Good Child Care Research Articles

Managing child abuse or suspected child abuse in primary care: Results from a qualitative study of general practitioners trained in detecting child abuse: Managing child abuse or suspected child abuse in primary care

IntroductionIdentifying and alerting suspected child abuse enables its investigation and management. In France, anyone can report the situation to child services when child abuse is suspected. However, the number of reports of concern received from physicians is low, and lack of knowledge is a frequent obstacle. This study aimed to explore the practices of trained general practitioners (GPs) regarding the identification and management of suspected child abuse. MethodWe led a qualitative study from February to November 2021 based on a grounded theory approach. We conducted semi-structured interviews with GPs working in the south of France who had received training in identifying child abuse. We performed an inductive analysis using NVivo software. ResultsWe interviewed 10 GPs (data saturation with seventh GP). Despite the training, obstacles seemed to persist, such as apprehension of the parents’ reaction, the technical difficulties of the process, and the lack of feedback after making a report. Being accompanied by a professional who can be directly contacted would facilitate the communication of worrying information. Without direct links to a single referent, doctors would prefer alternative ways of referring their patients to organizations they were familiar with. Discussion and conclusionGPs expressed a need for easy access to childcare professionals to support them in the decision to file a report of suspected child abuse. A multidisciplinary approach and a dedicated point of contact seemed to help the process. Nominating a child protection referent doctor per department and creating specific units in hospitals for children at risk would help GPs get effectual contacts for reporting worrying information and better care for children at risk of abuse.

Building the clinical workforce of pediatric infectious diseases in Bolivia for better care of children with cancer

Abstract Background Infections in children with cancer can be fatal if not appropriately managed. Access to trained and competent professionals in infection care and prevention (IC&P) improve care outcomes. Bolivia expects about 1700 new pediatric cancer cases annually. In 2023, 2371 hematological neoplasms were reported in children, cared mainly at 4 public hospitals where, until 2016, 5 pediatric infectious disease (PID) specialists were working in 2 of these 4 hospitals. For better PID clinical workforce for critically ill children, we built a PID medical residency training. In 2017, the training accepted its first trainees at Hospital del Niño “Dr. Ovidio Aliaga Uría” (Hospital del Niño), a public hospital in La Paz. Here, we describe the program, how we built it, and its outcomes. Methods The PID training goal is to train leaders in PID for clinical observations, PID literature interpretation, and to transform them into concepts that can be applied to ID pathogenesis or treatment. At the end of the 2-year PID training program, we expect trainees will gain expertise in PID clinical practice and clinical or translational science research. Our PID program was based on other PID specialty training programs from Mexico, Spain, and the USA of which, we adapted standard topics and formats of training. The content has routine and prevalent PIDs of Bolivia and the region, including on immunocompromised patients. We expected that the trainee dedicate full time to the PID training program plus caring for assigned patients and those requested consultations in the wards and clinics of Hospital del Niño; review articles; participate in clinical discussions; attend the Infection Control Course of St. Jude Children’s Research Hospital; attend and / or present in the PID case-based learning international sessions; visit the virology, bacteriology, parasitology and immunology laboratories of the national reference laboratory; and attend international rotations at participating hospitals. Results Since 2017, 5 new PID pediatricians graduated from our program, 3 work in public hospitals that care for children with cancer and 2 work in government insurance hospitals. They are working in hospitals in La Paz (n=2), Cochabamba (n=1), Santa Cruz (n=1), and Tarija (n=1). These graduates are leaders in ICP, antimicrobial stewardships, and education of hospital staffs. As per December 2023, they produced 5 articles for local journals, 2 for international journals, 7 abstracts for scientific meetings. Currently, 2 pediatricians participate in the PID training program, and post-graduation, they plan to work in departments of Potosí and Sucre where there are no PID specialists. Challenges to establish PID specialists in Bolivia are lack of value attributed to PID and its role in care quality. Conclusion Creating local expertise in PID are essential to improve and sustain the optimum care for children with cancer in Bolivia especially in places where these personnel did not exist before. However, for best investment return of PID trained professionals, having PID job descriptions and paid positions in hospitals will absorb PID specialists to benefit the largest population of children with cancer in Bolivia.

