Danish Parents Research Articles

How Does Representational Mind-Mindedness Translate Into Observable Parenting Behaviors Among Parents of Six-Year-Olds?

Mind-Mindedness reflects parents' capacity to treat their child as an individual with a mind of their own. Research is lacking on how Representational Mind-Mindedness (RMM) translates into observable parenting behaviours beyond infancy. The present study examined how RMM was associated with parents' Acknowledging Behaviour (AB) and use of Mental State Talk (MST), and whether these associations were moderated by parents' educational level. The sample consisted of 133 Danish parents and their 6-year-old children, who were observed engaging in a challenging puzzle and in a shared reminiscing task during home visits. RMM was operationalized as parents' use of mental attributes when describing their child. There was no significant association between RMM and AB. RMM was significantly associated with MST, but only among parents with higher education level. The present study illuminates differences in how the representational measure of parents' mentalization capacity translates into observable parenting behaviors among early school-aged children.

Translation and cultural adaption of the control preference scale across various care settings in a Danish hospital

BackgroundIn recent decades, there has been a growing emphasis on involving patients in healthcare decision-making, driven by political, ethical, and research considerations. Although patient involvement is associated with improved health outcomes, understanding patient preferences regarding their role in decision-making is crucial for effective interventions. The Control Preferences Scale (CPS) measures patient preferences along a continuum from passive to active participation. However, its application in Denmark necessitates translation and cultural adaptation.MethodologyThis study aimed to translate and culturally adapt the CPS for Danish use across diverse healthcare settings: acute care, cancer care, elective surgery, chronic medical treatment, and parental involvement in pediatric care. Following a cross-sectional design, the translation process was systematically planned and executed using Beaton’s guidelines, including the five stages: forward and back translation, synthesis, expert review, and pre-testing.ResultsThe translation and adaption process was carried out successfully. Few linguistic challenges were identified and resolved by the expert review. The findings of the pre-testing indicated high acceptability and usability of the adapted CPS among 152 Danish patients and parents. The collaborative role emerged as the most preferred across settings (69.8%), with passive roles more prevalent among cancer patients (30%) and parents waiting with their child to see a pediatrician (23.3%). Notable, more women preferred collaborative or active roles (83.9%) than men (73.9%). The content validity assessment yielded positive feedback, affirming the relevance and comprehensiveness of the CPS.ConclusionsIn summary, the adaptation and validation of the CPS for Danish use proved successful, providing a valuable tool for assessing patient’s role preferences in healthcare decision-making. However, future studies are recommended to ensure construct validity and reliability through psychometric testing.

The Effect of LENA (Language ENvironment Analysis) for Children with Hearing Loss in Denmark including a Pilot Validation for the Danish Language.

Background/Objectives: This study aimed to investigate whether day-long recordings with Language Environment Analysis (LENA) can be utilized in a hospital-based Auditory Verbal Therapy (AVT) program in Denmark for children with hearing loss and to conduct a pilot validation in the Danish language. Methods and materials: A license for the LENA system (LENA SP) was purchased, and trials were offered to three families enrolled in the AVT program. Each family made two day-long recordings with 3-4 months in between and received feedback during the therapy sessions. From 18 × 10-min clips randomly pulled out of the recordings, a comparison of adult word counts (AWC) between the LENA algorithm counts and the counts made by two human transcribers was made and used for the pilot validation. Results: LENA proved to be valuable as a guiding tool for Danish parents. Pilot validation showed good correlations and an acceptable limit of agreement (LoA). Conclusions: LENA holds the potential for Danish validation and use in AVT/clinical practice. When used in clinical practice, parents must be informed of the biases and limitations, and possible ethical issues must be considered. Because of the GDPR rules, there is a need to discuss the possibility of implementing this tool clinically in Denmark and the EU.

