This paper is a provisional report from an ongoing field experiment in Uppsala, Sweden, with the aim to reduce the number of serious childhood accidents. Groups of parents have been systematically trained to function as child-environment supervisors. The experiences have been very positive so far. The child-environment supervisors have proved to possess good knowledge about how to prevent accidents. A large number of hazards have been detected and successfully eliminated. The groups are now taking an active part in the planning of new housing estates. The findings also indicate that the Child Health Organization should be able to play a more active role in the work of environmental improvement for the safety of children. A suggestion for a collective strategy for such activity has been worked out.
Evidence-based methods to identify behavioural problems among children are not regularly used within the Swedish Child healthcare. A new procedure was therefore introduced to assess children through parent- and preschool teacher reports using the Strengths and Difficulties Questionnaire (SDQ). This study aims to explore nurses', preschool teachers' and parents' perspectives of this new information sharing model. Using the grounded theory methodology, semi-structured interviews with nurses (n = 10) at child health clinics, preschool teachers (n = 13) and parents (n = 11) of 3-, 4- and 5-year-old children were collected and analysed between March 2014 and June 2014. The analysis was conducted using constant comparative method. The participants were sampled purposively within a larger trial in Sweden. Results indicate that all stakeholders shared a desire to have a complete picture of the child's health. The perceptions that explain why the stakeholders were in favour of the new procedure-the 'causal conditions' in a grounded theory model-included: (1) Nurses thought that visits after 18-months were unsatisfactory, (2) Preschool teachers wanted to identify children with difficulties and (3) Parents viewed preschool teachers as being qualified to assess children. However, all stakeholders had doubts as to whether there was a reliable way to assess children's behaviour. Although nurses found the SDQ to be useful for their clinical evaluation, they noticed that not all parents chose to participate. Both teachers and parents acknowledged benefits of information sharing. However, the former had concerns about parental reactions to their assessments and the latter about how personal information was handled. The theoretical model developed describes that the causal conditions and current context of child healthcare in many respects endorse the introduction of information sharing. However, successful implementation requires considerable work to address barriers: the tension between normative thinking versus helping children with developmental problems for preschool teachers and dealing with privacy issues and inequity in participation for parents.
Cites: Qual Health Res. 2006 Apr;16(4):547-5916513996
Accidental poisoning in pre-school children requiring hospital admission has increased sixfold from 1955 to 1975 in the Stockholm area. The mortality from this accident has decreased from 0.5 to less than 0.1 per 100 000 pre-school children in the whole of Sweden during the same period. Medical and psychosocial background factors were investigated in 104 consecutive in-patients (0--6 years old) with accidental poisoning and compared to an out-patient group, a group of patients who only had called the poison control centre, and a matched control group from Child Health Centres. There were no difference between the groups regarding health and history of earlier accidents except that 20--25% of the families of the poisoned children and 7% of the control families had called the Poison Control Centre before. Change of residence during the last 6 months was much commoner among families of poisoned children than of nonpoisoned. Other social stress factors were more common among in-patients than out-patients. The measures taken by the parents to combat the poisoning were adequate in most cases. The decrease in mortality inspite of the increase in potentially dangerous accidental poisonings may be attributed to a good knowledge among parents about adequate measures and where to seek advice resulting in early treatment, and to intensive care and antidote therapy.