Roche Brenda, Cowley Sarah, Salt Niki, Scammell Amy, Malone Mary, Savile Philippa, Aikens Daphine, Fitzpatrick Susan
BRG--Wandsworth Primary Care Research Centre, Wandsworth PCT, Bolingbroke Hospital, London, UK.
Fam Pract. 2005 Oct;22(5):507-12. doi: 10.1093/fampra/cmi046. Epub 2005 Jun 17.
The first year of a child's life is a crucial time for child development. Current guidance about child health surveillance and health promotion programmes emphasises a partnership approach between health professionals and parents when it comes to child health care. Parents' voices have been largely absent from discussions about local child health programmes. For partnership working to be effective and for local services to be able to evolve effectively parents' views are vital.
This study aimed to explore parents' views on the child health surveillance and health promotion programmes offered during the first year of their child's life. The study aimed to be consumer-led through the involvement of lead parents in all stages of the research process.
This study employed a qualitative methodology of focus groups and individual interviews. 35 participants were drawn from three general practices using a snowball sampling technique. Eligibility was determined as parents with a child under the age of one year or expecting a baby within the study timescale and registered at one of the 3 general practices. Focus groups were led by three 'parent-researchers' and individual interviews were conducted by a researcher. All focus groups and interviews were tape-recorded, transcribed and analysed using Atlas.Ti.
Several main themes were identified in this study. Firstly, when discussing scheduled health checks for children under one year of age parents expressed more positive feelings for the eight-week check which was seen to be comprehensive and informative rather than the eight-month check which was viewed as bureaucratic and less reassuring. Secondly, parents clearly articulated a need for reassurance and support from health professionals involved in child health surveillance and health promotion programmes. Thirdly, a crucial professional in the delivery of these programmes was the health visitor. Whilst parents expressed support for the concept of health visitors some health visitors were seen as bureaucratic and as making judgements of need based on socio-economic factors. Finally, some parents spoke of feeling excluded from accessing support as they were deemed not to be 'in need'.
Wider concepts of partnership working between health professionals and parents, and, needs assessment are important to this study. Crucial elements of the partnership appear to be missing and this coupled with needs assessments that leave parents feeling excluded mean that there are discrepancies between expectations and experiences of parents. These issues require consideration in order to improve services and experiences.
儿童生命的第一年是其成长发育的关键时期。当前有关儿童健康监测与健康促进项目的指南强调，在儿童医疗保健方面，健康专业人员与家长应采取合作方式。然而，在关于地方儿童健康项目的讨论中，基本没有家长的声音。要使合作有效开展，地方服务得以有效发展，家长的意见至关重要。
本研究旨在探讨家长对其孩子一岁前接受的儿童健康监测与健康促进项目的看法。该研究旨在通过让主要家长参与研究过程的各个阶段，以消费者为主导。
本研究采用焦点小组和个人访谈的定性方法。通过滚雪球抽样技术，从三家普通诊所选取了35名参与者。入选条件为孩子年龄在一岁以下或在研究时间段内即将分娩，且在这三家普通诊所之一登记的家长。焦点小组由三名“家长研究员”主持，个人访谈由一名研究员进行。所有焦点小组讨论和访谈均进行录音、转录，并使用Atlas.Ti软件进行分析。
本研究确定了几个主要主题。首先，在讨论一岁以下儿童的定期健康检查时，家长对八周检查的评价更为积极，认为其全面且信息丰富，而对八个月检查则看法不佳，认为其官僚主义严重且缺乏安抚作用。其次，家长明确表示需要参与儿童健康监测与健康促进项目的健康专业人员给予安心和支持。第三，健康访视员是实施这些项目的关键专业人员。虽然家长对健康访视员这一概念表示支持，但有些健康访视员被认为官僚主义严重，且根据社会经济因素判断需求。最后，一些家长表示因被认为“不需要”而感觉无法获得支持。
健康专业人员与家长之间更广泛的合作工作概念以及需求评估对本研究很重要。合作的关键要素似乎缺失，再加上需求评估让家长感到被排斥，这意味着家长的期望与体验之间存在差异。为了改善服务和体验，需要考虑这些问题。
