Latino Disparities in Child Mental Health Services

TOPIC:  Access and utilization of mental health services for Latino children.
PURPOSE:  As Latino children may experience higher rates of unmet needs, this article examines the current literature for the reasons for the disparity and the barriers to the utilization of mental health services for Latino children.
SOURCES:  An integrative literature review was undertaken from child psychiatry and nursing.
CONCLUSIONS:  The literature confirmed a pattern of underutilization of mental health services by Latino children, but did not completely address the reasons for the disparity. Suggested barriers were language and cultural issues. Gaps in the literature include a lack of agreement for definition of a mental health problem and the tools to identify these, insufficient studies into the barriers for Latino children in the access and utilization of mental health services, and cultural and language issues related to Latino research.     

PRACTICE REPORTS

Edwina Thomas, BA, MM, RN, Clinical Nurse Specialist (Midwifery) Nepean Hospital, Sidney, NSW, Australia
The responsibility of caring for pregnant women and both their unborn and newly born babies falls directly and squarely upon the shoulders of midwives in whatever setting in which they work. In small peripheral hospitals midwives often fulfil much of the role played by registrars and residents in larger institutions. This certainly helps enable these midwives to provide holistic care, and truly function as midwives, but in doing so increases both the responsibility undertaken by, and the public's expectations of the midwife. Similarly, in all midwife-led antenatal clinics the responsibility of recognising deviations from normal and implementing timely, effective intervention is great. To protect ourselves we tend to engage in a lot of ritualistic practices that do little to ensure maternal and fetal well-being, but which serve to 'prove' we 'did everything possible' for a good outcome.     

UNITED KINGDOM: CARING DIFFERENTLY: INTERMEDIATE CARE - AN ALTERNATIVE APPROACH TO SERVICE PROVISION IN RESPONSE TO CLIENT NEED AND WORKFORCE CHANGES IN THE NHS

The King's Fund is an independant organisation whose prime function is to support development of health and social services. The following paper outlines one aspect of its work which is concerned with the introduction of so called ‘intermediate care’ services for people who need help during the transition between medical dependance and personal independance, but who do not require the specialist medical expertise provided in an acute hospital setting. It is argued that currently there are few services specifically designed to meet this group of patients needs and a ‘black hole’ exists in service provision. The purpose of such a service is to provide intensive therapy in order to maximise their ability to live independently, improve the quality of their lives, and provide the opportunity for them to learn greater self-care skills in order that they can manage their own health more effectively in the longer term.     

School nurse assessment of primary school children: Analysis of data from the school entrant health questionnaire

Edgecombe GA, Avant KC, Griffin P, Corneille K. International Journal of Nursing Practice 1998; 4: 40–50
School nurse assessment of primary school children: Analysis of data from the school entrant health questionnaire
The School Entrant Health Questionnaire (SEHQ) has been used by the School Nursing Program in Victoria since April, 1997. The SEHQ assists school nurses in developing a health profile of primary grade children and in discriminating between children with problems and children without problems. The SEHQ assesses children in 11 domains: general health, medications, immunisations, dental health, speech/language, hearing, vision, disabilities, general development, behaviour and emotional well-being, and family stress. The SEHQ was found to be reliable and valid, and to provide an excellent means of distinguishing between students who had problems and needed intervention and those who did not. This paper presents an analysis of data from the first testing of the SEHQ.     

Record Keeping and Health Service Mirrored by Data from Swedish Child Health Care Records

Abstract. In order to study the completeness and accuracy of the recording of Child Health Care data, 212 randomly sampled records from all of Sweden were collected. The degree of completeness and accuracy was determined by scoring information from the records. The results showed that the recorded data lacked accuracy to a large extent, and completeness to a somewhat lesser extent. Information on the development of the child, especially speech and language development, but also psychomotor development, were the main areas lacking completeness. Health information, environmental conditions, behaviour, illnesses, accidents and evaluation of the neonatal period were also very poorly recorded. The results indicate that the records of the Child Health Care service do not constitute, in the respects studied, a complete and secure basis for clinical work, research, planning or evaluation of the quality of the health services.     