Navigating health communication: The effects of mediatization on responsibility in complex decision-making

This article investigates the mediatization of responsibility in the context of health care decision-making and biological citizenship. The analyzes how Danish parents navigate the pervasiveness, polysemy, and media logic of health communication, and how the authority and legitimacy of certain types of health communication play into their sense of responsibility. The study consists of interviews with 18 Danish parents who were in the process of deciding or had recently decided on whether to give their child the human papillomavirus (HPV) vaccine. This study draws on mediatization theory, sociological theory of responsibility, and research on health communication to illustrate the media-centered conditions that shape parents’ decision-making processes. We find that the pervasiveness and polysemic nature of the information available about the vaccine creates an imperative to understand the information while parents also have to navigate the media logic regarding media’s motivation for presenting information about HPV vaccines in certain ways. As a consequence, parents’ decision-making responsibility as biological citizens is undergoing significant changes that place increasing responsibility on the parents in this study.

Initial programme theory development: The first step in a realist evaluation of a cross-sectoral intervention for expectant Danish parents living with psychosocial risks.

A distinct inequality in maternity care exists, and women with psychosocial risks are at a greater risk of adverse birth outcomes. In several high-income countries, a psychosocial risk assessment early in pregnancy is recommended so that expectant parents are offered an appropriate level of care which facilitates relevant, tailored interventions for those in need. In 2017, a cross-sectoral and interdisciplinary intervention for expectant parents with psychosocial risks was developed and implemented in the North Denmark Region. The development process of the intervention has not been reported and theory-based knowledge about how supportive interventions bring about change for expectant parents with psychosocial risks is scarce. Through the initial phase of a realist evaluation, we aimed to elicit key contexts and mechanisms of change regarding the intervention for expectant parents with psychosocial risks. Through an initial programme theory, this article illustrates how, for whom and in which contexts the intervention is intended to work. Data is comprised of intervention documents, 14 pilot observations and 29 realist interviews with key stakeholders. A thematic analytical approach inspired by retroductive thinking was applied to identify and analyse patterns related to the incentive of the intervention, its structure, intended outcomes, generative mechanisms and contextual matters. Generative mechanisms responsible for bringing about change in the intervention were identified as healthcare professionals' approach, continuity, trust, early intervention and social network. Cross-sectoral collaboration and healthcare professionals' competencies were assumed to be central stimulating contextual factors. The initial programme theory developed in this study will serve as the basis for further refinement via empirical testing in a later phase of the realist evaluation.

Trends in congenital clubfoot prevalence and co-occurring anomalies during 1994–2021 in Denmark: a nationwide register-based study

BackgroundCongenital talipes equinovarus (clubfoot) is a common musculoskeletal anomaly, with a suspected multifactorial etiopathogenesis. Herein, we used publicly available data to ascertain liveborn infants with clubfoot delivered in Denmark during 1994–2021, and to classify co-occurring congenital anomalies, estimate annual prevalence, and compare clubfoot occurrence with maternal smoking rates, a commonly reported risk factor. Characterizing this nationwide, liveborn cohort provides a population-based resource for etiopathogenic investigations and life course surveillance.MethodsThis case-cohort study used data from the Danish National Patient Register and Danish Civil Registration System, accessed through the publicly available Danish Biobank Register, to identify 1,315,282 liveborn infants delivered during 1994–2021 in Denmark to Danish parents. Among these, 2,358 infants (65.1% male) were ascertained with clubfoot and classified as syndromic (co-occurring chromosomal, genetic, or teratogenic syndromes) and nonsyndromic (isolated or co-occurring multiple congenital anomalies [MCA]). Annual prevalence estimates and corresponding 95% confidence intervals (CIs) for children with nonsyndromic clubfoot were estimated using Poisson regression and compared with population-based, maternal annual smoking rates obtained from publicly available resources.ResultsInfants most often presented with nonsyndromic clubfoot (isolated = 88.6%; MCA = 11.4%); limb and heart anomalies were the most frequently identified MCAs. Prevalence (per 1,000 liveborn infants) was 1.52 (CI 1.45–1.58) for isolated and 0.19 (CI 0.17–0.22) for MCA clubfoot. Prevalence estimates for both isolated and MCA clubfoot remained relatively stable during the study period, despite marked decreases in population-based maternal smoking rates.ConclusionsFrom 1994 to 2021, prevalence of nonsyndromic clubfoot in Denmark was relatively stable. Reduction in population-level maternal smoking rates did not seem to impact prevalence estimates, providing some support for the suspected multifactorial etiopathogenesis of this anomaly. This nationwide, liveborn cohort, ascertained and clinically characterized using publicly available data from the Danish Biobank Register, provides a population-based clinical and biological resource for future etiopathogenic investigations and life course surveillance.