Factors influencing parental fatigue in children with retinoblastoma based on the unpleasant symptoms theory

Parents of children with retinoblastoma, the most common primary ocular malignant tumour in childhood, bear a heavy caregiving burden and are very susceptible to fatigue. However, little is known about their current status of fatigue and factors influencing fatigue; therefore,this study, based on the theory of unpleasant symptoms, and included 317 parents of children with retinoblastoma in China, whose general demographic data were collected, and on whom the fatigue severity scale (FSS), the generalized anxiety disorder (GAD-7) and 2-item patient health questionnaire (PHQ-2) were administered, from 9 March to 1 June 2020. The parents’ FSS score and fatigue incidence were 4.41 ± 1.14 and 67.19%, respectively. The fatigue level was positively correlated with anxiety, depression, education, times of hospitalisations, and treatment types (r = 0.125–0.468, P < 0.05) and negatively correlated with health status, sleep quality, economic status, and family economic situation (r = − 0.120 to − 0.322, P < 0.05). Parent’s anxiety level, being an only child and female sex of child influenced parents’ fatigue. Healthcare personnel need to focus their attention on this high-risk fatigue group and implement appropriate interventions to reduce their fatigue level, promote their physical and mental health, and facilitate better care for children.

The Impact of Qualification and Hospice Education on Staff Attitudes during Palliative Care in Pediatric Oncology Wards-A National Survey.

Our knowledge about the attitudes of healthcare staff to palliative care in pediatric oncology is scarce. We aimed to assess their perceptions of palliative care in Hungary and find answers to the question of how to provide good palliative care for children. Physicians (n = 30) and nurses (n = 43) working in the field of pediatric oncology (12 of them specialized in hospice care) were interviewed. Palliative care practice (communication, integration of palliative care, professionals' feelings and attitudes, and opportunities for improvement) was assessed by semi-structured interviews evaluated in a mixed quantitative and qualitative way by narrative categorical content analysis and thematic analysis. All providers displayed high negative emotions, positive evaluations, and used many active verbs. Nurses showed higher levels of denial, more self-references, and were more likely to highlight loss. Physicians emphasized the importance of communication regarding adequate or inadequate palliative care. Hospice specialists showed a higher passive verb rate, a lower self-reference, a lower need for psychological support, and a greater emphasis on teamwork and professional aspects. Our results show that nurses are more emotionally stressed than doctors in palliative care in pediatric oncology. To our knowledge, a study comparing doctors and nurses in this field has yet to be carried out. Our results suggest that pediatric oncological staff can positively evaluate a child's palliative care despite the emotional strain. Regarding hospices, professional practice in palliative care may be a protective factor in reducing emotional distress and achieving professional well-being.

The birth of pediatric urology in the United States: From pioneers to subcertification

Pediatric urology is a subspecialty of urology that emerged from a culture in which children with urological disorders were cared for by general urologists and general pediatric surgeons. The development of pediatric urology as a subspecialty was years in the making, highlighted by individuals who recognized that children with urological conditions were not just "small adults," but required special experience and training. Subspecialization was initiated by persistent visionaries who recognized the need for a trained cadre of experts to provide better care for children. It took the coordinated effort of all subgroups and leaderships in pediatric urology to push these efforts over the goal line. The focus of this review is to highlight certain individuals who played major roles in this vision and to document the efforts of many to coordinate the pathways to sub-specialization. The careers of Meredith F. Campbell and Frank B. Bicknell were researched to identify their rationale and roles in developing pediatric urology as a distinct medical specialty in the United States. In addition, the minutes of the meetings of the Pediatric Urology Advisory Council (PUAC) with the American Board of Urology (ABU) were reviewed. The origins of the Society for Pediatric Urology (SPU) and the American Academy of Pediatrics Section of Urology (AAP-SOU) were researched. The contributions of each to the certification of pediatric urology as a distinct subspecialty was delineated. Campbell was Chair of Urology at the New York University (NYU) School of Medicine and wrote prolifically about pediatric urology. He published one of the first practical textbooks in pediatric urology, almost completely self-written, in 1937. Bicknell, a general urologist in Michigan on the faculty at Wayne State University School of Medicine, led the initiative to create the Society for Pediatric Urology (SPU) that first met at the 1951 annual American Urological Association (AUA) meeting in Chicago and included nine attendees. Subsequently, John Lattimer (College of Physicians and Surgeons at Columbia University) organized a well-attended meeting of urologists interested in pediatrics at the 1964 annual AAP meeting in New York City. This led to the formation of the AAP Section on Urology. Integral to the justification for the development of a subspecialty was evidence of a published corpus of content. In addition to published textbooks devoted exclusively to pediatric urology, this was further fulfilled by the AAP Section on Urology Pediatric Supplement to the Journal of Urology, first published in 1986, and later with the Journal of Pediatric Urology in 2005. The SPU and the AAP Section on Urology came together to form the Pediatric Urology Advisory Council (PUAC) in 2000, which worked with the ABU to create subspecialty certification in pediatric urology with an independent exam, first administered in 2008 to 176 applicants. The metaphor "We have stood on the shoulders of giants" is apt for pediatric urology: Meredith Campbell, Frank Bicknell, David Innes Williams (Hospital for Sick Children, London), and J. Herbert Johnston (Alder Hay Hospital, Liverpool) come to mind among the first generation of pediatric urology pioneers, and others among their colleagues also had significant impact. Clearly this is a story of persistence and attention to detail on the part of those giants and those who followed. Pediatric urology became a distinct discipline after the SPU and AAP-SOU came together to create a robust cohort of pediatric urologists who through education and negotiation were able to help the ABU and the American Board of Medical Specialties (ABMS) recognize that subspecialization would lead to better care for children with urologic disorders. This benchmark set a high bar for future subspecialization in urology and other fields.

