Family Practice Advance Access originally published online on May 30, 2008
Family Practice 2008 25(3):146-153; doi:10.1093/fampra/cmn021
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"This is not normal ... "—Signs that make the GP question the child's well-being
a Research Unit of General Practice in Copenhagen, Center for Sundhed og Samfund 5, Øster Farimagsgade, PO Box 2099, DK-1014 Copenhagen, Denmark
b Institute of Education, University of Warwick, Coventry CV4 7AL, UK
Correspondence to Kirsten Lykke, Research Unit of General Practice in Copenhagen, Center for Sundhed og Samfund 5, Øster Farimagsgade, PO Box 2099, DK-1014 Copenhagen, Denmark; email: kirstenlykke{at}dadlnet.dk
Received 27 June 2007; Accepted 21 April 2008.
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Abstract |
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Background. The GPs are uniquely placed to recognise children with mental problems and emotional stress that influence their well-being.
Objectives. The aim of the article is with focus on the GP's daily practice, to descript how the GP separates the healthy normal child's developmental crises from children with problems that need special attention and treatment.
Methods. A qualitative research design is used based on material from focus-group discussions and individual interviews with 28 GPs from a Danish county. Data was analysed descriptively.
Results. The GPs' attention was directed towards the contextual and relational sides. The GPs frequently became aware of a child in need during clinical work as a feeling of "this is not normal". This reaction could be triggered by the child's symptoms and problems, the parents' narrative of the child's daily life, the child's and the parents' communication and behaviour in the consultation, the family's use of the health care system and the doctor's knowledge of the family members.
Conclusion. The GP is used to observe and reflect on what happens in the consultation room. The GP might benefit from a systematic attention to the contextual issues. The GPs are frontline workers; they need a good dialogue with the experts and relevant supervision from them to meet the challenge of recognising children in need. It takes more than insight and will from the professionals, it requires a socio-political and socio-economic effort.
Keywords. Child health services, child protection, doctor–parent–child relationship, general practice, psychosocial problems.
Lykke K, Christensen P and Reventlow S. "This is not normal ... "—Signs that make the GP question the child's well-being. Family Practice 2008; 25: 146–153.