Australian general Practitioners' perspectives on their role in well-child health care.

Article (PDF Available)inBMC Family Practice 14(1):2 · January 2013with80 Reads
DOI: 10.1186/1471-2296-14-2 · Source: PubMed
Abstract
Background In a General Practitioner (GP) setting, preventative medicine is reported as the predominant source of health care for the well-child. However, the role of the GP in well-child health care is not well understood in Australia. The aim of this study was to describe the role of the GP in providing services for well-children and families in Australia. Methods This was a qualitative descriptive study. Face-to-face interviews were held with 23 GPs to identify their role in the provision of well-child health care. Participants worked in a variety of general practice settings and 21 of the 23 GPs worked in the Greater Western Sydney area. Results Five main themes were identified in the analysis: ‘prevention is better than cure’, ‘health promotion: the key messages’, ‘working with families’, ‘working with other health professionals’, and ‘barriers to the delivery of well-child health services’. Conclusions Participating GPs had a predominantly preventative focus, but in the main well-child care was opportunistic rather than proactive. The capacity to take a primary preventative approach to the health of children and families by GPs is limited by the increasing demands to manage chronic disease. Serious consideration should be given to developing collaborative models of care where GPs are joined up with services funded by State and Territory governments in Australia, such as the universal maternal child and family health nursing services that have well children and families as their prime focus.
    • "Surveillance is expensive and requires the training of staff, who then engage with the children to conduct the screening. Other barriers include time constraints and difficulties in accessing high-quality and affordable primary health care for children (Australian Institute of Health and Welfare, 2009) and obstacles for children receiving appropriate interventions even when they are recognised as being at risk of developmental delay (Jeyendra et al., 2013; Schmied et al., 2011). Some professionals believe that the current surveillance practices (without the need for formal screening) are however, sufficient to identify ASD (Barton, Dumont-Mathieu, & Fein, 2012). "
    [Show abstract] [Hide abstract] ABSTRACT: Objective Screening for autism spectrum disorder (ASD) is an important first step in the identification of children considered at risk of developing the disorder and in need of further assessment, intervention, and services. In this paper, we reviewed some commonly used ASD-specific screening tools and focused on the use of an ASD-specific screening tool developed in Australia, the Autism Detection in Early Childhood (ADEC), in enhancing the early identification of young children with ASD. The ADEC was developed as a clinician-administered screening tool that was time-efficient, suitable for children under 3 years, easy to administer, and suitable for persons with minimal training and experience with ASD. MethodA systematic search of published research studies was performed to review key findings of the ADEC and some commonly used ASD-specific screening tools through February 2015. The Psych-Info and Google Scholar online databases were searched concurrently for entries containing any combination of the terms (a) autism screening and (b) autism detection in early childhood. ResultsWe found four studies suggesting that screening for ASD using the ADEC can be sensitive and specific in children under the age of three. The ADEC is comparable to some commonly used ASD-specific screening tools. Conclusions Based on the studies presented, as compared to some commonly used ASD-specific screening tools, the ADEC is a sound and effective ASD screening tool, suitable for use with young children ranging from 12-36 months of age, and can be used with confidence to compliment the developmental surveillance and assessment processes. There is also the potential and possibility of translating the ADEC across different socio-economic populations, including developing and low-resource countries.
    Article · Aug 2016
    • "While there are benefits of surveillance, there are also barriers to developmental surveillance achieving its potential positive impact. These include time constraints and difficulties in accessing high quality and affordable primary healthcare for children according to need [9], and obstacles for children receiving appropriate interventions even when they are recognised as being at risk of developmental delay10111213. For example, in Australia there are long waiting periods for both private and public assessment and intervention services for identified developmental problems such as speech and language disorders or global developmental delay [14]. "
    [Show abstract] [Hide abstract] ABSTRACT: Background Universal developmental surveillance programs aimed at early identification and targeted early intervention significantly improve short- and long-term outcomes in children at risk of developmental disorders. However, a significant challenge remains in providing sufficiently rigorous research and robust evidence to inform policy and service delivery. This paper describes the methods of the ‘Watch Me Grow’ study that aims to maximise accurate early detection of children with developmental disorders through a partnership formed between policy makers, service providers and researchers. Methods/Design A mixed methods study design was developed consisting of: (1) a qualitative study of parents and health service providers to investigate barriers and enablers of developmental surveillance; (2) recruitment of a birth cohort and their longitudinal follow-up to 18 months of age to: a) assess risk factors for not accessing existing developmental surveillance programs and b) estimate the prevalence of children identified with developmental risk; (3) comparison of surveillance outcomes with a reference standard at 18 months of age to assess the diagnostic test accuracy of existing and alternative developmental surveillance tools; and (4) comparison of developmental surveillance models to inform policy recommendations. Data linkage will be used to determine the uptake and representativeness of the study participant group versus non-participants. Discussion The Watch Me Grow study is expected to provide a collaborative opportunity to enhance universal developmental surveillance for early accurate identification of developmental risk. This will also provide quality evidence about identification of developmental risk and access to services to be embedded in existing practice with linkages to policy development.
    Full-text · Article · Sep 2014
    • "Additional services for families are available through private midwives and CFHs, nurses working in pharmacies or private general medical practices (where they can see a doctor or a practice nurse). CFH nursing services continue to offer scheduled universal services at regular intervals until children start school (NSW Department of Health 2008, COAG 2009a), whereas general practitioners (GPs) offer CFH services opportunistically when families present for medical treatment or for immunisation (Jeyendra et al. 2013). This complex mix of maternity and CFH, public and private services in Australia makes the planning and coordination of care across various services challenging (Schmied et al., 2008b; The Allens Consulting Group 2009). "
    [Show abstract] [Hide abstract] ABSTRACT: To examine collaboration in the provision of universal health services for children and families in Australia from the perspective of midwives and child health and family health nurses.
    Article · Jun 2014
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