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Can nurses be key players in assessing early motor development using a structured method in the child health setting?

https://arctichealth.org/en/permalink/ahliterature272582
Source
J Eval Clin Pract. 2015 Aug;21(4):681-7
Publication Type
Article
Date
Aug-2015
Author
Kine Johansen
Kristina Persson
Anna Sarkadi
Karin Sonnander
Margaretha Magnusson
Steven Lucas
Source
J Eval Clin Pract. 2015 Aug;21(4):681-7
Date
Aug-2015
Language
English
Publication Type
Article
Keywords
Child Development
Female
Humans
Infant
Male
Motor Activity
Motor Skills
Nursing Assessment
Observation
Physical Therapists
Sweden
Abstract
Increasing evidence highlights the importance of early interventions for motor disorders in children. Given the key medical role of the nurse within the Swedish Child Health Service (CHS), we aimed to examine if nurses could apply a structured assessment of early motor development at the child health centre to enable early identification of children at risk.
Structured Observation of Motor Performance in Infants (SOMP-I) assesses infant's level of motor development and quality of motor performance using subscales converted to total scores. The total score for both level and quality can then be plotted within the SOMP-I percentile distribution at the child's age for comparison with a reference population. Fifty-five infants (girls: 30) were assessed according to SOMP-I at three child health centres. Assessments were performed by nurses (n?=?10) in a clinical setting; one nurse performed the assessment while another nurse and a physiotherapist observed.
Agreement for the assessment of level as a continuous variable was excellent [intraclass correlation coefficient (ICC) 0.97-0.98], but was lower for quality (ICC 0.02-0.46). When the children were categorized according to the percentile range categories, the assessors were in agreement for the majority of the children, with respect to both level (78-82%) and quality (78-87%).
Despite brief experience with SOMP-I, the agreement was excellent when assessing the level of motor development, but was less satisfactory for the assessment of quality of motor performance. More extensive education and training may be necessary to improve the nurses' ability to assess quality, as this domain was an entirely new concept to the nurses. Further research is warranted to determine the applicability of SOMP-I as a standardized method for nurses to assess motor development within the CHS.
PubMed ID
25958886 View in PubMed
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Clinical utility of the Structured Observation of Motor Performance in Infants within the child health services.

https://arctichealth.org/en/permalink/ahliterature286084
Source
PLoS One. 2017;12(7):e0181398
Publication Type
Article
Date
2017
Author
Kine Johansen
Kristina Persson
Karin Sonnander
Margaretha Magnusson
Anna Sarkadi
Steven Lucas
Source
PLoS One. 2017;12(7):e0181398
Date
2017
Language
English
Publication Type
Article
Keywords
Child Development - physiology
Child Health Services
Female
Humans
Infant
Longitudinal Studies
Male
Motor Skills - physiology
Motor Skills Disorders - diagnosis
Sweden
Abstract
This study aimed to evaluate the clinical utility of the Structured Observation of Motor Performance in Infants (SOMP-I) when used by nurses in routine child healthcare by analyzing the nurses' SOMP-I assessments and the actions taken when motor problems were suspected.
Infants from three child health centers in Uppsala County, Sweden, were consecutively enrolled in a longitudinal study. The 242 infants were assessed using SOMP-I by the nurse responsible for the infant as part of the regular well-child visits at as close to 2, 4, 6 and 10 months of age as possible. The nurses noted actions taken such as giving advice, scheduling an extra follow-up or referring the infant to specialized care. The infants' motor development was reassessed at 18 months of age through review of medical records or parental report.
The assessments of level of motor development at 2 and 10 months showed a distribution corresponding to the percentile distribution of the SOMP-I method. Fewer infants than expected were assessed as delayed at 4 and 6 months or deficient in quality at all assessment ages. When an infant was assessed as delayed in level or deficient in quality, the likelihood of the nurse taking actions increased. This increased further if both delay and quality deficit were found at the same assessment or if one or both were found at repeated assessments. The reassessment of the motor development at 18 months did not reveal any missed infants with major motor impairments.
The use of SOMP-I appears to demonstrate favorable clinical utility in routine child healthcare as tested here. Child health nurses can assess early motor performance using this standardized assessment method, and using the method appears to support them the clinical decision-making.
Notes
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PubMed ID
28723929 View in PubMed
Less detail

'Now I use words like asymmetry and unstable': nurses' experiences in using a standardized assessment for motor performance within routine child health care.

https://arctichealth.org/en/permalink/ahliterature279457
Source
J Eval Clin Pract. 2016 Apr;22(2):227-34
Publication Type
Article
Date
Apr-2016
Author
Kine Johansen
Steven Lucas
Pär Bokström
Kristina Persson
Karin Sonnander
Margaretha Magnusson
Anna Sarkadi
Source
J Eval Clin Pract. 2016 Apr;22(2):227-34
Date
Apr-2016
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Child
Child Health Services - organization & administration
Clinical Competence
Female
Focus Groups
Health Knowledge, Attitudes, Practice
Humans
Inservice training
Male
Motor Disorders - diagnosis
Nurse's Role
Nurse-Patient Relations
Sweden
Time Factors
Abstract
There is an increasing recognition that early intervention is important for children with motor disorders. The use of standardized assessment methods within the Swedish Child Health Services (CHS) may improve early identification of these children and thereby their development and quality of care. Given the key role of nurses within the CHS, we explored their experiences of using a structured assessment of motor performance (SOMP-I) in a clinical setting, and investigated possible barriers and facilitators for implementation of the method within the CHS.
The study was conducted in 2013 in Uppsala County, Sweden. Ten child health nurses participated in two focus group interviews, which were analysed using systematic text condensation.
The analysis yielded three themes: (1) increased knowledge and professional pride - nurses described their desire to provide high-quality care for which SOMP-I was a useful tool; (2) improved parent-provider relationship - nurses felt that using SOMP-I involved both the parents and their infant to a greater extent than routine care; and (3) conditions for further implementation - nurses described that the time and effort needed to master new skills must be considered and practical barriers, such as lack of examination space, resource constraints and difficulties in documenting the assessment must be addressed before implementing the SOMP-I method in routine care.
Child health nurses felt that the SOMP-I method fitted well with their professional role and increased the quality of care provided. However, significant barriers to implementing SOMP-I into routine child health care were described.
PubMed ID
26489378 View in PubMed
Less detail