The Research Unit for General Practice, Department of Public Health, Faculty of Health Sciences, University of Copenhagen, Øster Farimagsgade 5, Copenhagen, Denmark.
Br J Gen Pract. 2010 Jan;60(570):e4-9. doi: 10.3399/bjgp10X482059.
Too many abused and neglected children are being overlooked by GPs and other professionals who are in contact with the families. Some suggestions for a definition of 'a child in need' have been given, but the functionality of these definitions has not been tested in general practice.
To describe the problems presented by GPs as cases with children in need during supervision, and from here to suggest an empirically-based definition of a child in need in general practice.
A mixed-method evaluation design was used.
Twenty-one GPs, in Denmark, participated in supervision groups concerning cases with children in need in general practice.
The data were analysed via field notes and video recordings; case categorisation into sex, ethnicity, and developmental stages; thematically using the GPs' own descriptions; and a theoretically supported style.
Analysis of the data led to the suggested definition of a case concerning 'a child in need' in general practice as one that directly or indirectly involves problems with a specific child, an as-yet unborn child, or one or both parents of a family currently or potentially threatening the wellbeing of the family or the child.
Based on this analysis, one suggestion as to why some abused and neglected children are overlooked in general practice is that GPs often have to navigate in difficult indirect consultations, where there is a high risk of losing the overview.
太多受虐待和被忽视的儿童被全科医生和其他接触这些家庭的专业人员所忽视。已经提出了一些关于“需要照顾的儿童”的定义建议,但这些定义在全科实践中的功能尚未得到检验。
描述全科医生在监督过程中遇到的有需要儿童的案例所呈现的问题,并由此提出一个基于经验的全科实践中需要照顾的儿童的定义。
采用混合方法评估设计。
丹麦的 21 名全科医生参加了关于全科实践中需要照顾的儿童案例的监督小组。
使用现场记录和视频记录对数据进行分析;根据性别、种族和发育阶段对案例进行分类;使用全科医生自己的描述进行主题分析;并采用理论支持的风格。
数据分析导致提出了一个关于全科实践中“需要照顾的儿童”的案例的定义,即直接或间接涉及特定儿童、尚未出生的儿童或一个或两个父母的问题,这些家庭目前或潜在地威胁到家庭或儿童的福祉。
基于这一分析,一些受虐待和被忽视的儿童在全科实践中被忽视的原因之一是,全科医生经常不得不进行困难的间接咨询,在这种咨询中,很容易失去全局观。