Mothers’ Views on the Storage and Usage of Their Children’s Biological Material Under the Danish Biobanking Model: A Narrative Approach Using Epistemic Injustice

ObjectivesTo investigate the knowledge and attitudes of mothers living in Denmark on the storage and usage of their children’s biological material. The Danish Neonatal Screening Biobank contains blood from the Phenylketonuria-screening test. Legal, ethical, and moral concerns have been raised in several countries of how consent is obtained best in pediatric biobank governance. Research on knowledge and attitudes of Danish parents on the usage of their children’s biological material is scarce. MethodsA coproduced study between a mother and 2 researchers. We analyzed 5 online focus group interviews using Ricoeur’s hermeneutical narrative analysis. ResultsMothers have very little knowledge on the storage and usage of their children’s biological material. They consider the Phenylketonuria-screening test to be part of a birth package, which leaves very little option of choice. They accept donating the material as a token of appreciation in an act of altruism toward the wider society but are only comfortable supporting Danish research. ConclusionsAn exploration of the communal narrative build in the interviews reveal an overall feeling of duty to help benefit society, an overwhelming trust toward the health system, and epistemic unjust storage information practices.

Averting, stepping-up or shielding: school strategies and intensive minority parenting among second-generation minority Danish parents

ABSTRACT Based on ethnographic fieldwork and life-story interviews, this article examines parenting and school strategies of the emergent second generation of minority Danish parents and how they are shaped by their generational position. Across socio-economic differences, the participating parents are highly engaged in their children’s schooling and well-being, practising an ‘intensive parenting’ widespread in the contemporary social generation and also dominant among majority Danish parents. Yet they also draw on their first-hand knowledge of being minority children in Danish schools and society to protect their children against discrimination against Muslims and negative influence from both majority and minority Danes. The article suggests that the parents thus engage in ‘intensive minority parenting’ and employ different school strategies: an ‘averting strategy’ characterised by fending off negative influences and antagonists in multi-ethnic neighbourhoods; a ‘stepping-up strategy’ characterised by performing middle-class parenthood in (upper)middle-class neighbourhoods; and a ‘shielding strategy’ characterised by carving out a safe new cultural space in ‘free schools’ with other second-generation parents. Differing from the paths of ‘segmented assimilation’, these strategies do not depend on ethnic background, but rather on the parents’ current social environment and interrelated factors of their own experiences with school, further education, their family and broader society.

How co-production helped to facilitate the development and implementation of the New Forest Parenting Programme in Denmark

AbstractEvidence-based parent training is a widely recommended in the treatment of ADHD. However, most studies have not tested parent training with clinically referred children and practising clinicians in real-life clinical settings. In this presentation I will present findings from a randomised controlled trial funded by TrygFonden that evaluated the implementation of NFPP in hospital based child psychiatry clinics in the Denmark. The presentation will focus on the many implementation challenges that arose in translating a behavioural intervention from English into Danish. These include cultural adaptations and changes to mode of delivery that were required to ensure Danish parents would be able to engage with and access the intervention. Changes and adaptations were deeply informed by co-production with Danish parents and health care providers to ensure the successful development of NFPP in Denmark, appropriate evaluation, and widespread implementation within secondary care services in Denmark. The presentation will conclude with some preliminary findings from a second study funded by Trygfonden which is seeking to explore barriers to implementation of NFPP within Danish community based child and family services. Again, co-production has been invaluable in guiding the development of NFPP within Danish community care services. Identifying and overcoming barriers in implementation through co-production are essential parts of research needed to close the gap between intervention research and clinical practiceDisclosure of InterestNone Declared

Re-constructing parental identity after parents face their offspring's suicidal behaviour: An interview study

