Monash University, Melbourne, Australia.
Aust N Z J Psychiatry. 2013 Jun;47(6):538-45. doi: 10.1177/0004867413476756. Epub 2013 Feb 11.
To report the views of parents, general practitioners and practice nurses on the proposed changes to incorporate social and emotional health checks of three-year-olds into the Healthy Kids Check, a one-off pre-school health assessment delivered through general practice.
Participants were recruited from three socio-culturally diverse urban areas of Melbourne for a qualitative study involving 28 parent interviews and six focus groups with a total of 40 practitioners. Participants discussed child social and emotional development, health-seeking and preventive health care for young children. Transcripts were thematically analysed.
Common themes showed: (i) Although both parents and practitioners were receptive to the idea of social and emotional screening, parents had limited knowledge about mental health issues for young children and the need for early intervention. (ii) All groups questioned the current capabilities of practice staff to identify problems, and practitioners expressed a need for further training and tools. (iii) Parents and practitioners cautioned that screening may increase parental anxiety and lead to unnecessary referrals. Practitioners countered this with examples of cases not recognised by parents. (iv) Participants questioned the value of earlier identification of problems without effective and accessible therapeutic pathways.
For programmes to be effective, parents need to be reminded of the benefits of early intervention and encouraged to attend preventive health appointments. Practitioners require further training and tools specific to the primary care setting. Further investment in specialist and allied health services is considered essential to assure better outcomes for young children's mental health following screening and referral. Practitioners welcome a more collaborative relationship with other professionals (e.g. early educators) in assessing children's social and emotional development. General practice has the capability but requires a more structured approach to assessing the social and emotional health of young children.
报告家长、全科医生和执业护士对将三岁儿童的社会和情感健康检查纳入健康儿童检查（一项通过全科医生提供的一次性学前健康评估）的意见。
从墨尔本三个社会文化多样性的城区招募参与者，进行一项定性研究，共包括 28 名家长访谈和 6 个共有 40 名从业者参加的焦点小组。参与者讨论了儿童社会和情感发展、儿童健康寻求和预防保健。对转录本进行了主题分析。
共同主题表明：（i）尽管家长和从业者都对社会和情感筛查的想法持开放态度，但家长对幼儿心理健康问题和早期干预的必要性知之甚少。（ii）所有群体都质疑目前实践人员识别问题的能力，从业者表示需要进一步培训和工具。（iii）家长和从业者警告说，筛查可能会增加家长的焦虑，并导致不必要的转介。从业者则用父母没有注意到的案例进行了反驳。（iv）参与者质疑在没有有效和可及的治疗途径的情况下早期识别问题的价值。
为了使项目有效，需要提醒家长早期干预的好处，并鼓励他们参加预防保健预约。从业者需要进一步的培训和特定于初级保健环境的工具。进一步投资于专门的和相关的健康服务被认为是确保在筛查和转介后儿童心理健康有更好结果的必要条件。从业者欢迎与其他专业人员（如早期教育者）在评估儿童社会和情感发展方面建立更具协作性的关系。全科医疗具有这种能力，但需要更结构化的方法来评估幼儿的社会和情感健康。
