Erisman, JC, de Sabbata, K, Zuiderent-Jerak, T and Syurina, EV (2020) Navigating complexity of child abuse through intuition and evidence-based guidelines: a mix-methods study among child and youth healthcare practitioners. BMC Family Practice, 21 (1). ISSN 1471-2296

[thumbnail of s12875-020-01226-6.pdf]
s12875-020-01226-6.pdf - Published Version

Download (754kB) | Preview


<jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>Dutch child and youth health care (CYHC) practitioners monitor and assess the well-being of children. One of their main concerns is identifying cases of child abuse, which is an arduous and sensitive task. In these contexts, CYHC-practitioners use both evidence-based guidelines aimed at increasing the quality of care through rationalised decision-making, and intuition. These two practices are seen as being at odds with each other, yet empirical research has shown that both are necessary in healthcare. This study aims to unravel how intuition is perceived and used by Dutch CYHC-practitioners when identifying and working with cases of child abuse, and how this relates to their evidence-based guidelines.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>A sequential exploratory mixed-methods design: in-depth semi-structured interviews with CYHC-physicians focused on perceptions on intuition, which were followed by a survey amongst CYHC-practitioners on the recognition and use of the concept.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>The majority of CYHC-practitioners recognise and use intuition in their daily work, stating that it is necessary in their profession. CYHC-practitioners use intuition to 1) sense that something is ‘off’, 2) differentiate between ‘normal’ and ‘abnormal’, 3) assess risks, 4) weigh secondary information and 5) communicate with parents. At the same time, they warn of its dangers, as it may lead to ‘tunnel vision’ and false accusations.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusion</jats:title> <jats:p>Intuition is experienced as an integral part of the work of CYHC-practitioners. It is understood as particularly useful in cases of child abuse, which are inherently complex, as signs and evidence of abuse are often hidden, subtle and unique in each case. CYHC-practitioners use intuition to manage and navigate this complexity. There is an opportunity for guidelines to support reflection and intuition as a ‘good care’ practice.</jats:p> </jats:sec>

Item Type: Article
Additional Information: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.
Subjects: R Medicine > R Medicine (General) > R735 Medical education. Medical schools. Research
R Medicine > RA Public aspects of medicine
R Medicine > RJ Pediatrics
R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services
Depositing User: Symplectic
Date Deposited: 02 Nov 2021 14:50
Last Modified: 02 Nov 2021 14:50

Actions (login required)

View Item
View Item