Method: A quantitative cross-sectional survey research design was employed. One hundred and thirty-five pediatricians responded to a specially constructed instrument sent to a systemic, randomly chosen sample. The participants rated 40 vignettes of abuse and neglect according to their perception of the extent of the risk to the welfare of the child and their willingness to report these situations. They also rated 15 signs according to their perception of the extent to which each sign could lead to a suspicion of maltreatment.

Results: Situations which fell within the biomedical perspective were ranked as containing a higher level of risk to the child than situations which were not (i.e., psychological abuse and educational neglect). Situations describing explicit signs or negative consequences of an act were ranked higher than those in which rationalization by the parent was included. These findings indicate that concrete evidence affects pediatricians judgement of what constitute maltreatment. The pediatricians were less willing to report situations of child maltreatment to the police than to the welfare department.

Conclusions: Certain situations of abuse or neglect might be overlooked by pediatricians in the process of diagnosing maltreated children. This may be explained by inadequate awareness of the psychosocial factors needed to identify maltreated children. Pediatricians' willingness to report seemed to depend on their altitude toward the receiving professional, and situations requiring involvement of the police may be disregarded.

Résumé

Resumen

El conocimiento actual acerca de cómo los pediatras se acercan al maltrato infantil, se basa principalmente en estudios realizados en Estados Unidos. Aunque el contexto social puede influir en la manera en que los pediatras evalúan los casos de maltrato, los estudios llevados a cabo en otros paises pueden ayudar a determinar cómo el entrenamiento/formación profesional afecta, independientemente del contexto social, la manera en que los pediatras se acercan a estos casos. Esta cuestión fue analizada en un estudio llevado a cabo entre 135 pediatras en Israel. Se utilizó un instrumento creado para este estudio, para analizar la percepción de los pediatras acerca de la severidad de situaciones de maltrato y abandono. También se analizaron los factores que podían afectar su percepción, así como sus actitudes respecto a la notificación del caso a la policía o al departamento de bienestar. Los resultados indican que hay áreas en la detección y notificación de casos de maltrato infantil a las que los pediatras no siempre prestan la atención necesaria. Se hacen sugerencias que podían contribuir a conseguir que los pediatras cumplan la importante tarea que les corresponde.