Abstract
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.
Highlights
BackgroundThe Swedish Child Healthcare Services (CHS) reach more than 95 per cent of the 0–5-year-old population [1]
Grounded theory was employed in order to develop a theoretical model to describe how causal conditions and current context of child healthcare and preschool affect the introduction of information sharing through Strengths and Difficulties Questionnaire (SDQ) from the nurses, preschool teachers and parents’ perspectives
Information sharing through SDQ works in practise and causal conditions endorse introduction of information sharing regarding children’s mental health, successful implementation requires considerable work with regard to identified barriers
Summary
BackgroundThe Swedish Child Healthcare Services (CHS) reach more than 95 per cent of the 0–5-year-old population [1]. One of the objectives of the CHS is to detect developmental and mental health problems in children and provide interventions [2]. In an overview of Swedish research, the Royal Swedish Academy of Sciences pointed out the lack of data on the mental health of young children [3]. Research that address challenges in measuring preschool aged children’s mental health was identified as a field of special importance. Behavioural problems that present early may become persistent and increase the risk for later negative academic [4,5], social and mental health outcomes [6] and need to be identified and addressed. Economists claim that investments to improve children’s health and development in early childhood are the most compelling investment a society can make since the cost is returned many times over, from a lifetime perspective [10]
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