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- Magnusson, Margaretha
(författare)
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Barnhälsovård : Studier av effektivitet och föräldratillfredsställelse
- 1999
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The research examined the role of the Swedish health surveillance program in identifying health problems and the degree to which Child Health Centers (CHC) respond to parents' expectations. The five studies were based on populations of pre-school children in Uppsala county.Analysis of the surveillance program showed a very low yield of newly detected health problems from about 3500 physician examinations of children at 2, 6, 12 and 18 months. About 2.5% of the children had newly detected problems, but most were minor or moderate. Only four severe problems were detected during the 14000 examinations by CHC physicians.Retrospective analysis of records for children with severe disabilities and diseases showed that 63% were detected neonatally. Only 20% were detected at the CHC, and less than half of these were found during scheduled examinations.A screening program for communication disorders was analyzed in a case-control study. Sensitivity for the screening was only 25%, and specificity was 61%.Two studies measured parental satisfaction in 1970, 1988 and 1993. In 1988, child health service was the responsibility of district nurses serving the general population, while in 1970 and 1993 it was handled by nurses working primarily with children. A significantly greater proportion of parents who perceived their infants as having behavior or feeding problems sought help from the CHC and were more satisfied with the advise received in 1970 and 1993 than 1988. General parental assessment of the service showed the same pattern.The results raise questions about the rationality of regular physician examinations for all infants, the respective roles of nurses and physicians in health surveillance, and the impact of organization and other factors on parental satisfaction with child health services.
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