Parents' experiences of their child's participation in divorce groups in Norway: A phenomenological study.

BACKGROUND: Children and youth who experience divorce are found to have increased risk of emotional and behavioural adjustment problems. Different prevention programmes have been developed to help and support children. Previous studies have focused on the child or the group leader's experience with divorce groups, but studies describing parent's experience are missing. The aim of this study was to explore parents' experiences of their child's participation in divorce groups. METHODS: An inductive, qualitative and descriptive design was applied with philosophical orientation in naturalistic inquiry based on the outlines of a phenomenological perspective. Two fathers and three mothers from two different counties in Norway participated whereof four of them were interviewed twice. Systematic text condensation was used for the analysis. RESULTS: Three themes emerged from the analysis: encouraging the child, missing communication and challenging situations. Parents described how they encouraged the child to attend divorce groups and hoped they would gain a deeper understanding of their parents' divorce and their own feelings. Missing communication relates to lack of information about the groups from the school, the group leader and from the child. Missing information was found to be a challenge for the parents and made them think that the divorce group was beneficial for the child but maybe not always for the family. Parents described challenging situations due to the divorce, and they struggled to understand their child and their own behaviour. CONCLUSIONS: The opportunity for the child to talk to other children in the same situation in divorce groups was positive for the parents. To be beneficial for both children and their parents, structured information and cooperation among the school, the child and both parents are important. The knowledge from this study can support the development and use of intervention programmes in the future.

'We expected more about sex in the sex week' - A qualitative study about students' experiences with a sexual health education programme, from a health-promotion perspective.

PURPOSE: The purpose of this study is to explore adolescents' experiences with participation in a sexual health education programme named «Week 6¼, from a health-promotion perspective. METHODS: Six focus group interviews were conducted with adolescents aged 15-16 in Norway. Qualitative content analysis was used to analyse the data material. RESULTS: The results can be summed up by the main theme: "We like «Week 6¼ but … we expected more about sex in the sex week". The main theme consisted of two main analysis-derived themes: "The students want a topical sexual health education, with realistic and relevant learning subjects and exercises", and "The students want to contribute to the content and implementation, in order to improve the learning outcomes of «Week 6¼". Further, four categories were identified: organization and content, positive experiences, the potential for improvement, and learning outcome. «Week 6¼ is desirable, but students expect to learn more. Teaching should have a positive approach, and adolescents do not want their educators to get embarrassed. CONCLUSION: Although the teaching methods with active participation are enjoyable, it is necessary with more time for discussions and questions. Student participation in planning and implementation of the programme seems crucial for promoting salutogenic teaching processes.

Trends in the utilization of youth primary healthcare services and psychological distress.

BACKGROUND: Psychological distress among young people is increasing in Northern Europe. According to established healthcare utilization theory, this will create a greater need for youth primary healthcare and subsequently lead to more help-seeking behavior by distressed young people. The aim of this study was to investigate the association between the use of youth primary healthcare services and psychological distress in times of increasing mental health problems and increased service need. METHODS: This study consisted of five waves of repeated annual cross-sectional data collected from young people (aged 13-19) living in Norway between 2014 and 2018 (n = 368,579). Population-weighted and design-adjusted generalized linear regression with a log-link was used to examine the use of youth primary healthcare services over time. RESULTS: We found that a large proportion of young people use primary healthcare services and that young people with high levels of psychological distress use primary healthcare services twice as much as their peers with low levels of psychological distress. In addition, between 2014 and 2018 both psychological distress and primary healthcare service utilization increased: psychological distress increased by 5% and total primary healthcare service use increased by 500 consultations per 1000 young people. Overall, psychological distress had a conditional association with youth primary healthcare service use and could account for between 16 and 66% of the change in the use of services between 2014 and 2018, depending on the service type. However, the absolute increase seen in the use of primary healthcare services was mainly driven by young people with low levels of psychological distress as opposed to young people with high psychological distress. This suggest a converging trend. CONCLUSIONS: Our findings suggest that there might be serious barriers between need and help-seeking behavior for young people with high levels of psychological distress and that the pattern of utilization among young people with lower distress may indicate overuse, possibly as an inadvertent consequence of a newly introduced school absence policy. While further research is needed to confirm these findings, our work may inform healthcare providers and policy makers about primary healthcare utilization trends among young people.

Adolescent siblings of children with cancer: a qualitative study from a salutogenic health promotion perspective.

PURPOSE: To explore the experiences of adolescents with a sibling suffering from cancer from a salutogenic health promotion perspective. METHODS: Seven female siblings aged 13-17 years were interviewed. The interviews were transcribed and subjected to qualitative content analysis. RESULTS: The analysis findings adhered largely to one main theme: new challenges and needs in everyday life, consisting of the two domains cancer into life and helpful resources to cope. Categories related to the cancer into life domain were new routines and concerns, fear, loneliness, and growing up. Helpful resources to cope were categorized as support from others, understanding, faith and hope, and normal activities. CONCLUSION: Prominent in the siblings' descriptions were the challenging changes in everyday life including difficult feelings such as loneliness, and a need for understanding. Social support appeared as a crucial salutogenic coping resource to achieve understanding, faith and hope, and identity-crucial spheres to achieve meaning in life. This study has demonstrated the significance of salutogenesis in a new setting, and the findings could be of relevance to teachers and health professionals consulting with the siblings of children with cancer. Further research should be conducted to pinpoint concrete health-promoting measures that might benefit this group.

Examining boys' and girls' health-related quality of life from the first to the third year of upper secondary school: A prospective longitudinal study.

