Abstract：
Child abuse is a major health problem that can lead to physical and psychological issues. Its diagnosis can be difficult and sensitive. Physicians are submitted by law to inform the parents when they report to child welfare services or judicial authorities, unless otherwise in the minor\'s interest. This exercise is destabilizing for both patients and physicians. The physician must be trained to detect and announce a possible diagnosis of child abuse. To facilitate and increase those reports, we have developed guidelines for the physicians to help the exercise of announcement. These guidelines were based on pre-existing recommendations about how to announce bad news. We have also planned to put into practice these guidelines with a communication skills training program based on standardized patients. We propose the acronym PROTECT; P for plural: never stay alone in such situations, R for remaining a caregiver and not becoming an investigator or judge, O for obligation to protect minors, T for time, to take enough time to inform the parents and the child but in a limited time frame, E for explaining to the parents what preoccupy the professionals; C for centring ourselves on the child, his or her symptoms, needs and pain; T for total care of the child that should integrate physical, psychological, and social child health, through a global and interdisciplinary approach in collaboration with child welfare services, and should involve also the child in the process. This tool will be applied by simulation in child welfare training with standardized patients. The evaluation of this tool and its application would need further study.
摘要：
虐待儿童是一个主要的健康问题，可能导致身体和心理问题。它的诊断可能是困难和敏感的。医生在向儿童福利服务机构或司法当局报告时，依法提交通知父母，除非未成年人的利益另有规定。这项运动对患者和医生都不稳定。医生必须接受培训，以发现并宣布可能的虐待儿童的诊断。为了促进和增加这些报告，我们为医生制定了指南，以帮助实施公告。这些指南基于关于如何宣布坏消息的现有建议。我们还计划通过基于标准化患者的沟通技能培训计划将这些指南付诸实践。我们建议首字母缩写词PROTECT；P表示复数：在这种情况下永远不要独处，R表示仍然是护理人员，而不是成为调查员或法官，保护未成年人的义务，T代表时间，花足够的时间通知父母和孩子，但在有限的时间范围内，E向父母解释专业人员的注意力；C将自己集中在孩子身上，他或她的症状,需求和痛苦；对于孩子的全面照顾，应该整合身体，心理,和社会儿童健康，通过与儿童福利服务合作的全球和跨学科方法，也应该让孩子参与这个过程。该工具将通过模拟在标准化患者的儿童福利培训中应用。对该工具及其应用的评估需要进一步研究。