Enabling structural resilience of street-involved children and youth in Kenya: reintegration outcomes and the Flourishing Community model.

Millions of children and youth live on city streets across the globe, vulnerable to substance use, abuse, material and structural neglect. Structural resilience, the re-establishment of access to structural goods within a society such as housing, education, and healthcare following some interruption, provides an orientation for research and interventional efforts with street-involved children and youth (SICY). Further, a structural resilience framework supports organizing interactions between levels and sectors of a socio-ecology. Following the expressed interests of Kenyan SICY, and consistent with emerging policy interests at national and global levels, we assess reintegration trajectories of Kenyan SICY (n = 227) participating in a new program intervention and model. The intervention combines two coordinated, parallel programs - one focused on the rescue, rehabilitation, reintegration and resocialization of SICY, and the other focused on empowering families and communities to provide better care for children and youth who are reintegrating from life on the streets to the broader community. Data were collected and analyzed from multiple stages across SICY involvement with the intervention. We found 79% of SICY participants reintegrated with the broader community, and 50% reintegrated with families of origin and returned to school. Twenty-five percent of participants reintegrated to a boarding school, polytechnical school, or began a business. Probability of reintegrating successfully was significantly improved among participants whose families participated in the family- and community-oriented program, who were younger, with less street-exposure, expressed more personal interests, and desired to reintegrate with family. To our knowledge, these are the first quantitative data published of successful reintegration of SICY to the broader, non-institutionalized community in any low- or middle-income country. Future research should (1) identify factors across socio-ecological levels and sectors contributing to health and developmental outcomes of reintegrated children and youth, (2) mechanisms to support SICY for whom the interventional strategy did not work, (3) methods to prevent street-migration by children and youth, and (4) system development to coordinate follow-up and relevant investment by institutions, organizations and community leaders to continue reintegration work.

Fear of hyperglycemia in parents of children with type 1 diabetes mellitus - a multi-center multi-national study.

Study aims: (1) developing and validating a novel questionnaire for measuring fear of hyperglycemia among parents of children with type 1 diabetes (T1D) - the Hyperglycemia Fear Survey - Parent version (FoHyper-P); (2) investigating correlations between parental fear of hyperglycemia and objective measures of glycemic control. A multi-center, multi-national study of 152 parents of children with T1D was conducted in three large diabetes clinics from Israel, Poland, and Greece. Inclusion criteria were parents of children aged 6-16 years, at least 6 months from diagnosis, at least 3 months of CGM use and parental involvement in care. Parents filled the FoHyper-P and the Hypoglycemia Fear Survey - Parent Version (HFS-P). Patient data were obtained via electronic medical records and informative questionnaires. Bonferroni correction was performed to counteract multiple comparisons. Significant strong-moderate correlations were found between FoHyper-P and HFS-P including total questionnaires scoring (r=0.747, PBonf. <0.001), worries subscales (r=0.735, PBonf <0.001), and behavior subscales (r=0.532, PBonf <0.001). Using linear regression models we found a positive association between the worry subscale and HbA1C. Weak correlations (P<0.05, not significant after Bonferroni correction) were found between time in range, time above range and parental fear of hyperglycemia as well as between worry subscales and a higher HbA1C in the past year, percent of hyperglycemia and lower TIR. The FoHyper-P is a novel, validated tool for assessing parental fear of hyperglycemia. Integrating it into clinical practice addresses an underestimated aspect of parental diabetes management, enabling better care for children with T1D.

