How Stressful Is Examining Children with Symptoms of Child Abuse?—Measurement of Stress Appraisal (SAM) in German Physicians with Key Expertise in Pediatrics

Round 1

Reviewer 1 Report

Thank you for the opportunity to review this paper. This paper has a contribution to child sexual abuse areas.

1. Introduction - Update the literature review - consider incorporating literature about the disclosure issue on CSA accidents.  Also, explore if any studies related to your topic employed the Research approach of the role of Paediatricians on CSA victims. With this, you would be able to argue why this study is important which could show the gap between other research.

2. The methodology of a manuscript needs to be comprehensive to allow other researchers to replicate the study with ease. For your manuscript to serve this purpose you need.

3.  Findings - The findings are thought-provoking - To do justice to these very interesting themes that emerged.

Thank you and regards

 

 

Author Response

Thank you for the opportunity to review this paper. This paper has a contribution to child sexual abuse areas.

1. Introduction - Update the literature review - consider incorporating literature about the disclosure issue on CSA accidents. Also, explore if any studies related to your topic employed the Research approach of the role of Paediatricians on CSA victims. With this, you would be able to argue why this study is important which could show the gap between other research.

Thank you for this suggestion, we updated literature and included actual information from literature:

Amy J.L. Baker, Stacie LeBlanc, Trinae Adebayo, Ben Mathews. Training for mandated reporters of child abuse and neglect: Content analysis of state-sponsored curricula. Child Abuse & Neglect ,

Volume 113, 2021: 104932.

2. The methodology of a manuscript needs to be comprehensive to allow other researchers to replicate the study with ease. For your manuscript to serve this purpose you need.

We emphasized this aspect in the section explaining methodology of data acquisition.

 3. Findings - The findings are thought-provoking - To do justice to these very interesting themes that emerged.

Thank you and regards

Reviewer 2 Report

·         The abstract needs to be reviewed and revised for English grammar and syntax. Subject-verb agreement in particular should be reviewed.

·         The German Civil Code endangerment of child welfare definition should be in quotation marks. The authors also should pay close attention to rules and guidelines for block quotations when quotations exceed a certain word limit.

·         It seems that a limitation to this study is the sample size. The authors should address this limitation in the manuscript.

·         Was the item that asked pediatricians about suggestions for change forced choice or open-ended?

Author Response

Thank you for your kind review of our manuscript. We emphasized our arguments in the discussion of results.

The abstract needs to be reviewed and revised for English grammar and syntax. Subject-verb agreement in particular should be reviewed.

The manuscript was checked by an English native speaking science writer. Language changes are marked in the revised manuscript. Subject-verb agreement was reviewed in detail, especially in the abstract section.

The German Civil Code endangerment of child welfare definition should be in quotation marks. The authors also should pay close attention to rules and guidelines for block quotations when quotations exceed a certain word limit.

Quotation marks were inserted. Quotation guidelines are paid special attention. Changes are marked in the revised manuscript.

It seems that a limitation to this study is the sample size. The authors should address this limitation in the manuscript.

We agree. Therefore, we inserted text to emphasize this aspect.

Was the item that asked pediatricians about suggestions for change forced choice or open-ended?

The item was open-ended and also with forced choice. This aspect is differentially displayed in tables of results.

Reviewer 3 Report

Subject: Manuscript etitled How Stressful Is Examining Children With Symptoms of Child 2 Abuse? – Measurement of Stress Appraisal (SAM) in German 3 Physicians With Key Expertise in Paediatrics and Supplementary Materials

This interesting study investigated, in terms of the transactional stress model, if German paediatricians experienced an imagination  story with a child protection scenario as more stressful, more threatening, challenging and less controllable than another potentially stress-triggering scenario. The participants were confronted with the scenario of a physical medical emergency -febrile child with a seizure vs. a child protection scenario -suspicion of child maltreatment. The imagination story with the child protection scenario  was, on average, rated as more threatening, more central, and more stressful than the medical emergency scenario.

The majority of the participants in this study felt moderately familiar with the content and averagely confident about the practical application of the formal strategic documents, which both outline how to handle child protection cases in Germany within the legal framework, many subsequently admitted to still having concerns about the legal aspects of such situations.

To be able to identify possible measures to reduce stress and to improve the confidence of paediatricians when they are confronted with child protection issues, the study participants had been asked to report wishes and suggestions for improvements. Participants suggested further training opportunities on the topic, as well as concrete directives on how to proceed in such cases in practice, in addition they besides formal strategic documents, which were compiled to provide practical recommendations, the surveyed paediatricians saw need for more help in this regard, they also wished for better regional and interdisciplinary networks, concrete addresses and contact persons to whom they could turn to in urgent cases when support measures and other interventions to safeguard a child’s wellbeing needed to be initiated as quickly as possible.

The authors underline the need to optimize paediatricians’ potential in the child protection system, they need better support in coping with the identified stressors in child abuse scenarios.

This paper is very well organized, clearly written and professionally done, references are cited according to the rules of journal, the topic is important and accurate.

 

Author Response

Thank you for your kind review of our manuscript.

Subject: Manuscript etitled How Stressful Is Examining Children With Symptoms of Child 2 Abuse? – Measurement of Stress Appraisal (SAM) in German 3 Physicians With Key Expertise in Paediatrics and Supplementary Materials

This interesting study investigated, in terms of the transactional stress model, if German paediatricians experienced an imagination  story with a child protection scenario as more stressful, more threatening, challenging and less controllable than another potentially stress-triggering scenario. The participants were confronted with the scenario of a physical medical emergency -febrile child with a seizure vs. a child protection scenario -suspicion of child maltreatment. The imagination story with the child protection scenario  was, on average, rated as more threatening, more central, and more stressful than the medical emergency scenario.

The majority of the participants in this study felt moderately familiar with the content and averagely confident about the practical application of the formal strategic documents, which both outline how to handle child protection cases in Germany within the legal framework, many subsequently admitted to still having concerns about the legal aspects of such situations.

To be able to identify possible measures to reduce stress and to improve the confidence of paediatricians when they are confronted with child protection issues, the study participants had been asked to report wishes and suggestions for improvements. Participants suggested further training opportunities on the topic, as well as concrete directives on how to proceed in such cases in practice, in addition they besides formal strategic documents, which were compiled to provide practical recommendations, the surveyed paediatricians saw need for more help in this regard, they also wished for better regional and interdisciplinary networks, concrete addresses and contact persons to whom they could turn to in urgent cases when support measures and other interventions to safeguard a child’s wellbeing needed to be initiated as quickly as possible.

 The authors underline the need to optimize paediatricians’ potential in the child protection system, they need better support in coping with the identified stressors in child abuse scenarios.

This paper is very well organized, clearly written and professionally done, references are cited according to the rules of journal, the topic is important and accurate.

Thank you for your kind review of our manuscript.