covid-19 pandemic: Consequences of parental job loss on psychological and physical abuse towards children. Child abuse & neglect. 2020; 110, 104709.
5. 5. Prasasti AK, Widyatuti W. The role of community nurses to prevent domestic violence during the covid-19 pandemic. In Proceedings of the International Conference on Nursing and Health Sciences. 2021; 2 (1): 9-18.
6. 6. Kim H, Wildeman C, Jonson-Reid M, Drake B. Lifetime prevalence of investigating child maltreatment among US children. Am. J. Public Health. 2017; 107, 274–80.
7. 7. Hillis S, Mercy J, Amobi A, Kress H. Global prevalence of past-year violence against children: a systematic review and minimum estimates. Pediatrics. 2016; 137(3):e20154079. 10.1542/peds.2015-4079
8. 8. Administration for Children and Families. Child maltreatment 2020. [homepage on the Internet]. 2018. [Cited 2021 May 15]. Available from :https://www.acf.hhs.gov/sites/default/files/cb/cm2018.pdf.

9. 9. Kuhfeld M, Soland J, Tarasawa B, Johnson A, Ruzek E, Liu J. Projecting the potential impact of covıd-19 school closures on academic achievement. Educational Researcher. 2020; 49(8), 549-65.
10. 10. Mazza C, Ricci E, Biondi S, Colasanti M, Ferracuti S, Napoli C, et al. A Nationwide survey of psychological distress among ıtalian people during the covid-19 pandemic: Immediate psychological responses and associated factors. Int J Environ Res Public Health.. 2020; 2;17(9):3165.DOI: 10.3390/ijerph17093165.
11. 11. UN Women. Covid-19 and ending violence against women and girls. [homepage on the Internet]. 2020; 10. [Cited 2020 May 9]. Available from: https://www.unwomen.org/-/ media/headquarters/attachments/sections/library/ publications/2020/issue-brief-COVİD-19-and-endingviolence-against-women-and-girls-en.pdf?la=en&vs=5006
12. 12. Usher K, Bhullar N, Durkin J, Gyamfi N, Jackson D. Family violence and covid‐19: Increased vulnerability and reduced options for support. Int J Mental Health Nursing. 2020.
13. 13. Allen-Ebrahimian B. China’s domestic violence epidemic, Axios. [homepage on the Internet]. 2020 [Cited 7th April 2020] Available from: https://www.axios.com/china-domestic-violencecoronavirusquarantine-7b00c3ba-35bc-4d16-afdd-b76ecfb28882.html
14. 14. Bradbury‐Jones C, Isham L. The pandemic paradox: the consequences of covid‐19 on domestic violence. Journal of clinical nursing. 2020. DOI:10.1111/jocn.15296
15. 15. Boserup B, McKenney M, Elkbuli A. Alarming trends in US domestic violence during the covid-19 pandemic. Am J Emergency Med. 2020. DOI:10.1016/j.ajem.2020.04.077
16. 16. Davies S, Batha E. Europe braces for domestic abuse ‘perfect storm’ amid coronavirus lockdown. [homepage on the Internet]. 2020. Thomas Reuters Foundation News. [Cited 2020 Apr 17]. Available from: https://news.trust.org/ item/20200326160316-7l0uf
17. 17. As domestic abuse rises in lockdown, France to fund hotel rooms. [homepage on the Internet]. Reuters News Agency, Aljazeera. 2020. [Cited 2020 Apr 7]. Available from: https://www.aljazeera. com/news/2020/03/domestic-abuse-rises-lockdownfrance-fund-hotelrooms-200331074110199.html
18. 18. Agrawal D. The coronavirus could cause a child abuse epidemic. [homepage on the Internet]. The New York Times. 2020. [Cited 2020 May 5]. Available from: https://www.nytimes.com/2020/04/07/opinion/coronavirus-child-abuse.html
19. 19. LeBlanc P. Child abuse reports are down during the pandemic. Experts say that's a bad sign. [homepage on the Internet]. CNN. 2020. Available from: https://edition.cnn.com/2020/05/17/politics/child-abuse-pandemic/index.html.
20. 20. Polis Akademisi Başkanlığı. Kovid-19 salgını ve sonrası devlet, demokrasi ve güvenlik. [homepage on the Internet]. 2022. [Cited Jan 24, 2022]. ]Available from: https://www.pa.edu.tr/Upload/editor/files/Kovid19%20Devlet,%20Demokrasi%20ve%20Güvenlik.pdf.