IntroductionParents are affected when their offspring engages in non-fatal suicidal behaviour. Although research exists on parents’ mental and emotional state when they realise this behaviour, relatively little attention has been devoted to exploring how their parental identity is affected. PurposeTo explore how parents re-constructed and negotiated their parental identity after realising that their offspring was suicidal. MethodA qualitative exploratory design was adopted. We conducted semi-structured interviews with 21 Danish parents who self-identified as having offspring at risk of suicidal death. Interviews were transcribed, analysed thematically and interpreted by drawing on the interactionist concepts of negotiated identity and moral career. FindingsParents’ perspectives on their parental identity were conceptualised as a moral career encompassing three distinct stages. Each stage was negotiated through social interaction with other people and the wider society. Entry into the first stage, disrupted parental identity, occurred when parents realised that they could lose their offspring to suicide. At this stage, parents trusted their own abilities to resolve the situation and keep their offspring safe and alive. This trust was gradually undermined by social encounters, which caused career movement. In the second stage, impasse, parents lost faith in their ability to help their offspring and to change the situation. Whereas some parents gradually resigned entirely to impasse, others regained their trust in their own abilities through social interaction in the third stage, restored parental agency. ConclusionOffspring's suicidal behaviour disrupted parents' self-identity. Social interaction was fundamental if parents were to re-construct their disrupted parental identity. This study contributes with knowledge about the stages characterising the reconstructive process of parents' self-identity and sense of agency.

Direct and indirect effects from parenting self-efficacy and parenting practices to social-emotional adjustment in 3- to 5-year-old children

Parenting self-efficacy has been tied to myriad child outcomes during middle childhood and adolescence, directly and indirectly through parenting practices. The present study examines contemporaneous associations between parenting self-efficacy, parenting practices, and child outcomes during the preschool years in a community sample of 1455 Danish parents (76.7 % mothers) of 3–5-year-old children (49 % girls). Parents (M = 39.2 years old) completed a survey describing parenting self-efficacy and three facets of parenting practices: inductive reasoning, psychological control, and instrumental reward. Parents also described child adjustment in four domains: prosocial behavior, hyperactivity, conduct problems, and emotional problems. Results revealed direct concurrent associations between parenting self-efficacy and each child outcome, with greater efficacy tied to more prosocial behavior and less hyperactivity, conduct problems, and emotional problems. Parent psychological control mediated associations from parenting self-efficacy to child hyperactivity, conduct problems, and emotional problems. Inductive reasoning mediated associations from parenting self-efficacy to child prosocial behavior. Consistent with previous findings from older children, parental use of psychological control had debilitating consequences for preschool children. Inductive reasoning, in contrast, appeared to promote positive development.

‘This Society Has Taken Me.’ Intensive Parenting and Fragile Belonging among Second-Generation Minority Danish Parents

Based on life-history interviews and fieldwork among second-generation minority Danish parents from different ethnic backgrounds, this article explores changes in parenting norms and practices between first-generation and second-generation minority Danish parents. The second-generation parents generally experience that, compared to their own parents and contemporary first-generation parents, they have a more ‘open’ and ‘engaged’ relationship with their children and their schools, making them feel intimately shaped by Danish society. Contesting integration and governmentality approaches, the article takes an Eliasian figurational approach, illuminating the historical changes in and current characteristics of the relationship between state, school, children, and parents that shapes the Danish ‘state-school figuration’. It explores how these second-generation minorities’ entanglement in the interdependencies of this figuration—first as children and later as parents—makes it valuable and sensible for them to engage in the ‘intensive parenting’ applauded in Danish schools. Yet, due to these interdependencies, their intensive parenting involves both distancing themselves from and acting as cultural brokers for first-generation parents, as well as using their own insider knowledge to protect their children from negative influence, stigmatisation, and discrimination.

