How Comprehensive Are Well Child Visits?

Abstract

Most of the 450 child health conferencevisits documented were fairly stereotyped, with nurses as well as physicians focusing on physical examinations, immunizations, and feeding advice and with little attention to psychosocial content. Comprehensive patient care clearly is not yet expected by mothers attending well child clinics. Parents must learn that psychosocial concerns and behavioral problems are legitimate topics for discussion, and doctors and nurses must initiate and encourage this type of discussion explicitly in well child care. It has been accepted for many years that well child care should be comprehensive in nature and should include attention to the social and emotional components of child health and development. In the absence of specific medical problems, one of the basic purposes of regular visits for well child care is to offer anticipatory guidance, supervise developmental progress, help the family with child rearing problems, and deal with mi¬ nor emotional abnormalities or diffi¬ culties in family relationships in a

How Much Time Is Spent on Well-Child Care and Vaccinations?

“…NOV 1999 sicians and 28 to 36 minutes for nurse practitioners in the 1975 study byHoekelman 19 of the adequacy of health care activities in well-child care; 6 to 15 minutes in the study by Kahn and Wirth 20 of changes in pediatrician activity after the addition of a nurse practitioner to the practice, 10 minutes in the 1971 study by Korsch et al21 of how well-child care was conducted; 13 minutes for pediatricians and 21 minutes for nurse practitioners in the 1971 study by Charney and Kitzman22 of nurse practitioners teaming with pediatricians in private practice; 14 minutes for pediatricians and 30 minutes for nurse practioners in the 1969 study by Schiff et al23 of nurse practitioners in pediatric offices; and 13 minutes in the 1967 study by Bergman et al…”

Use of a chart audit: teaching well child care to paediatric house officers

“…Therefore, new residents would have a relatively poor background in these areas. As parents often do not feel that psychosocial issues are proper topics to discuss with paediatricians (Korsch et al 1971), the residents had to initiate the discussion of developmental and behavioural issues. House officers would be less apt to inquire about and discuss topics about which they have little knowledge…”

Special Section: Learning from Experience: Shifting from Clinical Parent Training to Broader Parent Education

“…For example, in one study (Hickson, Altemeier, & O'Conner, 1983) parents in pediatricians' offices were asked what they were most worried about concerning their children: 30% were most worried about physical health issues, while 70% were most worried about parenting, behavior, and development. Although our own surveys had indicated that parents typically viewed their pediatrician as being well trained to help them deal with these nonphysical health areas, there was ample evidence indicating that due to issues such as lack of training and time limitations, pediatricians typically were not able to adequately address most parenting issues during clinic visits (Korsch, Negrete, Mercer, & Freeman, 1971;Reisinger and Bires, 1980;Sharp, Pantell, Murphy, & Lewis, 1992;Starfeild & Borkowf, 1969).…”