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Exploring public health nurses' acceptability of clinical assessment tools in a Norwegian child health centre
Elisabeth Ovanger Barrett1, Hilde Laholt2, Geir Fagerjord Lorem3
1Faculty of Health Sciences - Department of Psychology/Specialist in Clinical Community Psychology, UiT - The Arctic University of Norway, Municipality of Tromsø, Norway.
Insights
Public health nurses find assessment tools helpful for identifying at-risk infants. However, systematic use may impede their flexible, parent-focused approach, highlighting the need for training and clear referral pathways.
Area of Science:
- Child Health
- Developmental Pediatrics
- Public Health Nursing
Background:
- Infant mental health struggles are often subtle, leading to missed early identification in primary care.
- Primary healthcare offers frequent contact during infancy for timely developmental assessments.
- The Alarm Distress Baby Scale (ADBB) is designed to detect social withdrawal in infants aged 2-24 months.
Purpose of the Study:
- To investigate factors influencing Norwegian public health nurses' acceptance of clinical assessment tools.
- To understand nurses' perspectives on integrating tools like the ADBB into child health services.
Main Methods:
- Focus group discussions were conducted with public health nurses prior to ADBB training.
- Explored nurses' views on their professional roles, practices, and the use of assessment tools.
Main Results:
- Nurses identified key themes: supporting parents, safeguarding infants, interpreting infant cues, and organizational factors.
- The role of a public health nurse involves supporting parents and safeguarding infants.
- Interpreting infant expressions presents a challenge in clinical practice.
Conclusions:
- Assessment tools are viewed as aids for detecting at-risk infants.
- Systematic tool implementation may conflict with nurses' flexible, egalitarian, and resource-focused practice.
- Acceptability hinges on continuous training and established referral systems for assessment tools.
Background:
Infants' symptoms of mental struggle are often diffuse and undifferentiated, and health services do not identify many infants at risk of poor development. However, primary health care is advantageous for early identification, given there are frequent consultations during the infant's first two years. Health policy encourages using evidence-based screening but use varies in primary health care. The Alarm Distress Baby Scale (ADBB) is an assessment tool targeting social withdrawal in infants 2-24 months of age.
Aim:
To explore contextual factors related to public health nurses' (PHNs) acceptability of clinical assessment tools in a Norwegian child health centre.
Methods:
Prior to an upcoming ADBB training, we used focus group discussions with PHNs to explore their views on their professional role and practice and how this concurs with using assessment tools.
Findings:
Thematic analysis resulted in the following themes: (1) A Role requiring Supporting the Parents and Safeguarding the Infant; (2) The Challenge of Interpreting Infant Expressions; and (3) Organisational Preconditions for Accepting New Methods.
Conclusion:
Our findings show that PHNs regard assessment tools as an aid to detect infants at risk, but that systematic use of such tools can hinder their ability to be flexible, egalitarian, and resource-focused. We also find that acceptability of assessment tools requires a system for continuous training and a well-established referral routine.
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