In the health care services, children's rights to participate in all matters that concern them are considered important. However, in practice this can be challenging with young children. In My Shoes (IMS) is a computer-assisted interview tool developed to help children talk about their experiences. The aim of the study was to evaluate the IMS' ability to elicit pre-schoolers' subjective experiences and accurate accounts of a routine health visit as well as the children's engagement in the interview process.
Interviews were conducted with 23 children aged 4-5?years, 2-4?weeks after their health visit. The interviews were transcribed verbatim and analysed using a method inspired by Content Analysis to evaluate IMS's ability to elicit accounts about subjective experiences. Accurate accounts were assessed by comparing the transcribed interviews with the filmed visits at the child health centre. The children's engagement was defined by the completion and length of the interviews, and the children's interaction with the software.
All children gave accounts about their subjective experiences, such as their emotional state during the visit, available toys or rewards they received. All children related to the correct event, they all named at least one person who was present and 87% correctly named at least one examination procedure. The majority of children (91%) completed the interview, which lasted 17-39?min (M?=?24), and 96% interacted with the IMS software.
IMS was feasible to help children describe their health care experiences, in both detail and depth. The children interacted with the software and maintained their interest for an extended period of time.
Child Psychiatry is now a well recognized and established sub-specialty in Canada. It has gone through a period of vigorous and healthy growth. Like psychiatry in general it now faces a number of challenges which provide potential threat but which may lead to better definition of priorities and of its most effective function. Other disciplines, medical and non-medical, increasingly compete for a place on the therapeutic spectrum. Within psychiatry the rhetoric between different schools of thought provides ammunition for those who have no use for any form of psychiatry however it may be provided. The challenge is to develop more effective ways of using the skills of the child psychiatrist within a recognition that the number of practitioners will never approach what would be required to have child psychiatry alone cover the treatment needs of children and adolescents. The field requires the adoption of a more flexible metaphor for training and practice with competence in the different schools of theory and of therapy. Attention needs to be paid to the consumer movement, to the impact of better informed parents and public and to the developing of a parsimonious and selective approach to the use of scarce professional time. The healthy growth of research in child psychiatry is a development long overdue and places the discipline on a scientific rather than a clinical practice base. At a time when funding and the cost of health care are crucial issues the development of a secure knowledge base, efficient methods of service delivery and the integration with other mental health care providers are opportunities and grounds for optimism about the future of the sub-specialty.
The following article presents an overall picture of child health care delivery in Finland. The history and priorities of the Finnish Child Care Services are discussed with statistical data regarding birth rate, mortality and immunization.