21. 21. Marques ES, Moraes CL, Hasselmann MH, Deslandes SF, Reichenheim ME. Violence against women, children, and adolescents during the covid-19 pandemic: Overview, contributing factors, and mitigating measures. Cad Saude Publica. 2020; 36: e00074420. DOI: 10.1590/0102-311X00074420
22. 22. Pollack D and Krase K. Reports of child abuse seem to be falling: How can we know what's really happening?.The New Social Worker. 2020; 1-4. https://www.researchgate.net/publication/344138982
23. 23. Caccialanza R, Laviano A, Lobascio F, Montagna E, Bruno R, Ludovisi S, et al. Early nutritional supplementation in non-critically ill patients hospitalized for the 2019 novel coronavirus disease (covid-19): Rationale and feasibility of a shared pragmatic protocol. Nutrition. 2020; 74.DOI: 10.1016/j.nut.2020.110835
24. 24. Li S, Wang Y, Xue J, Zhao N, Zhu T. The impact of covid-19 epidemic declaration on psychological consequences: a study on active weibo users. International Journal of Environmental Research And Public Health. 2020; 17: 2032.
25. 25. Campbell AM. An increasing risk of family violence during the covıd-19 pandemic: Strengthening community collaborations to save lives. Forensic Science International: Reports. 2020; 100089.
26. 26. Thomas EY, Anurudran A, Robb K, Burke TF. Spotlight on child abuse and neglect response in the time of covid-19. 2020; 5:371. Available from: www.thelancet.com/public-health.
27. 27. Hirt S, Ball A, Katie W. Children more at risk for abuse and neglect amid coronavirus pandemic, experts say. USA Today Network. 2020; Available from: https://www.usatoday.com/story/news/investigations/2020/03/21/coronavirus-pandemic-could-become-child-abuse-pandemic-experts-warn/2892923001/
28. 28. Schmidt, S., Natanson, H. With kids stuck at home, ER doctors see more severe cases of child abuse. The Washington Post. 2020; https://www.washingtonpost.com/education/2020/04/30/child-abuse-reports-coronavirus/
29. 29. Kamenetz A. Child sexual abuse reports are on the rise amid lockdown orders. Npr. 56 [homepage on the Internet]. Retrieved from Child abuse during the Covid-19 pandemic. 2020; Available from: https://www.npr.org/sections/coronavirus-live-updates/2020/04/28/847251985/childsexual-abuse-reports-are-on-the-rise-amid-lockdown-orders
30. 30. Karaçam Z. Sistematik derleme metodolojisi: sistematik derleme hazırlamak için bir rehber. Dokuz Eylül Üniversitesi Hemşirelik Yüksekokulu Elektronik Dergisi. 2013; 6 (1), 26-33.
31. 31. Yamaoka Y, Hosozawa M, Sampei M, Sawada N, Okubo Y, Tanaka K, et al. Abusive and positive parenting behavior in Japan during the covid-19 pandemic under the state of emergency. Child Abuse & Neglect. 2020; 120 105212. 1-11. DOI:10.1016/j.chiabu.2021.105212
32. 32. Brown SM, Doom JR, Lechuga-Peña S, Watamura SE, Koppels T. Stress and parenting during the global covid-19 pandemic. Child Abuse & Neglect. 2020; 110, 104699.
33. 33. Lee SJ, Ward KP, Lee JY, Rodriguez CM. Parental social isolation and child maltreatment risk during the covid-19 pandemic. Journal of Family Violence. 2022; 37(5), 813-24.
34. 34. Wong JY, Wai AK, Wang MP, Lee JJ, Matthew L, Kwok JY, et al. Impact of covıd-19 on child maltreatment: ıncome ınstability and parenting ıssues. International Journal of Environmental Research and Public Health. 2021; 18:1-10 1501. DOI:10.3390/ijerph18041501.
35. 35. AboKresha SA, Abdelkreem E, Ali RAE. Impact of covid-19 pandemic and related isolation measures on violence against children in Egypt. Journal of the Egyptian Public Health Association. 2021; 96(1): 1-10.
36. 36. Chung G, Lanier P, Wong PYJ. Mediating effects of parental stress on harsh parenting and parent-child relationship during coronavirus (covid-19) pandemic in Singapore. Journal of Family Violence. 2020; 1-12.
37. 37. Bérubé A, Clément MÈ, Lafantaisie V, LeBlanc A, Baron M, Picher G, Lacharité, C. How societal responses to covid-19 could contribute to child neglect. Child Abuse & Neglect. 2021; 116, 104761.
38. 38. Sari NP, van IJzendoorn MH, Jansen P, Bakermans-Kranenburg M, Riem MM. Higher levels of harsh parenting during the covid-19 lockdown in the Netherlands. Child Maltreatment. 2022; 27(2), 156-62.
