Nurses’ Knowledge, Attitudes, and Perceptions of Child Abuse and Neglect in the Gulf Cooperation Council (GCC) Countries: A systematic review

Underreporting of suspected cases of child abuse and neglect (CAN) is a significant global healthcare concern. In the Gulf region, conservative cultural norms contribute to socioecological challenges in identifying and reporting CAN. In healthcare settings, nurses play a pivotal role in safeguarding children, as their knowledge, attitudes, and perceptions (KAP) directly influence recognition, reporting, and intervention. This review examined nurses' KAP towards CAN within the Gulf Cooperation Council (GCC) countries. The review followed the Joanna Briggs Institute (JBI) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) The protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO; registration number: CRD42023429338). A comprehensive search of MEDLINE, CINAHL, SCOPUS, Web of Science and PubMed was conducted using Boolean logic and Medical Subject Headings terms. Data extraction focused on study setting, target population, and key findings. Findings were synthesised using the SeCOM-B framework, which integrates the Social-Ecological Model (SEM) and the COM-B Model. Six studies from Saudi Arabia met the inclusion criteria. Despite this, nurses demonstrated inconsistent knowledge of CAN-related legal aspects and reporting requirements. Nurses held supportive attitudes toward identifying and reporting suspected cases of CAN. Key barriers to reporting suspected cases included fear of negative consequences, limited training and unfamiliarity with national child protection frameworks. The review highlighted important issues at the individual, institutional and structural levels that may influence nurses' KAP regarding CAN. Addressing these issues requires multilevel interventions, including strengthening education and training, enhancing institutional support, and effectively implementing child protection frameworks within nursing practice. Further research across other GCC countries is needed to strengthen regional evidence.