No shows: a problem in health care

The mothers who kept their appointments were likely to be or have been head of household; they had to assume more responsibility and independence than the mothers in nuclear families. They were more likely to have been socialized in Michigan or Mexico than in Texas. They were more likely to have transportation available. They brought their children to the clinic to be sure they were all right. They tended to have prenatal care early and regularly for the same reason. The mothers who broke a number of appointments lived in nuclear families. They had never had to assume the total responsibility for their children. Unlike the good users, they were more likely to have been socialized in Texas. Some did not keep appointments because they did not have transportation. Some did not see any reason to take a child to the doctor unless he was sick. However, many of them did have prenatal care to be sure they were all right. "Start where the patient is" is still a good precept for public health nursing practice. Understanding where these mothers are should enable us to adapt our approach and practice to help them achieve their goal of good health care for their children.