A scale for home visiting nurses to identify risks of physical abuse and neglect among mothers with newborn infants.

OBJECTIVE

The aim was to construct and test the reliability (utility, internal consistency, interrater agreement) and the validity (internal validity, concurrent validity) of a scale for home visiting social nurses to identify risks of physical abuse and neglect in mothers with a newborn child.

METHOD: A 71-item scale was constructed based on a literature review and focus group sessions with social nurses and paraprofessionals who had experience with underprivileged families. This scale was applied in a random sample of 40 home visiting social nurses, who collected data in a sample of 373 nonabusive and 18 abusive/neglectful mothers with a newborn child.

RESULTS

Items with prevalence rates below 5% and items making no significant difference between maltreating and non-maltreating mothers were omitted. The final version contained 20 items. This scale showed high internal consistency (alpha = .92) and high interrater reliability (r = .97). Exploratory factor analysis yielded a three-factor solution: Isolation (8 items, explaining 62.17% of the common variance), Psychological complexity (6 items, 18.86%), and Communication problems (6 items, 8.41%). Scores on Communication problems and Isolation significantly predicted scores on a social deprivation scale, which significantly distinguished maltreating from non-maltreating mothers. Mothers scoring high on Communication problems or Isolation obtained higher scores for social deprivation than low-scoring mothers.

CONCLUSIONS

Home visiting nurses can identify risks for physical abuse and neglect among mothers with a newborn infant by focusing on signs of social isolation, distorted communication and psychological problems.