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Document Type

Dissertation - University Access Only

Award Date


Degree Name

Doctor of Philosophy (PhD)

Department / School

Graduate Nursing

First Advisor

Thomas Stenvig


child abuse, differential diagnosis, grounded theory


The abuse of children is a prevalent social phenomenon that takes place within all socioeconomic structures. No grounded theory study to date has examined the processes which lead child abuse experts to recognize child abuse. The aim of this qualitative study was to construct a substantive theory, using the Strauss and Corbin grounded theory method, to describe the core processes and domains that are central to the recognition of child abuse. Ten health care providers who were established experts in the area of child abuse were interviewed. A substantive theory of expert providers' evolution of a differential diagnosis in child abuse emerged from this study. This theory demonstrates the process of expert providers' recognition of child abuse. Coming to a differential diagnosis was the central task in the recognition and diagnosis of abuse. Utilizing a specific set of skills and clinical reasoning abilities, expert providers synthesized information from the presenting evidence, child and parent interactions, and multidisciplinary communication to formulate a differential diagnosis which included child abuse and other medical conditions. This theory lends itself to nursing education and advanced nursing practice. Educational efforts in child abuse content should focus on incorporating strategies to assist students in the formulation of a differential diagnosis of child abuse.

Library of Congress Subject Headings

Child abuse -- Diagnosis
Medical personnel


Includes bibliographical references (page 140-152)



Number of Pages



South Dakota State University


Copyright © 2012 Nancy Kertz. All rights reserved