Table 3 Determinants of action of professionals, as categorized by the I-Change model
Teachers | Nurses and physicians | ||
|---|---|---|---|
Determinants I-Change model | Key themes | Sub themes | Sub themes |
Performance skills | Lack of communication skills | ● Communicating bad news to parents | ● Clarification and communication of gut feeling |
● Involving children in conversation | ● Handling unmotivated parents | ||
● Dealing with parents who display aggressive behaviour | |||
Action plans | Lack of strategy for acting upon signs of abuse | ● Need for consultation in case of suspicions | ● Need for direct consultation with colleagues during the complete process |
● Need of clear guidelines with regard to procedures | |||
Barriers | Internal barriers | ● Teachers’ feelings of guilt towards children | ● Relationship with parents creates a blind spot |
● Fear of parents’ reaction to the report | ● Maintaining relationship with parents | ||
● Fear of false positives | ● Personal fears (for asking sensitive questions) | ||
External barriers | ● Privacy laws | ● Safety risks for the professional | |
● Parents’ control in accepting help | ● Small distance between nurses’ work district and their home | ||
● Impossibility to report anonymously | |||