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.