Child health care nurses' experience of language screening for 2.5-year-old children: A qualitative study.

AIM: To investigate the experience of Child Health Care Nurses (CHCNs) using language screening for 2.5-year-old children. DESIGN: An exploratory qualitative design with an inductive approach. METHOD: Data were collected through semi-structured, interviews with Swedish CHCNs who regularly performed language screening for children. The interviews were analysed by thematic analysis. RESULTS: Four themes were identified: 'The difficult visit', 'Explanations for language delay', 'Language screening across cultures' and 'Language screening with children exposed to adverse life events'. PATIENT OR PUBLIC CONTRIBUTION: Our findings suggest that in routine care a modified procedure is used for the language screening of children aged 2.5 to secure the child's cooperation and to preserve an alliance with the parents. Consequently, the validity of the screening is called into question, particularly when it comes to children from families with origins outside the dominant culture and children exposed to adverse life events.

Gait biomechanics in patients with intra-articular tibial plateau fractures - gait analysis at three months compared with age- and gender-matched healthy subjects.

INTRODUCTION: Tibial plateau fractures involve the knee joint, one of the most weight-bearing joints in the body. Studies have shown that gait asymmetries exist several years after injury. Instrumental gait analysis, generating both kinematic and kinetic data from patients with tibial plateau fractures, is uncommon. AIM: To examine walking ability and knee range of motion in patients suffering intra-articular tibial plateau fractures. METHOD: Twenty participants, eight males and 12 females, aged 44 years (range 26-60), with unilateral isolated tibial plateau fractures, were examined 12 weeks (range 7-20) after injury. The investigation consisted of passive range of motion (ROM) using a goniometer, six-minute walking test (6 MW), pain estimation using the visual analogue scale (VAS), the "Knee injury and Osteoarthritis Outcome Score" (KOOS) self-assessment questionnaire and instrumental 3-dimensional gait analysis (3DGA). 3DGA included spatiotemporal variables (speed, relative stance time, step length), kinematic variables (knee flexion, knee extension, ankle dorsiflexion) and kinetic variables (generating knee power (extension) and ankle power (plantarflexion)). A skin marker model with twenty reflective markers was used. Non-parametric tests were used for comparisons of the injured leg, the uninjured leg and a reference group. RESULT: The participants walked more slowly compared with healthy references (p < 0.001). Stance time and step length was shorter for the injured side compared with the uninjured side (p < 0.014). Step length was shorter compared with the reference group (p = 0.001). The maximum knee extension in the single stance phase was worse in the injured side compared with the uninjured side and the reference group (p < 0.001) respectively. The maximum ankle dorsiflexion during stance phase was higher in the injured leg compared with the uninjured side and the reference group (p < 0.012). Maximum generated power in the knee was lower in the injured side compared with the uninjured side and the reference group (p < 0.001 respectively). The same was true of maximum power generated in the ankle (p < 0.023). The median KOOS value was lower in the study group (p < 0.001). ROM showed decreased flexion and extension in the knee joint and decreased dorsiflexion in the ankle joint compared with the uninjured side (p < 0.006). The average distance in the six-minute walking test was shorter in the study group (p < 0.001). CONCLUSION: Patients who have sustained tibial plateau fractures generally display a limitation in their walking pattern 3 months after injury. These limitations are mainly related to the inability to extend the knee.

Child healthcare nurses' experiences of asking new mothers about intimate partner violence.

AIMS AND OBJECTIVES: To investigate child healthcare nurses' experiences of asking mothers of 8-month-old children about intimate partner violence using a two-step questionnaire. BACKGROUND: Exposure to intimate partner violence is detrimental to women and to their children, and its early detection is vital. Child health care is a promising setting for detecting intimate partner violence. DESIGN: The overall project had a quasi-experimental design and was employed in 2015 at 12 child healthcare centres in Sweden. The project aimed to test a two-step method for talking about intimate partner violence with mothers (n = 198) at the child healthcare centre. In this article, we disclose the experiences of the intervention from the perspective of the nurses (n = 13) who were educated and involved in the intervention. METHODS: Data were collected by semi-structured interviews, analysed by thematic analysis. RESULTS: Five categories emerged: using the two-step questionnaire method, asking about IPV as an important issue, being comfortable in the professional role and with asking about IPV, the importance of time and place in asking about IPV and spillover effects. CONCLUSIONS: Asking mothers visiting the child health clinic about their experiences of intimate partner violence was seen as an important task. Using a questionnaire could facilitate asking, but the questionnaire must be short and easy to use. Furthermore, the time and place for initiating a talk about this sensitive topic must be carefully chosen. RELEVANCE TO CLINICAL PRACTICE: The Violence in Families questionnaire was regarded as a useful tool and could thus be implemented in practice. However, it is important to offer education to the nurses prior to implementing a routine of asking about intimate partner violence in the child healthcare setting.