Assessing the need for child-care health consultants

This study surveyed health and safety needs of child-care programs; examined the perceptions of directors, the person identified as being responsible for a program, concerning health consultation; and determined how directors would secure funds to pay for consultative services. The survey was conducted in a state without mandates for child-care health consultation and minimal access to consultants. The researchers designed and pilot-tested a Child Care Health and Safety Survey. Working with a task group of statewide child health experts, the researchers revised the survey and mailed it to a random sample of child-care programs. Twenty-two Head Start Programs, 122 licensed child-care centers, and 116 family child-care homes participated, representing a return rate of 73, 36, and 30%, respectively. The majority of programs expressed interest in child-care health consultation offered for free or fee-based. Directors identified reasonable means of obtaining funds to support consultation. All programs had needs related to supporting health practices in their settings, provision of health services for staff, and health screening for children. Public health nurses, specially trained to advise child care, are well positioned to offer consultation. Systems of health consultation may be accepted as fee-for-service arrangements, supporting sustainability.     

Nurses' first encounters with parents of new-born children--public health nurses' views of a good meeting

? The nurse’s view of the first meeting with parents of new‐born children may have consequences for the quality of future contact. A good start will lay a solid foundation for a lasting relationship, and have an affect on the nurse’s work to support parents and children and to promote health. We do not know what nurses mean by a ‘good meeting’. ? The aim of this study was to discover how nurses view the first meeting as a general preventive measure aimed at all parents and their new‐born children. ? Four focus groups interviews were held with nurses from different primary health care areas in the county of Skåne, southernmost Sweden. ? Analysis of the content in the transcribed interview texts disclosed eight subcategories: good contact/reciprocal relationship; willingness to listen; guest/equal roles; time/peace and quiet; the family in its environment; socio‐cultural aspects; confirmation/support; and individual advice. ? Three categories were established: creating trust; creating a supportive climate; and creating a picture of the family’s life situation. ? The home visit was seen as an important way to establish trust and obtain a picture of the family’s life situation, which was in turn essential for creating a supportive climate.     

Fluoride mouthrinses for preventing dental caries in children and adolescents

The Mission of the Cochrane Nursing Care Field (CNCF) is to improve health outcomes through increasing the use of the Cochrane Library and supporting Cochrane's role by providing an evidence base for nurses and related health care professionals involved in delivering, leading, or researching nursing care. The CNCF produces “Cochrane Corner” columns (summaries of recent nursing‐care‐relevant Cochrane Reviews) that are regularly published in collaborating nursing‐care‐related journals. Information on the processes this Field has developed can be accessed at: http://cncf.cochrane.org/evidence-transfer-program-review-summaries .     

Developing a Clinical Framework for Children/Youth Residential Treatment

The idea of implementing consistent overall clinical approaches in residential treatment facilities may improve care by influencing family engagement, interactional styles of residential staff and clinicians with children and youth, specific therapeutic interventions including the management of problematic behaviors, milieu approaches, and group interventions, as well as inform programmatic structure, rules, and expectations of residential living. A clinical framework should demonstrate contemporary and evidence supported practices in order to achieve meaningful success. This article summarizes a literature search and discussion points regarding family/community engagement, individualized assessment/treatment, interprofessional teams, and organizational factors in developing a clinical framework for children/youth residential treatment.     

深圳宝安某社区流动儿童保健服务现状分析

目的了解深圳宝安某社区流动儿童保健服务工作的现状,针对该现状提出一系列改进措施,以提高社区流动儿童保健水平。方法按照整群随机抽样原则在该社区流动人口比较集中的地区随机抽取300名儿童,采用自制的问卷调查表对300名3岁以下流动儿童监护人进行问卷调查。结果该社区3岁以下流动儿童1年以来进行健康体检率为69．02％,系统管理率为40．74％,“五苗”合格接种率为81．4％。结论因监护人工作不稳定,人员流动大,经常被送回家乡给老人带是儿童未参加体检的主要原因。其次,监护人文化程度较低,未充分认识儿童体检的重要性。宣传不到位和体检项目单一也有一定因素。     

