The pediatric nurse: link between pediatrics and youth health care

INTERVENTION: Intervention The intervention comprises the procedure that started in 2015 at the Amphia hospital, Breda, The Netherlands. In this procedure, pediatric nurses are the linking pin between pediatrics, Dutch Youth healthcare and social domain. Two pediatric nurses are present at the outpatient clinic of the Amphia hospital during one shift/week for the execution of the intervention. In addition as part of the intervention, they have the availability to pay visits to other locations (i.e. the clients home) during 1.5 day/week. The procedure starts at the moment a child (and its parents) consults a pediatrician. If it appears from the anamnesis by the pediatrician that the child suffers from problems in which (psycho)social factors are involved, the child can be considered for inclusion in the study. If so, the pediatrician explains the study to the child and its parents, hands them over the research information as well as an informed consent form. In addition the pediatrician refers the child to the pediatric nurse for (psycho)social problems. The pediatric nurse contacts the family by telephone within two weeks after the consultation with the pediatrician. In consultation with the child and the parents an appointment is made at the parents’ house or at the outpatient clinic. During this consultation the pediatric nurse clarifies the problem and together with the parents and the child she considers which care fits best to the child. This procedure can take several consultations. When necessary, the pediatric nurse connects the child to other professional authorities in the field as for example the infant welfare center (i.e. teaching in upbringing) or specialized youth assistance. When it becomes clear that the family is able to go on by itself or when they are transferred to another professional authority the pediatric nurse closes the contact after a written feedback toe the family, the pediatrician and (with parental consent) the general pract CONDITION: Mental problems, Social problems, Psychosiocial problems, Psycho‐somatic problems, Youth care ; ; PRIMARY OUTCOME: Parental and children’s satisfaction with the care provided (Exit questionnaire); ; Parental and children’s satisfaction with the care provided is measured by use of the validated Youth‐ and raising help questionnaire, Exit. The Exit questionnaire contains a parental and children’s (12 years and over version.; ; ; ; Throughput; ; Throughput is measured as the timespan between the first consultation with the pediatrician and the; first contact with follow‐up care.; SECONDARY OUTCOME: Parenting stress ; ; Parenting stress and changes in parenting stress are measured by use of the parenting stress questionnaire. ; ; ; ; Severity ; ; Problem severity is measured from the parental and professional perspective. ; ; Parental perspective ; ; Parents complete a ‘Visual Analogue Scale’(VAS) for the subjects, the JIVES scoring form, concerning: crying, sleeping, eating and development for children aged 0‐2 years. For children aged 2‐18 years they complete a ‘Strengths and Difficulties Questionnaire’ (SDQ). ; ; ; ; Professional perspective ; ; ; ; ; Other study parameters ; ; ; ; Evaluation new working method ; ; ; ; ; Intervention costs and structural funding ; ; ; To get an impression of the perspective of the professional on (changes) in problem severity, pediatricians also complete a VAS (JIVES scoring form). With this instrument they give an overall score for problem severity. ; The professionals experiences with the intervention are valued to measure the program integrity, the efficiency and effectivity of the new working method, the collaboration process and the total approach. ; To give an indication of the costs involved with the new working method qualitative analysis of a few cases are performed. Where possible, the costs of the different activities will be documented. ; During interviews with experts from the health insurance company and youth healthcare it will be discussed how the new working method can be funded structurally and which factors have to be taken into account. INCLUSION CRITERIA: All children, aged 0‐18 years, who visit the outpatient clinic of the Amphia hospital from October 2017 to May 2018, and suffer from the following problems are eligible for the study: During the consultation, the pediatrician checks whether the child is eligible for inclusion in the study. If a child is eligible, the pediatrician explains the study and hands over an informed consent form. At the moment a parent of the child and the child itself (age 12 and over) has signed the informed consent, the child is included in the study. Somatic complaints will be treated by the pediatrician for both the children from the intervention and the control group.