Skane University Hospital, Lund, Sweden.
Department of Paediatrics, Clinical Sciences, Lund University, Lund, Sweden.
Acta Paediatr. 2018 Feb;107(2):301-306. doi: 10.1111/apa.14108. Epub 2017 Oct 26.
The Swedish Social Board has implemented a support strategy to guide out-of-home care for children, which translates as children's needs in focus (CNIF) and includes a systematic health assessment. It was fully introduced into the Skåne province in 2012 and our study covered the first four years of the CNIF health assessments, from 2012 to 2015.
We studied children aged 0-17 years in out-of-home care who had been referred by social workers for a CNIF health assessment, using their medical records to investigate both their health and the value of the health assessments.
From 2012 to 2015, only 409 (6%) of the 11 413 children in out-of-home care were referred for health assessments. Their health issues included depression and anxiety (29%), poor dental health (30%), seeking medical care for traumatic injuries (36%), previous contact with child psychiatry services (38%) and missed medical appointments (36%), dental appointments (36%) and child health programme appointments (39%). In addition, 10% of the girls and 9% of the boys were obese.
This study found high levels of wide-ranging health issues. Despite national Swedish guidelines and policies, only 6% of the children in out-of-home care were referred by social workers for a CNIF health assessment.
瑞典社会事务委员会实施了一项支持策略,以指导儿童的家庭外护理,即儿童为中心的需求(CNIF),并包括系统的健康评估。该策略于 2012 年在斯科讷省全面实施,我们的研究涵盖了 2012 年至 2015 年 CNIF 健康评估的前四年。
我们研究了由社会工作者转介接受 CNIF 健康评估的 0-17 岁家庭外护理儿童的医疗记录,以调查他们的健康状况和健康评估的价值。
2012 年至 2015 年,只有 11413 名家庭外护理儿童中的 409 名(6%)被转介进行健康评估。他们的健康问题包括抑郁和焦虑(29%)、口腔健康状况不佳(30%)、因创伤性损伤寻求医疗护理(36%)、之前曾接触过儿童精神病学服务(38%)以及错过医疗预约(36%)、牙科预约(36%)和儿童健康计划预约(39%)。此外,10%的女孩和 9%的男孩肥胖。
本研究发现存在广泛的健康问题,且程度较高。尽管有国家瑞典指南和政策,但只有 6%的家庭外护理儿童被社会工作者转介接受 CNIF 健康评估。