Table 1 Cases of intervention refusal encountered by PHNs in Japan and characteristics of their support (mother/child)
(1) With child abuse n = 8 | Without abuse n = 12 | N = 20 | ||||
|---|---|---|---|---|---|---|
Described cases of intervention refusal | (2) With mental disorder | (3) Other | Total | |||
Total | 8 | 7 | 5 | 20 | ||
Refuser | Mother | 3 | 5 | 2 | 10 | |
Parents | 4 | 1 | 3 | 8 | ||
Male cohabiter | 1 | 0 | 0 | 1 | ||
Child (along with the mother in 1 case) | 0 | 2 | 0 | 2 | ||
Intervention refused (multiple answers) | Administrative services | Home visit, etc. | 3 | 2 | 2 | 7 |
Advice to improve the nurturing environment | 2 | 3 | 1 | 6 | ||
Institutionalization | 2 | 1 | 1 | 4 | ||
Developmental support for the child | 1 | 1 | 0 | 2 | ||
Medical services | Recommendation of medical consultation or treatment | 1 | 2 | 1 | 4 | |
Test for definite diagnosis | 0 | 0 | 1 | 1 | ||
Community support | Going to school | 1 | 0 | 1 | 2 | |
Reporting of the missing child | 1 | 0 | 0 | 1 | ||
Person/ agency involved in support (multiple answers) | Administrative agencies | PHN | 8 | 7 | 5 | 20 |
Other local government departments | 3 | 5 | 3 | 11 | ||
Child guidance center | 6 | 3 | 2 | 11 | ||
Child and family support center | 3 | 1 | 1 | 5 | ||
Public assistance worker | 3 | 1 | 0 | 4 | ||
Police | 2 | 1 | 0 | 3 | ||
Medical agencies | Medical institution | 2 | 5 | 2 | 9 | |
Private midwife | 0 | 1 | 1 | 2 | ||
Health/welfare agencies | Welfare service office for the disabled | 0 | 2 | 0 | 2 | |
Social welfare council | 0 | 1 | 0 | 1 | ||
Educational institutions | School | 3 | 1 | 1 | 5 | |
Nursery school | 1 | 1 | 1 | 3 | ||
Relatives | Parents of the parents living outside the prefecture | 1 | 0 | 0 | 1 | |
Inhabitants | Welfare worker | 2 | 1 | 1 | 4 | |
Community consultant including mother-child consultant | 2 | 0 | 0 | 2 | ||
Category of support (multiple answers) | Direct support | Continued contact | 8 | 7 | 5 | 20 |
Of which: Repeated home visits | 4 | 1 | 2 | 7 | ||
Childcare support | 3 | 4 | 2 | 9 | ||
Persuasion and reminder | 3 | 1 | 1 | 5 | ||
Relationship building | 1 | 1 | 1 | 3 | ||
Approach to the husband | 1 | 1 | 0 | 2 | ||
Childbirth support | 1 | 1 | 0 | 2 | ||
Livelihood support | 1 | 0 | 0 | 1 | ||
Job assistance | 0 | 1 | 0 | 1 | ||
Regular hospital visits | 0 | 1 | 0 | 1 | ||
Observation in collaboration with the community midwife | 0 | 1 | 0 | 1 | ||
Team approach | Collaboration with multiple professions | 8 | 7 | 5 | 20 | |
Case conference | 4 | 2 | 4 | 10 | ||
Engagement of key person | 1 | 1 | 0 | 2 | ||
Approach from the midwife | 0 | 1 | 0 | 1 | ||
Use of social resources | Introduction of service | 3 | 2 | 2 | 7 | |
After-school service for children | 0 | 1 | 0 | 1 | ||
Short stay of the mother | 0 | 1 | 0 | 1 | ||