INTRODUCTION:

Child abuse has come to mean any purposeful act of physical, emotional, or sexual abuse done by a person responsible for the child's care, including acts of neglect. While the concept of abuse is straightforward, the meaning is less so. Yes, abuse occurs when one person intentionally harms another, yet it is a common event in life, and most of us are guilty of it on occasion.

Abuse, on the other hand, is a kind of control. When a situation is truly abusive, it is because one party is attempting to control the other through abuse. While this may be an explanation for abuse, it is by no means a justification. A person has no right to mistreat another person in order to exert control over them. Abuse victims must understand that the abuse is wrong and that it is never their fault. Every individual has the right to live a life free of abuse².

What is CHILD ABUSE?

· Child abuse" can be defined as causing or permitting any harmful or offensive contact on a child's body; and, any communication or transaction of any kind which humiliates, shames, or frightens the child³.

Child Abuse Levels:

1. At home: Abusers are either parents or substitutes for parents.

2. Educational institutions, such as schools, day care centres, boarding schools, hostels, and residential centres.

3. Society: Allowing children to live in poverty or denying them access to fundamental requirements of life.

4. Discipline and neglect: Discipline is a deliberate action taken to constrain or control a kid's behaviour that is not intended to harm or injure the youngster.

Neglect is an omission that occurs when a child fails to achieve their fundamental needs for food, shelter, clothes, and rights.

Abuse can be caused by a variety of factors, including

1. Marital issues,

2. Financial challenges,

3. Frustration,

4. illness-related stress,

5. Parent-child conflict, and

6. A loss of control over anger⁴.

Types of abuse:

1. Physical abuse: of a child occurs when a parent or caregiver causes a child to sustain any non-accidental physical injury. Physical abuse manifests itself in a variety of ways. Please seek immediate assistance if you see any of the following indicators. Physical abuse was reported by 28.3 percent of adults as a child.

Striking, kicking, burning, biting, hair pulling, choking, throwing, shoving, whipping, or any other action that injures a child is considered physical abuse. Even if the caregiver did not intend to hurt the child, it is still considered abuse if the child is hurt. Physical discipline by a parent that does not hurt or impair a child is not considered abuse; however, there are always nonviolent alternatives.

2. Sexual abuse - When an adult uses a child for sexual purposes or engages a child in sexual actions, this is known as sexual abuse. It can also be when an older or more strong child utilises another child for sexual fulfilment or excitement. As a child, 20.7 percent of adults say they were sexually molested. The following are examples of child sexual abuse: Making a child view or show sex organs, Inappropriate sexual talk, Non-contact abuse, Making a child view a sex act, Contact abuse, Fondling and oral sex, Penetration, Making children perform a sex act, Exploitation, Child prostitution and child pornography.

3. Emotional abuse: Emotional abuse occurs when a parent or caregiver affects a child's mental and social development or causes serious emotional distress. While a single episode of emotional abuse may be considered abuse, most cases of emotional abuse are the result of a pattern of behaviour that causes harm over time. 10.6% of adults say they were emotionally abused as children.

The following are examples of emotional abuse:

· Telling a child, he or she is undesired or unloved, showing little interest in the child, not initiating or reciprocating affection, not listening to the child, not validating the child's feelings, breaking promises, cutting the child off in conversation are all examples of rejection or ignoring.

· Calling a child, a name, criticizing, ridiculing, insulting, berating, mocking, using language or taking action that targets a child's feelings of self-worth are all examples of shaming or humiliation.

· Terrorizing includes accusing, blaming, insulting, punishing with or threatening abandonment, harm, or death, setting a child up for failure, manipulating, using a child's frailty or dependency on adults, slandering, screaming, and shrieking.

· Isolation: excluding the child from peers and beneficial activities, limiting the youngster to a limited space, prohibiting play or other stimulating experiences.

· Engaging a youngster in criminal activity, lying to defend actions or ideas, and fostering misbehaviour are all examples of corruption.

4. Child neglect: When a parent or caregiver fails to provide the necessary care, supervision, affection, and support for a child’s health, safety, and well-being, this is known as child neglect. Physical neglect and poor supervision are examples of child neglect, as are emotional neglect, medical neglect, and educational neglect⁵.

Child Abuse Management:

· Educating parents.

· Guidance at school.

· Counseling.

· Assistance with finances.

· Foster care in a home.

· Training in assertiveness.

· Child protection services, such as an emergency shelter, a day care centre, and telephone hotlines⁶.

Community health nurse's role in child abuse:

1. Parents should be advised by a community health nurse to never leave their children unattended, especially outside the home.

2. Parents should be advised by a community health nurse to teach their children the distinction between good and negative touches.

3. The community health nurse should encourage parents to participate in their children's activities and to be aware of their children's friends.

4. The therapeutic needs of a family can be met in a variety of ways by a community health nurse.

5. Child-care skills such as adequate feeding, effective punishment, and constructive communication are frequently taught by community health nurses to mothers.

6. By teaching both parents and children in a calm, courteous, and informed manner, community health nurses display effective communication skills and discipline.

7. During home visits, a community health nurse can demonstrate how to physically and psychologically care for a relative.

8. The community health nurse should advise school instructors to provide sex education to their students.

9. A community health nurse should urge a mother to be honest with her daughter's feelings so that she does not feel alone.

10. The community health nurse should advise the mother on how to properly care for their children, such as bathing, brushing, and so on.

11. Instead of punishing and scolding the youngster for doing the improper work, the community health nurse advises family members to teach them how to conduct the household chores properly.

12. Parents should not overlook or disregard their children, according to the community health nurse.

13. Community health nurses should counsel teachers on how to treat pupils with kindness in the classroom and provide health-care programmes.

14. The parent should be advised by the community health nurse not to send their children alone.

15. Parents should be advised by a community health nurse not to send their girl children with strangers. Send them on autopilot and never by themselves.

16. In school health programmes, a community health nurse should advise teachers that they must provide instruction about actions such as snorting in order to save themselves⁷.

REFERENCES:

1. Kamalam S. Essentials in community Health Nursing Practice. 2nd ed,2012: p 407-415

2. Mendagudli Veerabhadrappa. Kedar Tushar. Child Abuse –A Review. World Journal of Advance Healthcare Research. 2021;5 (3):243-246.

3. C.Manivannan, S.Rathamani, T.Latha Manivannam‘’Text book of Community health nursing’’, 1st edition, Emmess Medical Publishers, Bangalore, Page no.207-209.

4. Availableonline(https://www.statpearls.com/ArticleLibrary/viewarticle/26823#:~:text=The%20World%20Health%20Organization %20(WHO,abuse%3A%20neglect%2C%20physical%20abuse%2C

5. Kocher MS, Kasser JR. Orthopaedic aspects of child abuse. J Am Acad Orthop Surg. 2000;8 (1):10-20.

6. Sunderlal, Adarsh, Pankaj. Textbook of Community Medicine ed 2nd 2009;CBS Publisher and distributors 635-657

Received on 08.08.2021 Modified on 21.11.2021

Int. J. of Advances in Nur. Management. 2022; 10(1):84-86.

DOI: 10.52711/2454-2652.2022.00021