The importance of good childcare services for gender equality

The importance of good childcare services for gender equality Professor Ingela Naumann at Fribourg University discusses the impacts of the COVID-19 pandemic on childcare arrangements and family wellbeing, and how it highlighted gendered care norms. The COVID-pandemic put a spotlight on a central conundrum of modern society: you cannot do your job while simultaneously looking after your child. Whatever you do, in the long run one or the other will suffer: You can park your child in front of the TV so you can do that online meeting (bad educational value!), or you pretend to be present in that meeting while, actually, you are stacking blocks with your child (and you might miss that important part in the meeting for your input!). Yet, during COVID-lockdowns when childcare services and schools were closed and employment moved online for many, scores of parents tried to do exactly that: juggle employment and childcare in their homes, all at once. How did they fare?

Knowledge and Care Among Mothers Having Children with Cerebral Palsy

Cerebral palsy (CP) is a chronic, non-progressive, and incurable disorder that affects mobility and posture. Objective: To assess the Knowledge and Care among mothers having Children with Cerebral Palsy at Nishter hospital Multan. Methods: A cross sectional study designed was used. A sample of n=85 participants was recruited from Nishtar Hospital Multan Pakistan, through purposive sampling. The knowledge and care questionnaire were used for measurement of knowledge and care among mothers having children with cerebral palsy (CP). Filled questionnaires were entered and analyzed through SPSS version 21. Results: Findings revealed that 71.8% participants had poor knowledge regarding CP, 21.2% had fair knowledge and only 7% of participants had good knowledge regarding CP. Similarly, it was revealed that 50.6% participants had poor care, 41.2% had satisfactory care and only 8.2% were having good care for cerebral palsy children. Conclusions: Majority of the mothers of children with cerebral palsy in this study are unaware of the condition and show no concern for it. Support groups may be developed further to increase care giving' awareness of and concern with CP, which may aid them in finding the most suitable and timely interventions for their charges.

Considerations for shared decision management in previously untreated patients with hemophilia A or B.

Points to be taken into account to help families make decisions to best care for children born with hemophilia Medical advances are providing a range of treatment options for adults and children with hemophilia. There is, however, relatively limited information about managing newborns with the condition. Doctors and nurses can help parents to understand the choices for infants born with hemophilia. We describe the various points doctors and nurses should ideally discuss with families to enable informed decision-making. We focus on infants who require early treatment to prevent spontaneous or traumatic bleeding (prophylaxis), which is recommended to start before 2 years of age. Families with a history of hemophilia may benefit from discussions before pregnancy, including how an affected child would be treated to protect against bleeds. When mothers are pregnant, doctors can explain investigations that can provide information about their unborn child, plan for the birth, and monitor mother and baby to minimize bleed risks at delivery. Testing will confirm whether the baby is affected by hemophilia. Not all infants with hemophilia will be born to families with a history of the condition. Identification of hemophilia for the first time in a family (which is 'sporadic hemophilia') occurs in previously undiagnosed infants who have bleeds requiring medical advice and possibly hospital treatment. Before any mothers and babies with hemophilia are discharged from hospital, doctors and nurses will explain to parents how to recognize bleeding and available treatment options can be discussed. Over time, ongoing discussions will help parents to make informed treatment decisions:• When and how to start, then continue, prophylaxis.• How to deal with bleeds (reinforcing previous discussions about bleed recognition and treatment) and other ongoing aspects of treatment. ○ For instance, children may develop neutralizing antibodies (inhibitors) to treatment they are receiving, requiring a change to the planned approach.• Ensuring treatment remains effective as their child grows, considering the varied needs and activities of their child.

Richardson on moral innovation

Richardson on moral innovation

Evaluation of primary teeth affected by dental trauma in patients visiting a university clinic, part 2: dental injury types, treatment strategies, and complications.

