Content and me hod of health supervision by physicians in child health conferences in Baltimore, 1959.

Abstract

DREVENTIVE mental hygiene content Fand method were specifically introduced in 1947 into the child health conferences conducted by the Baltimore City Health Department. The area of behavior officially became a subject for health supervision, for history-taking, recording, advising, and teaching. A special method, anticipatory guidance, was also introduced. Physicians were expected to help mothers understand what was normal development, and thus to aid them to anticipate future changes in the behavior of the child. By anticipating changes that might be distressing, by preparing the mother for the changes, and helping her know that they are normal, anticipatory guidance should reduce the stresses of child rearing and promote mental hygiene of the child.' Other methods or practices for promoting mental hygiene were described in relation to the program.2 Assurance by the physician contributes to mental hygiene by reducing worry and by building the self-confidence of the parent. Listening to the mother's problems and encouraging her to talk are methods that are basic to a physician-parent relationship within which an effort is made to deal with ideas that have emotional significance. The effect of this mental hygiene program on the adjustment or emotional health of the children or their families could not be evaluated since there was no measurement of how much effort had been or was being expended with these methods. This resulted in the development of a method for quantitive appraisal of various components of health supervision as conducted by physicians in these clinics. Survey of these clinics with this method should indicate several things: (1) Do all physicians include the same amount of mental hygiene practice in a child health conference? (2) How often do physicians discuss behavior or development? (3) What proportion of the physician's practices are related to the objective of improved mental hygiene? (4) How often do physicians make distinct efforts to encourage the children's mother to talk? (5) How often do physicians assure the mother? (6) How often is anticipatory guidance offered in the average visit? (7) Is the use of one mental hygiene practice by a physician associated with the use of other mental hygiene practices?