The questionnaire was sent to a total of 94 participants working in North Savo region of Finland.
All participants answered to the online survey. Overall, there were 94 different forms returned.
Of the total respondents 45,7% (n=43) were KUH professionals and 54,3% (n=51) primary care professionals. On average of the VC attended primary care respondents, 6.7% (n=2) were social workers, 21.1% (n=1) were day care/school professionals, 6.3% (n=1) were family counselling workers (Neuvola) and 40.9% (n=9) were the family member of the patient. Detailed characteristics of the participants are represented in Table 1 and in Table 2.
Table 1. Characteristics of the all respondents
KUH professionals Other professionals 45 %
55 %
WORKPLACE OF THE PARTICIPANTS
Table 2. Characteristics of the primary care professionals
5.2 WHAT NEED ON THE LOCAL LEVEL THE VC MEETINGS HAVE BEEN USED FOR?
The first question regarding purpose of the VC meetings asked, “What need on the local level the VC meetings have been used for?” Around 67,4% (n=29) of the KUH professionals mentioned that the purpose of the VC meeting was a consultation. Other main proportion, by 14% (n=6), VC meetings were used for tutored peer meetings. With 7% (n=3), the purpose was shared patient meeting were the patient’s family members could have attended. The VC meetings were also mentioned to use as a training purpose with 2,7% (n=1). With 4,7% the purpose for VC meetings were mentioned as a shared professional guidance and something else, what. Open-ended answers included anonymous consultation (n=4), contact with the patient´s parent (n=4), developing overall cooperation between all actors (n=1), group VC with several actors from healthcare sector (n=1), test contact (n=1) and few included contact with occupational therapist (n=1). In addition, the purpose of tutored peer group was also repeat (n=5) in the open-ended answers.
Primary healthcare professionals
44 %
Social workers 6 % School/day care
professionals 17 % Family members
33 %
PROFESSIONALS FROM THE PRIMARY
HEALTHCARE (OTHER THAN KUH)
Table 3. KUH professionals´ responses of the purpose of VC
VC purpose % N
Nobody 67,4% 29
Consultation 4,7% 2
Shared professionals´ guidance 7,0% 3
Shared patient meeting 2,3% 1
Training 14,0% 6
Tutored peer meetings 4,7% 2
Similar question was addressed to the primary care professionals. They were asked about the option for VC: “What would have been the alternative VC option? “A one third of 31.9% (n=15) of the participants responded in the open answer. The responses included contacting the family counselling center (n=7), making a phone or electronical consultation to KUH (n=5), training option (n=4), nothing to replace and maintaining the children´s health and care plan as it is (n=4) and the option for arranging patient´s family to commuting to Kuopio for the appointment (n=1).
One of the primary health care professionals stated:
”.. In addition to the referral, consultations between primary healthcare actors were also being considered..”
Likewise, another health care professional from primary care, related his/hers experience as:
“..They would probably have continued to think about the matter with their own group or called and consulted child psychiatry over the phone..”
The following statements and responses support the open answers from primary care professionals. The main proportion of 23,4% (n=11) answered that the situation would have been continued to follow. With 17,0% (n=8) phone contact to child psychiatry clinic would have been an option. Around 14,9% (n=7) of the respondents comment consultation between all primary care actors would have been good alternative. A small proportion with 12,8% (n=6) of the respondents thought referral for child psychiatric care would have been a correct approach for VC.
Table 4. Primary care perspectives for VC option
Option for VC % N
Referral for special child psychiatric care 12,8% 6 Phone contacting to the child psychiatry clinic 17,0% 8 Consultation between all primary care actors 14,9% 7
The situation would have been followed 23,4% 11
Something else, what? 31,9% 15
According to KUH professionals´ responses about considering about the topic of the VC. All responses were open answers and they are categorized under several headings. Detailed headings and characteristics of the open answers are not attached in this thesis. All responses included child aged 1-year-old to 13-year-old. Topics range from aggression, eating problems, behavioral challenges and emotional regulation, tantrums, sleep difficulties, encountering a multicultural family, self-harm, the challenge of the overall situation, and other challenges.
Most of the respondents mentioned the topic of behavioral challenges and emotional regulation among the child. Tantrums and sensory; and emotional ability were the most common problems that had been mentioned (n=13). A vast majority mentioned was anger attacks and sleeping problems (n=7). The overall challenging situation of the child and family was mentioned (n=6).
Several children had problems with aggression (n=4). Open answers manifested concerns about other healthcare professionals encountering and child´s follow-up-care plan (n=4). Bear minimum were mentioned of eating problems (n=1), multicultural family (n=2) and self-harm (n=1).
KUH professionals related their experiences of the VC topic
“..the challenging regulation and sensory dilemmas of a one-year-old child, which are reflected in the early interaction with the parent as a stress factor and, if they continue, would
jeopardize the development of the child's skills”..
“..The situation of a 1.5-year-old child and family. No developmental concern for the child nor the symptoms, but the overall family situation is challenging..”
“..3-year-old twins, big behavior regulation problems. As a question of how to continue working at the primary care..”
Based on KUH professionals´ responses with 52% (n=22) did not avoid travelling due to the VC. A little over half of the professionals´ had to travel because of the meeting. Around 41%
(n=17) one person was able to avoid travelling due to the VC and with lowest portion of 7,1%
(n=3) two person were able to stay at work due to the VC meeting.
Table 5. How many KUH clinic/hospital school professionals avoided traveling due to
the VC
Quantity % N
Nobody 52,4% 22
1 40,5% 17
2 7,1% 3
3 0,0% 0
4 0,0% 0
5 0,0% 0
According to primary care professionals´ responses about avoiding traveling due to VC.
Overall, they had greater advantage utilizing VC services. One third of 31,9% (n=15) responses states that one person was able avoid traveling due to the VC. With 23,9% (n= 11) two persons were able to refrain from traveling. A little less with 19.1% (n=9) three persons were able to avoid traveling because of VC. With 14,9% (n=7), five persons were able to benefit from VC and did not had to travel. With 8,5% (n=4), nobody had travel and with the lowest proportion, with 2,1% (n=1) four persons were able to avoid traveling due to VC meetings. Based on primary care professionals´ responses shows that the mean traveling duration was approximately 46,56 kilometers (SD=40,81) between facilities from Kuopio child´s psychiatry clinic and primary care clinics.
Table 6. How many primary care professionals´ avoided traveling due to VC?
Quantity % N
Nobody 8,5% 4
1 31,9% 15
2 23,4% 11
3 19,1% 9
4 2,1% 1
5 14,9% 7
There was also a desire to know the part of patient´s relative traveling. Primary care professionals were asked about how many family members were able to avoid traveling because of VC. An overwhelming majority of almost 70,7% (n=29) no family avoided traveling because of VC. With 12,2 % (n=5) one or two family member were able to avoid traveling. With 2,4%
(n=1) three or five family member were able to avoid traveling because of utilizing VC services.
Table 7. How many family members avoided traveling because to VC?
Quantity % N
Nobody 70,7% 29
1 12,2% 5
2 12,2% 5
3 2,4% 1
4 0,0% 0
5 2,4% 1