This article focuses on treatments and complications in patients presenting dental trauma in primary teeth. Treatment alternatives begin with the decision of performing a procedure under clinical settings or pharmacological techniques (PC) in young children. Correct diagnosis and treatment are crucial to maximize the chances of a favorable outcome. The files of 320 patients aged 0-9years who presented to the Erciyes University Faculty of Dentistry Department for dental trauma management in primary teeth were evaluated in between 2018 and 2021 for 3-year period. The following information were extracted from patients' records: injury type, affected teeth, caries condition of the teeth, treatment preferences of the dentists. Additionally postoperative complications and their management were evaluated. While 63.1% of the traumatized teeth were caries-free, 35.8% of the teeth had caries. The most frequent dental injuries was simple crown fractures (42.9%), followed by complicated crown fractures (38.5%). Treatments were mostly done in clinical conditions (67.9%) and mostly patients attend regularly to follow-up visits (85.6%). Clinicians prefer more radical treatments under sedation or GA (92.4% extraction of injured tooth). Coronal discoloration was the most common complication, and 35.3% had pulp necrosis for longer term results. Follow-up decisions made after concussion in the primary teeth might be appropriate for the patient. Examination of the complication status of primary teeth with simple crown fracture injury revealed that 59.5% of patients did not have any complications. Follow-up decisions were found to be appropriate for crowns with coloration alone. All options should be considered to provide the best care for children after primary tooth trauma; this can be achieved by being informed about the treatment and its consequences, and if necessary, a positive prognosis can be achieved with an interdisciplinary approach.

Do Employed Females Provide Better Care to Their Children? The Case of Education and Health Care in Pakistan

The role of women as mothers is essential because they look after their children round the clock, and their positive attitude influences their children's behavior. Mothers' participation in the labor force also increases family income and influences both the health and education of children. This research aims to analyze the females' participation in the labor force and their children's care in Pakistan. The study investigates the relationship between females' employment and their time allocation to activities related to child care. Primary data collected through a survey is used to compute the data on required variables. Activities related to child care, such as activities that influence a child's education and health, are examined. The ordinary least squares (OLS) regression model was used to check the relationship between females' employment, their children's education, and health care. The result shows a negative impact of females' age on child care. At the same time, there is a positive relationship between females' age square, education, family size, and child care. The assets of the family have a positive impact on child care, while the variable is statistically significant in assets quintiles one and two. Result also highlights that female belonging to urban areas has a positive influence on child care. Finally, female employment negatively affects child employment. The major conclusion is that the female's age and employment lead to a decrease the child care. However, females' education, family size, and assets have a positive influence on child care. It is suggested that government should establish lower cost care centers for increasing the participation rate of females in the labor market. Moreover, mothers should manage their time efficiently to ensure the better care of their children by avoiding extra personal activities. Finally, mothers should better monitor their children by providing the best quality to their children, and focus should be made on females' education for the better care of children.

We must fill nursing workforce gaps and find new ways of working

Children’s nurses are tired and under pressure, but continue to provide the best care for children, young people and their families. The emotional cost to them is yet to be measured, but the latest annual report of the Paediatric Intensive Audit Network shows there has been a decline in units attaining the Paediatric Critical Care Society standards for the numbers of nurses and healthcare assistants employed over the previous 12 months (news, page 6).

Filling the data gaps on sickle cell anaemia in sub-Saharan Africa

Although sub-Saharan Africa is the epicentre of sickle cell anaemia globally, until recently, the disease has been widely neglected within the region. During the late 1990s, mortality in children younger than 5 years in sub-Saharan Africa was close to 200 per 1000 livebirths,1 and consequently, an incurable disease such as sickle cell anaemia affecting ten per 1000 children was not a priority. However, with many sub-Saharan African countries going through a period of epidemiological and demographic transition, overall child mortality is declining rapidly and provision of better care for children born with sickle cell anaemia has now become a necessity.

