Starting the Debate: Rethinking Well-Child Care in Europe

Polish adolescents' right to confidential primary health care is not respected despite high public acceptance

AIM

The right of underaged patients to confidential health care should be considered an inalienable human right. Access to such care is also advisable according to contemporary medical knowledge. The aim of this study was to verify the extent this right is exercised in Poland and to examine social attitudes towards this issue.

METHODS

A sample of Polish school-age pupils and parents (n = 800) was surveyed using an online questionnaire.

RESULTS

Only 4.2% of the surveyed adolescents were offered private time with a doctor during their last preventive visit (well-child visit), and this was more frequent for girls. At the same time, a very high level of acceptance for private time with a doctor was observed among Polish adolescents (90.8%) and their parents (84.3%).

CONCLUSION

Our findings suggest serious deficiencies in the protection of adolescent patients confidentiality. It is necessary to change medical practice and adapt legal regulations to the provisions of the Convention on the Rights of the Child.

What determines immigrant caregivers' adherence to health recommendations from child primary care services? A grounded theory approach

AIM

To investigate the diversity and specificity of the determinants of immigrant caregivers' adherence to child primary care (CPC) health recommendations.

BACKGROUND

Immigrant caregiver's adherence to CPC health recommendations is of utmost importance to minimize their children's health-related vulnerabilities. Some research has been conducted on the determinants of immigrants' access to health services, but much less is known about the determinants of their adherence to health professionals' recommendations once they get there, especially in a primary health care context. This study contributes to bridge these gaps.

METHODS

Interviews and focus groups were conducted, with immigrant and non-immigrant caregivers living in Portugal (n=35), from heterogeneous socioeconomic backgrounds. Focus group and individual interview scripts were developed to explore caregivers' understanding and use of CPC services and, particularly, their adherence to CPC recommendations. A socio-demographic questionnaire was also administered. Qualitative data were analyzed using a grounded theory methodology.

FINDINGS

'Adherence to CPC health recommendations' is a core and multidimensional concept. Several determinants were identified at individual, interpersonal, organizational and structural levels. Some determinants were highlighted both by immigrant and non-immigrant caregivers: valuing children's health, usefulness of recommendations, perceived health-care professionals' competence, central role of vaccination in CPC and caregivers' socio-economic conditions. Other determinants were specifically mentioned by immigrant caregivers: expectations about traditional versus pharmacological treatments, cultural mismatches in children's care practices, perceived quality of Portuguese CPC services versus CPC from countries of origin. These results provide innovative theoretical and empirical contributions to the field of primary health care and, particularly, to immigrant caregivers' adherence behaviors. Implications for research on treatment adherence in primary care contexts, the development of interventions that promote caregivers' adherence to CPC health recommendations and for child protection will be discussed.

Literacy promotion by health care professionals: A comprehensive biomedical and psychosocial approach

Literacy is the ability to read, write and understand print. Proficiency in literacy is fundamental to social inclusion and strongly linked to health outcomes. Thus, improving literacy is important for lifelong health promotion. Poverty, inadequate hearing, speech and vision and learning disabilities may challenge literacy development. In our review, we explore these topics and suggest recommendations to: Mitigate the Effects of Poverty, Access Comprehensive Medical Assessments, Promote Early Childhood Education and Advocate for Early Intervention and Remediation Programs.