چکیده (انگلیسی):

Background:Child abuse is often unrecognized at out-of-hours primary care (OOH-PC) services. The aim of our
study was to evaluate the clinical outcome of the screening instrument SPUTOVAMO-R2 for child abuse (checklist),
followed by a structured approach (reporting code), at OOH-PC services. The reporting code with five steps should
ensure consistent action in case of a suspicion.
Methods:All children attending one of the five participating OOH-PC services in the region of Utrecht, the Netherlands,
in a year time, were included. The checklist is an obligatory field in the electronic patient file and was filled in for all
children. In case of a positive checklist, the steps in the reporting code werefollowed.Additionally,thecasewas
evaluated in a multidisciplinary team to determine the probability of child abuse.
Results:The checklist was filled in for 50671 children; 108 (0.2 %) were positive. The multidisciplinary team diagnosed
child abuse in 24 (22 %) of the 108 positive checklists, and no child abuse in 36 (33 %). Emotional neglect was the most
frequent type of abuse diagnosed. For all abused children, care was implemented according to the protocol. The most
frequent care given was a referral to the hospital (N= 7) or contact with child’s own general practitioner (N=6).
Conclusion:A checklist followed by a reporting code guarantees consistent actions and care for children with a
suspicion of child abuse. The percentage of positive checklists is lower than expected. Validity of the checklist should
be assessed in a diagnostic study.