Creating coherent perinatal care journeys: An ethnographic study of the role of continuity of care for Danish parents in a vulnerable position

BackgroundWhile continuity of care is a core element of high-quality maternity care, it is potentially even more important for pregnant women and their partners who are at risk of adverse health outcomes because of psychosocial vulnerability. However, little is known about how a coherent care journey can be ensured for women and families who may require interdisciplinary and inter-sectoral services during pregnancy and the postnatal period. AimTo explore the role of continuity of care in creating a coherent care journey for vulnerable parents during pregnancy and the postnatal period. MethodsAn ethnographic study conducted in Denmark based on interviews with, and field observations, of 26 mothers and 13 fathers receiving services due to mental health problems, young age, past substance abuse and/or adverse childhood experiences. FindingsThree key findings emerged: 1). Developing relationships allowed parents to know and feel known by care providers, which helped them feel secure and reach out for support. 2). Handover of information allowed parents to feel secure as their need for support was recognised by care providers; some parents, however, felt exposed when information was shared 3). Receiving relevant services allowed parents to have their needs for support addressed, which requires easy referral pathways and coordination of services. ConclusionAll forms of continuity of care should be prioritised in the organisation of maternity care services for women and families in vulnerable positions. While relational continuity is important, continuity of care must also reach across providers, sectors and services to ensure coherent care journeys.

How Perceptions of Responsibility and Affective Consequences Influence Parents' Digital Media Engagement in Relation to Human Papillomavirus Vaccination.

Individuals are expected to be responsible for their own health and that of their families-and act accordingly. Yet, being in a position of responsibility might be undesirable for individuals either unable or reluctant to comply with the expectations this responsibility entails. In this article, I explore how parents experience the process of engaging responsibly with digital media in relation to the question of human papillomavirus vaccination. The study is based on interviews with eighteen Danish parents, and my findings show that these parents not only understand themselves but also other actors in terms of responsibility, and that being positioned in terms of responsibility can have negative affective consequences. I argue that meeting the expectations of biological citizenship should not necessarily be a goal in relation to complex health topics.

The ambiguities of surveillance as care and control: Struggles in the domestication of location-tracking applications by Danish parents

Abstract The implicit ambiguity of surveillance as both care and control has been a key theoretical issue in social science research on surveillance practices and technologies. This article addresses this ambiguity empirically by examining how parents using – or not using – location-tracking apps to monitor their children negotiate this tension. Drawing on 17 semistructured interviews conducted with parents in different regions of Denmark, we examine the struggles of these parents to fit this technology into their world and to reconcile their uses with ideals of trust, privacy, and good parenting. By highlighting how users and non-users perceive and negotiate the controlling affordances of tracking apps, we emphasise the potential for negotiation, contestation, and resistance raised by this technology, and the contingent nature of its appropriation and effects. Thereby, it brings nuances to techno-pessimistic accounts of child tracking and calls for further empirical studies examining how these technologies are experienced in practice.

Who knows best? Health risks and digital media engagement in Discourses relating to human papillomavirus vaccination.

In Denmark, parents have needed to deal with inconsistent presentations of risk regarding the human papillomavirus (HPV) vaccination. This has complicated the parents' task of making a decision about having their daughters vaccinated. In this article, I analyse how Danish parents engage with digital media when making this decision. The results are based on interviews with 18 Danish parents of girls aged 10-13years old. In my analysis of the interviews, I found that parents align with one of two Discourses when engaging with digital media in relation to HPV vaccination: one centralised and one decentralised. In the centralised Discourse, parents leave it up to other actors such as health authorities to manage the risks of vaccination, thus limiting the experienced need to engage with digital media; in the decentralised Discourse, however, parents themselves assess potential risks, thereby increasing the need to engage with digital media. As a result, I discuss why some parents can consider it necessary to struggle to engage in literacies when making decisions about complex health topics, even when there are clear government recommendations.