AIM: To examine differences in health-related quality of life between boys and girls in the first and third years of upper secondary school. DESIGN: Prospective longitudinal study. METHODS: The KIDSCREEN-10 was used to assess health-related quality of life. Differences in health-related quality of life over time were estimated using a linear mixed-effects model for correlated measurements. RESULTS: In the first-year boys (N = 168) and girls (N = 228) reported a mean health-related quality of life score of 76.3 (SD 10.7) and 69.8 (SD 11.5), respectively. In the third year, the mean health-related quality of life score for boys and girls was 73.5 (SD 12.4) and 65.7 (SD 13.3), respectively. Boys had a significant decrease in health-related quality of life mean score of -2.6 and girls a significant decrease of -3.8 (p < .001) over the 3-year period. There was no significant difference between boys' and girls' health-related quality of life changes (p = .39).

Health complaints among adolescents in Norway: A twenty-year perspective on trends.

PURPOSE: Examine time trends in health complaints among adolescents in Norway between 1994 and 2014 and among population subgroups, e.g., age and gender, as well as their interactions. METHODS: Norwegian data on 11-16-year-olds were drawn from the Health Behaviour in School-aged Children survey (HBSC) and analyzed for 1994 (n = 4,952), 1998 (n = 5,026), 2002 (n = 5,023), 2006 (n = 4,711), 2010 (n = 4,342) and 2014 (n = 3,422). Design adjusted linear regression that accounts for clustering effects was used to examine mean scores of two subscales of the HBSC-symptom checklist: psychological and somatic health complaints. RESULTS: Psychological and somatic health complaints among adolescents in Norway followed somewhat different trajectories, but the mean scores of both types of health complaints appeared to increase during the 20-year period. For psychological health complaints, there was a three-way interaction between age, gender and time, indicating that increasing trends in health complaints depended on both age and gender, in which older adolescent girls had a greater increase over time relative to younger adolescents and boys. CONCLUSIONS: Findings from this study, together with earlier findings, suggest that there has been an increasing trend in health complaints among adolescents in Norway from 1994 to 2014, especially among older adolescent girls. Future research should examine if trends in health complaints also depend on gender and age in other contexts. This will help the planning and implementation of tailored and effective interventions.

Parents' experiences with sleep problems in children aged 1-3 years: a qualitative study from a health promotion perspective.

PURPOSE: The aim of this study was to explore the experiences of parents whose children aged 1-3 years have sleep problems, from a health promotion perspective. METHODS: This was a qualitative study, based on semi-structured interviews with 12 mothers in Norway. The material was analysed by qualitative content analysis. RESULTS: Parents experienced problems with getting their children to bed, getting them to fall asleep, and episodes of awakening at night. Parents expressed that it was time-consuming and difficult to teach their children sleep regulation. Parents handled the sleep problems through the following coping strategies: acknowledging challenges, clarifying one's self-understanding, implementing change measures, and safeguarding family well-being. These coping strategies resulted in this main theme: the health-promoting regulation of interactions, including parents' strengthening of sleep regulation in their small children and the safeguarding of well-being in the family. CONCLUSIONS: Early, individually customized guidance for parents, with a focus on revealing and acknowledging their experiences with sleep problems in children, is essential for parents to find opportunities to cope with such challenges. Appropriate goals seem to be important for them to succeed in strengthening sleep regulation in their children in a more satisfactory way.

Implementation of national guidelines for the prevention and treatment of overweight and obesity in children and adolescents: a phenomenographic analysis of public health nurses' perceptions.

OBJECTIVE: To explore and describe how public health nurses (PHNs) perceive the implementation of national guidelines for the prevention and treatment of overweight and obesity among children and adolescents in well-baby clinics and school health services. DESIGN, SAMPLE, AND MEASUREMENTS: An explorative descriptive design was carried out through individual interviews with 18 PHNs and analysed according to the phenomenographic tradition. RESULTS: Four implementation strategies were described and assigned a metaphor: the structured PHN, pragmatic PHN, critical PHN, and the resigned PHN. Competence, patient receptiveness, internal consensus, interdisciplinary collaboration, resources, and organizational embedding were the determinants identified that most frequently affect implementation, and these determinants were distributed at different levels of the organization. The extent of facilitation seemed to determine which implementation strategy would be used. CONCLUSIONS: How PHNs implemented the guidelines for overweight and obesity were affected by determinants at different organizational levels. Contextual facilitation of implementation seemed better in larger organizations, but factors such as leadership, drive, and experience compensated in smaller municipalities. The implementation of guidelines was hindered when the barriers exceeded the benefits.

Breastfeeding surveyed using routine data.

BACKGROUND: The purpose of this study was to investigate breastfeeding as a health indicator through routine data registered at public child health centres. The prevalence and course of breastfeeding were surveyed, as well as factors that affect breastfeeding. MATERIAL AND METHOD: Breastfeeding status at six weeks and six months of age and other routine data were systematically recorded in a newly developed electronic medical records system (Health Profile 0-20 years) for infants attending public child health centres in Bergen in the period 2010-11. This information was linked to data from the Medical Birth Registry. RESULTS: Of 6,093 infants, 73.6% were exclusively breastfed at six weeks of age and 18.9% at six months. In adjusted analyses, there was an association between breastfeeding cessation before six months and the factors smoking, low maternal age, marital status as single, unsatisfactory family situation and social network, and birth weight under 2,500 g. Attendance at a specialist breastfeeding centre and uncertain/abnormal sleep patterns in infants were associated with continued breastfeeding after six months. INTERPRETATION: The medical records system «Health Profile 0-20 years¼, linked to the Medical Birth Registry, was well suited to studying factors that can affect breastfeeding. Mothers and infants with increased need for follow-up were identified.