Family physician and Professor and Director in the Centre for Studies in Primary Care at Queen's University in Kingston, Ont.
Medical student at Queen's University.
Can Fam Physician. 2019 Mar;65(3):e113-e120.
To determine whether Canadian children aged 4 to 6 received well-child checks; to explore the nature of these checkups in a large family practice; and to examine the merit of using parent questionnaires about child resilience as a means of introducing a discussion about social and emotional development into this checkup.
Three-part mixed-methods study, using data derived from the Canadian Primary Care Sentinel Surveillance Network (CPCSSN), chart reviews of a family practice, and semistructured interviews with parents.
Primary care practices associated with CPCSSN, and a large primary care practice in Kingston, Ont.
Patients who were born between 2008 and 2011, and a sample of parents whose children were between the ages of 6 and 9.
International Classification of Diseases, version 9, codes from CPCSSN records were used to identify the prevalence of well-child checks in the 4-to-6 age group. Then 110 randomly selected charts from a large family practice were audited for inclusion of behavioural and social assessments of those aged 4 to 6. Finally, randomly selected parents from the same practice were invited to pilot-test the PERIK (Positive development and resilience in kindergarten) resilience questionnaire, interviewed about its merit, and asked to recall whether the identified areas of child development had been included in previous well-child checkups.
Data from CPCSSN indicated that 11% of Canadian children aged 4 to 6 had had an explicit well-child check by their family physician. Among the reviewed charts from the one practice, social context was documented for 45% of them, but social and behavioural development was usually not recorded. The 42 parents interviewed found the PERIK questionnaire useful, but not perfect, for opening discussions about aspects of child development that they had not realized were central to the child's future health.
This study offers an initial approach to exploring resilience in children and therefore addressing recognized and alterable predictors of adult well-being. Early social and emotional development predicts resilience that, in turn, foreshadows future health. The PERIK questionnaire facilitated discussions that could add tremendous value to the well-child checks of children aged 4 to 6.
确定加拿大 4 至 6 岁儿童是否接受了儿童健康检查；探索大型家庭实践中这些检查的性质；并研究使用关于儿童适应力的家长问卷作为在该检查中引入社会和情感发展讨论的一种手段的优点。
使用来自加拿大初级保健监测网络（CPCSSN）的数据、家庭实践的图表审查以及对父母的半结构化访谈的三部分混合方法研究。
与 CPCSSN 相关的初级保健实践以及安大略省金斯顿的一家大型初级保健实践。
2008 年至 2011 年之间出生的患者，以及其子女年龄在 6 至 9 岁之间的一组父母。
使用 CPCSSN 记录中的国际疾病分类，第 9 版代码，确定 4 至 6 岁儿童进行儿童健康检查的流行率。然后，对来自大型家庭实践的 110 份随机选择的图表进行审核，以纳入对 4 至 6 岁儿童的行为和社会评估。最后，从同一实践中随机选择父母邀请他们试用 PERIK（幼儿园积极发展和适应力）适应力问卷，询问他们对该问卷的看法，并要求他们回忆以前的儿童健康检查中是否包括儿童发展的确定领域。
来自 CPCSSN 的数据表明，11%的加拿大 4 至 6 岁儿童接受过家庭医生的明确儿童健康检查。在对一家实践的审核图表中，45%的图表记录了社会背景，但通常没有记录社会和行为发展。接受采访的 42 位父母认为 PERIK 问卷很有用，但并不完美，无法为他们打开关于他们没有意识到对孩子未来健康至关重要的儿童发展方面的讨论。
本研究提供了一种探索儿童适应力的初步方法，从而解决了公认的和可改变的成人幸福感预测因素。早期的社会和情感发展预测适应力，进而预示着未来的健康。PERIK 问卷促进了讨论，可以为 4 至 6 岁儿童的儿童健康检查增添巨大价值。
