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• W1538326877 abstract "There has been growing concern in recent years about child sexual exploitation (CSE), both internationally and in the UK (e.g. UNICEF Innocenti Research Centre 2005, 2012, Feinstein & O'Kane 2009, Frederick 2010). Increased awareness stems from several high profile cases in the media (for example: Jimmy Savile, Rolf Harris, Rotherham, the Boy Scout movement, the Roman Catholic Church), reports from practitioners about rising incidence, and a growing body of research (e.g. Wilshaw 1999, Firmin 2010, Beckett 2011, Jago et al. 2011, Smeaton 2011, Beckett et al. 2012, Berelowitz et al. 2012, 2013, Brodie & Pearce 2012, Gohir 2012, Sharp 2012). CSE is a type of sexual abuse in which children are sexually exploited for money, power or status….[they] may be tricked into believing they are in a loving, consensual relationship. They might be invited to parties and given alcohol. They may also be groomed online. In response to this growing awareness of CSE in the UK, several official enquiries (e.g. Jay 2013), inspections (e.g. Casey 2012) and serious case reviews (e.g. Galley 2010, Bedford 2015) have recently been undertaken. All of these highlight the failures of agencies to work together and share information. Galley (2010) notes, in particular, that universal services (education and health) failed to recognise the early signs of abuse and that health staff did not fully understand child protection procedures and information sharing policy. They also indicate that there was a general lack of understanding and curiosity about the signs and symptoms of sexual exploitation among professionals from all agencies. Bedford (2015) notes that in the case of sensitive health services, such as genito-urinary medicine clinics, this lack of curiosity was tactical as professionals feared that asking too many questions could result in the child or young person subsequently withdrawing from the service. These factors combined resulted in a failure to recognise the abuse for what it was. Instead of being seen as children at risk, children being sexually exploited were often judged to be ‘out of control’ and were often dealt with by agencies as offenders rather than as victims of abuse. Nurses are ideally placed to identify the warning signs and indicators associated with CSE: mental health problems; learning difficulties; repeated alcohol and drug misuse; repeated pregnancies; and repeated attendances at the emergency department. Moreover, given the consequences of this type of abuse to a young person's physical (sexually transmitted disease, pelvic floor injury, anal trauma) and mental (post-traumatic stress disorder, dissociation and depression) health, it becomes imperative to consider how nurses and other health professionals can be supported to become more inquisitive about CSE and better at identifying the early signs of abuse. To date there are no centrally issued guidelines on how health professionals can identify and treat children who have been sexually abused. The National Institute for Health and Care Excellence in the UK is in the process of developing guidance on the identification and management of young people at risk of sexually harmful behaviour, but it is unclear whether this includes CSE and given the parameters of the remit, it is unlikely. Additionally, the Department of Health (2015) published a pathway document to clarify the role of school nurses in respect of CSE. The Department of Health independent Health Working Group (2014, p.22) has recommended that all frontline health staff should receive training on the warning signs of CSE. The House of Commons Home Affairs Committee (2013) recommends that the details of all children up to the age of 16 who present at emergency departments are entered on the Child Protection Information System (not just younger children as is current practice). Further, they suggest that sexual health staff in particular need to be alert to CSE. As the example from Oxfordshire (Bedford 2015) demonstrates, improvements in staff training and awareness of CSE can result in a greater number of health professionals making referrals about, and seeking advice on possible cases of CSE. Clark and Thomson (2015) call for fear, audacity and values in nursing research. CSE is a real test bed of all three. How good would it be if nurses led the way?" @default.
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• W1538326877 date "2015-06-18" @default.
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• W1538326877 title "Child sexual exploitation: where are the nurses?" @default.
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• W1538326877 doi "https://doi.org/10.1111/jan.12710" @default.
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