■儿童性虐待(CSA)的临床管理由于其敏感性而需要医疗保健专业人员的专业技能,法律含义,以及严重的身体健康和心理健康影响。标准化,综合临床实践指南(CPGs)可能是关键。在这次系统审查中,我们检查了来自欧洲国家的现有CSA国家CPG(NCPG),以评估其质量和报告。
■我们系统地检索了六个国际数据库和多个灰色文献来源,按系统审查和荟萃分析(PRISMA)标准的首选报告项目进行报告。合格的指南是来自34个COSTAction19106网络国家(CANC)的国家卫生机构或协会的CSA指南,2012年1月至2022年11月发布。两名独立研究人员搜索,筛选,reviewed,并提取数据。NCPG的完整性与世卫组织2017年和2019年指南进行了比较。我们使用《评估研究与评估指南》(AGREEII)来评估质量和报告。PROSPERO:CRD42022320747。
■在通过数据库搜索确定的2919条记录中,没有人符合纳入标准。在通过其他方法识别的4714条记录中,包括来自17个(50%)CANC国家的24个NCPG。在17个(50%)符合条件的国家中,没有发现NCPG。国家内部和国家之间的内容差异很大。与世卫组织参考标准相比,NCPG在最先进的临床实践中缺乏许多组成部分,特别是在安全和风险评估方面,与护理人员的互动,心理健康干预。AGREEII的评估揭示了NCPG发展中的缺陷,关于科学的严谨性,利益相关者的参与,实施和评估。
■相当数量的欧洲国家缺乏NCPG;现有的NCPG往往不足。欧洲对CSA的医疗保健响应需要采取协调一致的方法来开发和实施高质量的CPG。我们提倡多学科团队制定泛欧CSA指南,以确保为幸存者提供优质护理。
■资金由国际失踪和受剥削儿童中心提供。
UNASSIGNED: The clinical management of Child sexual abuse (CSA) demands specialised skills from healthcare professionals due to its sensitivity, legal implications, and serious physical health and mental health effects. Standardised, comprehensive clinical practice
guidelines (CPGs) may be pivotal. In this systematic review, we examined existing CSA national CPGs (NCPGs) from European countries to assess their quality and reporting.
UNASSIGNED: We systematically searched six international databases and multiple grey literature sources, reporting by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. Eligible
guidelines were CSA guidance from national health agencies or societies in 34 COST Action 19106 Network Countries (CANC), published between January 2012 and November 2022. Two independent researchers searched, screened, reviewed, and extracted data. NCPGs were compared for completeness with reference WHO 2017 and 2019
guidelines. We used the Appraisal of
Guidelines for Research and Evaluation (AGREE II) to appraise quality and reporting. PROSPERO: CRD42022320747.
UNASSIGNED: Of 2919 records identified by database searches, none met inclusion criteria. Of 4714 records identified by other methods, 24 NCPGs from 17 (50%) of CANC countries were included. In 17 (50%) of eligible countries, no NCPGs were found. Content varied significantly within and between countries. NCPGs lacked many components in state-of-the art clinical practice compared to WHO reference standards, particularly in safety and risk assessment, interactions with caregivers, and mental health interventions. Appraisal by AGREE II revealed shortcomings in NCPG development, regarding scientific rigour, stakeholder involvement, implementation and evaluation.
UNASSIGNED: A notable number of European countries lack an NCPG; existing NCPGs often fall short. The healthcare response to CSA in Europe requires a coordinated approach to develop and implement high-quality CPGs. We advocate for a multidisciplinary team to develop a pan-European CSA
guideline to ensure quality care for survivors.
UNASSIGNED: Funding was provided by the International Centre for Missing and Exploited Children.