39. 39. Ebert C, Steinert JI. Prevalence and risk factors of violence against women and children during covid-19, Germany. Bulletin of the World Health Organization. 2021; 99(6), 429.
40. 40. Ono M, Honda S. Association between social support and child abuse potential among Japanese mothers. Children and Youth Services Review. 2017; 73, 88–92. DOI:10.1016/j.childyouth.2016.12.003.
41. 41. Rodriguez CM, Silvia PJ, Pu DF. Predictors of change in mothers’ and fathers’ parent-child aggression risk. Child Abuse & Neglect. 2018: 86, 247–256. DOI:10.1016/j.chiabu.2018.09.008.
42. 42. Tucker MC, Rodriguez CM. Family dysfunction and social isolation as moderators between stress and child physical abuse risk. Journal of Family Violence. 2014: 29: 175–86. DOI:10.1016/j.chiabu.2017.04.030.
43. 43. Cuartas J, McCoy DC, Rey-Guerra C, Britto PR, Beatriz E, Salhi C. Early childhood exposure to non-violent discipline and physical and psychological aggression in low- and middle-income countries: National, regional, and global prevalence estimates. Child Abuse & Neglect. 2019; 92, 93-105.
44. 44. Fréchette S, Romano E. How do parents label their physical disciplinary practices? A focus on the definition of corporal punishment. Child Abuse & Neglect. 2017; 71, 92-103.
45. 45. Lansford JE, Cappa C, Putnick DL, Bornstein MH, Deater-Deckard K, Bradley RH. Change over time in parents' beliefs about and reported use of corporal punishment in eight countries with and without legal bans. Child Abuse & Neglect. 2017; 71, 44-55.
46. 46. Harville EW, Taylor CA, Tesfai H, Xiong X, Buekens P. Experience of hurricane Katrina and reported intimate partner violence. Journal of Interpersonal Violence. 2011; 26, 833–45. DOI:10.1177/0886260510365861.
47. 47. Hawkins RL. Same at it ever was, only worse: Negative life events and poverty among New Orleans Katrina survivors. Families in Society. 2009; 90, 375–381. DOI:10.1177/0886260510365861.
48. 48. Seddighi H, Salmani I, Javadi MH, Seddighi S. Child abuse in natural disasters and conflicts: A systematic review. Trauma, Violence, & Abuse. 2019; 22, 176–185. DOI:10. 1177/1524838019835973.
49. 49. Schneider W, Waldfogel J, Brooks-Gunn J. The great recession and risk for child abuse and neglect. Children and Youth Services Review. 2017; 72: 71–81. DOI:10.1016/j.childyouth. 2016.10.016.
50. 50. NCCM, UNICEF. Violence against children in Egypt: quantitative survey and qualitative study in Cairo. Cairo: Alexandria and Assuit. [homepage on the Internet]. 2015. [cited 2021 May 10]. Available from: https://www.unicef.org/egypt/reports/violence-against-children-egypt.
51. 51. Bullinger LR, Carr JB, Packham A. Covid-19 and crime: effects of stay-at-home orders on domestic violence (No. w27667). National Bureau of Economic Research. 2020.
52. 52. Herrenkohl TI, Scott D, Higgins DJ, Klika JB, Lonne B. How covid-19 ıs placing vulnerable children at risk and why we need a different approach to child welfare. Child Maltreatment. 2021; 26(1) 9-16 DOI: 10.1177/1077559520963916, 9-16.
53. 53. American Academy of Pediatrics. Parenting in a pandemic: Tips to keep the calm at home. [homepage on the Internet]. 2020. [cited 2021 August 9]. Available from https://www.healthychildren.org/English/health-issues/conditions/COVİD-19/Pages/Parenting-in-a-Pandemic.aspx.
54. 54. Japan Pediatric Society. For those of you who live with your children. [homepage on the Internet]. 2020. [cited 2021 June 19]. Available from: http://www.jpeds.or.jp/uploads/files/20200406_02.pdf.
55. 55. World Health Organization. Coronovirus Pandemic Reports. [homepage on the Internet]. 2020a. [cited 2021 August 10]. Available from: http://www.euro.who.int/en/health-topics/health-emergencies/corona¬virus-COVİD-19/statements/statement-during-COVİD-19-pandemic,-vio¬lence-remains-preventable,-not-inevitable.
56. 56. World Health Organization. Mental health and psychosocial considerations during the covid-19 outbreak. 2020b. [homepage on the Internet]. [cited 2021 August 10]. Available from https://apps.who.int/iris/ handle/10665/331490