健康教育示范法在儿童糖尿病胰岛素应用中的作用

目的探讨示范法健康教育在1型糖尿病患儿及家长应用胰岛素中,关于血糖测定、胰岛素的注射方法、注射部位选择、剂量调节及贮存等5方面的技能掌握情况。方法对97例1型糖尿病患儿及家长,采用示范法进行健康教育,在实施教育前后对患儿及家长5方面技能掌握情况进行效果评估。并对评估效果进行比较。结果实施教育前后患儿及家长在胰岛素的应用中血糖测定、胰岛素的注射方法、部位选择、剂量调节及胰岛素的贮存等5方面的技能掌握情况比较有显著性差异(P<0.01)。结论示范法健康教育模式可提高患儿及家长对胰岛素的认知及使用的依从性,掌握胰岛素的正确使用方法,从而有效控制血糖,对1型糖尿病患儿主动配合,自我照顾和管理,提高生活质量具有非常重要的意义。     

The role of child health nurses in enhancing mothering know-how

Supporting early parenting and promoting family health is an important aspect of contemporary child health nursing in Australia. Recent studies suggest that within a service climate that increasingly funds targeted, population-based needs rather than universal needs, child health nurses are concerned about maintaining individual nurse-client relationships, particularly with individual families. There is however, limited evidence available to use in response to these concerns. In this paper the way a group of middle-class mothers of infants, who, in today's health service climate, may not be a target group for health services, develop their caregiving know-how, is discussed. The findings presented suggest that both expert and lay knowledge have a part to play in supporting women in their early mothering. Women such as these, in essence, need a clearing-house to help them sift through the overwhelming information they access, respond to, and turn into everyday practices that work. Well placed child health nursing services may achieve this. While there is significant support for this claim in the literature, mechanisms for effective support remains the challenge. A key may be found in nurses focusing on the promotion of communicative or interactive health literacy as an outcome of their programs.     

Utilization of parenting groups and consultation services as parenting support services by Japanese mothers of 18 month old children

Aim: To clarify the factors related to the utilization of parenting groups and consultation services by mothers with children aged 18 months. Methods: This was a cross‐sectional study using a self‐report questionnaire survey at health examinations in five health centers of an urban city in Tokyo, Japan, from July to September 2003. The final study population was comprised of the 371 mothers who provided information on both demographics and the utilization of services. Results: Of these 371 mothers, 166 participated in parenting groups since the birth of their 18 month old child. Logistic regression analyses indicated the following factors related to such participation: past experience in the use of services provided by the local government, trust in the specific group, and worries about their children. Participation in the parenting groups was not related to child‐rearing anxiety or mental health status. The participants indicated that the groups provided friends and child‐rearing information and alleviated stress. Worries about children and past experience in the use of public services would enhance the utilization of services. Conclusion: It is essential for service‐providers to offer services specific to the situation or desires of mothers. Mothers might need both consultation services and support groups to reinforce the mother–child relationship, for social support, and to freely discuss worries with both professionals and peers.     

Looking for Child Psychiatric Nursing—Vietnam 2005

In Vietnam, child health services are primarily focused on nutritional and developmental concerns. Child mental health issues, including homelessness, adolescent suicide, and sex trafficking of children, are not currently governmental priorities.     

Bad news: Families’ experiences and feelings surrounding the diagnosis of Zika‐related microcephaly

The rapidly increasing number of cases of Zika virus and limited understanding of its congenital sequelae (e.g., microcephaly) led to stories of fear and uncertainty across social media and other mass communication networks. In this study, we used techniques generic to netnography, a form of ethnography, using Internet‐based computer‐mediated communications as a source of data to understand the experience and perceptions of families with infants diagnosed with Zika‐related microcephaly. We screened 27 YouTube? videos published online between October 2015 and July 2016, during which the Zika epidemic started, peaked, and declined. We identified three themes: (a) experiencing the news of a diagnosis of Zika‐associated microcephaly; (b) experiencing feelings and expectations of the ‘imperfect’ child; and (c) seeking to understand microcephaly to care for the child. We found that families experienced distressing feelings of shock, sadness, hopelessness, and pain, while dealing with emerging and sometimes conflicting information being transmitted by news outlets, uncertainty about the child's health, and healthcare providers’ lack of clarity to guide the family members. The ‘unknown’ factor of ZIKA was an additional stressful factor in the experience of the families.