Stillbirth – transitions and rituals when birth brings death: Data from a danish national cohort seen through an anthropological lens

Many parents bereaved of a stillborn baby spend time with the child. In this time frame, different acts with the child in focus may occur. Some parents invite others to see the child too. Parents who suffer the loss of a newborn are vulnerable, and understanding acts and practices surrounding the dead newborn is important knowledge for caretakers. This article aims to enlighten the amount of time Danish parents spend with their stillborn in hospital settings that encourage this practice. Furthermore, it aims to transcend the mere quantitative numbers through a theoretical approach that frames the analysis and discussion of possible layers of meaning imbedded in time spent with a dead newborn. Data from a Danish cohort of bereaved parents were collected using web-based questionnaires. These numbers were successively interpreted through an anthropological lens within the perspective of transition and ritualisation. Knowledge from existing empirical literature was also fused. Danish parents spend hours or days with their stillborn child. They feel supported in this by healthcare professionals. Mainly close relatives join the parents while admitted to the hospital to see the stillborn child, followed by other family members and friends. Danish parents engage to a very high degree in contact with their dead baby. The analysis points out that 'Time' and 'Others' are needed to create a socially comprehensible status for parents and child when birth brings death. In liminal space during the transition, healthcare professionals act as ritual experts, supporting parents and their relatives to ascribe social status to the dead body of the child through ritualised acts. Instead of only thinking of this period as 'memory-making', we suggest regarding it as a time of ontological clarification as well.

Living With Fear: Experiences of Danish Parents in Vulnerable Positions During Pregnancy and in the Postnatal Period.

Targeted services are recommended to pregnant women/parents in vulnerable positions to support their well-being and improve health outcomes; however, being offered extra services is associated with feelings of fear and anxiety. Adopting an ethnographic approach, we explore what parents fear, how and why they experience fear, and how this shapes their childbearing experience and engagement with Danish maternity care services. We made field observations and conducted interviews with 39 parents in vulnerable positions, who shared multiple, ambiguous, and interrelated fears. Four main themes were constructed: fear of going back to a dark place, of having a negative impact on the baby, of being labeled, and of the consequences of service engagement and being open. We conclude that what parents fear, the intensity of these fears, and what potentially triggers it are contingent on their life story, their care pathways, and the maternity care system.

Perspectives on sugar consumption expressed on social media by French-speaking and Danish-speaking parents.

Meanings and practices attributed to sugar emerged as important barriers to healthy eating in an earlier study with French and Danish parents. Considering the impact of excessive sugar intake on human health and childhood obesity, this study focuses on gaining further understanding of connotations, perceptions and attitudes related to sugar among parents. A thematic analysis of sugar-related posts and comments on blogs and Facebook pages was performed, and in-depth interviews with experts (one in each country) were conducted. Data were set in a Social Judgment Theory analytical framework. Sugar consumption appears as a two-sided experience, being at times dangerous, sinful and addictive, but also comforting and delightful. This "sugar dilemma" unfolded aspects between asceticism and hedonism, state governance and personal responsibility. Three main behavioral strategies on how parents deal with these ambivalences emerged: i) restriction, ii) moderation, and iii) liberation. Restriction was more noticeable in France, whereas liberation was more pronounced in Denmark. In both countries, the ones who defended the respective opposite positions (restriction or liberation) were targets of judgmental moral tones. The three behavioral strategies corresponded to the main attitudes demonstrated in reaction to anti-sugar messages, which align to the Social Judgment Theory constructs: acceptance, non-commitment and rejection. Findings shed light on dietary, behavioral and social challenges faced by parents and highlight the importance of a diversified approach to tackle sugar consumption among families - an approach that considers individuals' attitudes, social context and value systems. Furthermore, online sugar-related content yields valuable information on the social construction and morality of health and nutrition discourses and the misleading, confusing and overwhelming nature of social media content. Parents' discussions are an example of the general dilemmas between (gendered) parenting expectations, individual freedom and morality of food choices.

From caregiver to risk manager: Professionals assessing parents in Danish childcare institutions

This article explores assessments and collaborative practices between Danish parents and professionals when young children enter nursery care. Based on practice research in Danish childcare institutions, the article focuses on how early childhood education policy is connected to early assessment, based on an understanding of children as vulnerable and in need of stimulation by adults in order to develop properly. In this policy environment, parents act not only as primary caregivers for their children but also as risk managers in collaboration with the professional staff. The article describes how parents’ acts of care can sometimes be interpreted by professionals as an unwillingness to collaborate, thus transforming evaluation of children’s adjustment to the day-care setting into assessments of parents’ skills. This objectification of the parents, risks disrupting collaboration and the child’s chain of care.