"Alone with our interpretations": Uncertainty in child abuse intervention among healthcare professionals. (May 2019) - Sigad, Laura I.
Abstract: The purpose of this article is to provide an insider's view and analysis of the way Israeli healthcare professionals give meaning to their work in cases related to child abuse and how they experience and cope with the inherent uncertainty of these complex situations. Conducted from a social constructivist perspective, this qualitative analysis is based on 20 in-depth, semi-structured interviews with a purposeful sample of healthcare professionals including doctors (11), healthcare administrators (2), nurses (5), and social workers (2). Data analysis included initial identification of the units of meaning, followed by cross-case analysis aimed at identifying core themes. The findings indicate that healthcare professionals who treat child abuse in Israel do so under a cloud of uncertainty, which can be observed on a number of levels, including the definition of abuse and dilemmas concerning reporting. The professionals who participated in this study exhibited varying perspectives, from viewing their work as a pioneering effort that lacks social and professional support, to viewing the future of child abuse assessment and treatment as part of an interdisciplinary effort. The findings reflect the limitations of an individualistic, emergency medical model of care and suggest how this model may be enhanced through a reflective, holistic view within an interdisciplinary framework that addresses a broader social and psychological context. Highlights: Healthcare professionals treating child abuse do so under a cloud of uncertainty. Findings suggest how medical model of care may be enhanced by an interdisciplinary framework. Findings describe pathways effective for overcoming uncertainty or living in it. The study explores the positive potential of uncertainty, whose effects may facilitate innovative solutions.