Why good childcare provision is important for gender equality

Why good childcare provision is important for gender equality

The Impact of Family Environment and Family Management on Early Childhood Care and Education in the Estate Sector of Sri Lanka

The family is responsible for shaping children to perform well in education and secure basic health care standards by crafting an enabling environment. Since the introduction of a comprehensive ECCE policy in 2004, families have been enabled to access quality early childhood care and education services in Sri Lanka, but the progress in selected estate communities falls short. This research thus explores how does family environment influenced by unique sociocultural determinants of estate communities (as a disadvantaged community) in the country affect ECCE provisions and their outcomes. Drawing on data from forty-four interviews, four focus group discussions, and empirical observations in six estate communities selected from Nuwaraeliya, Badulla, Kandy and Rathnapura districts indicates the failure of family management and uncooperative family environment are detrimental to the provision of ECCE services and obtaining intended outcomes. Estate dwellers are less likely to continue a manged-happy-family life as informed decision-making is left out unconsciously due to certain subculture determinants. The lack of age-appropriate experiences about childcaring responsibilities can lead to failures of family management; this in turn negatively affects ECCE in the estate sector. Thus, reinforcing an enabling family environment through contextualised policies is essential to ensure good and quality early childhood care and education for children in studied estate communities of the country.

Economic Factors Influencing Sexual Violence against Children (SVAC) in Primary Schools of Urban District, Zanzibar, Tanzania

This study was conducted to find out the economic factors influencing sexual violence against children (SVAC) in primary schools of Urban District, Zanzibar. The study used cross sectional research design based on single research approach that is qualitative approach. The study used both primary and secondary source of data collection. Primary data were collected using interviews with semi-structure checklist guide to elicit information from the sample population while secondary data were obtained through documentary reviews from books, journals, magazines, from published and un-published paper, internet sources, University of Iringa (UoI) and Zanzibar National Libraries and from other institutions and organizations dealt with sexual violence against children nationally and internationally. Purposive sampling technique was used in selecting 20 respondents and 22 key informants for this study. The collected data were analyzed using content analysis technique where by data were organized and summarized into different themes based on conceptual description of ideas. Finally, the results were presented in the form of word text narration. The study found that poverty and shortage of basic needs to the children were the economic factors influencing to the children in primary schools. Children who came from poor family failed to meet their necessity needs in right time; hence perpetrators of sexual violence used the same opportunity to perpetrate their sexual incidents to children. The study recommended that the government, Non-Governmental Organizations (NGOs), Faith Based Organizations (FBO) and community members should establish various training programs to the medias including radios and television related to good child care practicing, child rights and child protections, and monitored their child behaviour, giving them time to express their problems and needs and sharing their ideas with promotion of gender equality at all level.

An overview of the COVID-19 complications in paediatric population: A pandemic dilemma.

AimThe primary objective of this article is to understand the various complications caused by the coronavirus in the paediatric population.MethodAn electronic search was conducted using PubMed and incorporated forward and backward research methods on clinical trials, case reports, case series, guidelines and reports from the centre for disease control and prevention (CDC), and the keywords included COVID‐19, paediatrics, multisystem inflammatory syndrome in children (MIS‐C), complications, acute kidney injury and heart failure. Secondary resources included one study from preprint servers (www.preprints.org), last search 8 May 2021, with notion of nonpeer review status. Data were collected and analysed to stay current with the most recent alerts and guidelines for the best care for children during the COVID‐19 pandemic.ResultsEvaluation and analysis of literature revealed MIS‐C to be the most prevalent followed by neurological complications. Whereas the least prevalent were septic shock and ophthalmic complications.ConclusionEven though COVID‐19 is known to be a less severe in the paediatric population, the complications of the virus have caused a great deal of stress to the paediatric patients’ parents and paediatricians worldwide, and hence, emphasis should be given to the management of coronavirus complications in paediatrics.

Adolescents’ mental health problems increase after parental divorce, not before, and persist until adulthood: a longitudinal TRAILS study

Parental divorce is one of the most stressful life events for youth and is often associated with (long-lasting) emotional and behavioral problems (EBP). However, not much is known about the timing of the emergence of these EBP in adolescents relative to the moment of parental divorce, and its longitudinal effects. We therefore assessed this timing of EBP in adolescents of divorce and its longitudinal effects. We used the first four waves of the TRacking Adolescent’s Individual Lives Survey (TRAILS) cohort, which included 2230 10–12 years olds at baseline. EBP were measured through the Youth Self-Report (YSR), as internalizing and externalizing problems. We applied multilevel analysis to assess the effect of divorce on EBP. The levels of both internalizing and externalizing problems were significantly higher in the period after parental divorce (β = 0.03, and 0.03, respectively; p < 0.05), but not in the period before divorce, with a persistent and increasing effect over the follow-up periods compared to adolescents not experiencing divorce. Adolescents tend to develop more EBP in the period after parental divorce, not before. These effects are long-lasting and underline the need for better care for children with divorcing parents.