Encountering children with suspected neurodevelopmental disorders in Child Health Services: Swedish nurses' experiences.

Abstract

Purpose: To describe nurses' experiences encountering children with suspected neurodevelopmental disorders in Child Health Services.

Design and methods: This qualitative inductive study was conducted in Sweden. Twenty nurses were interviewed individually on a virtual platform using a semi-structured interview guide with open-ended and explorative questions. Interviews were audio recorded and transcribed verbatim and analyzed using qualitative content analysis.

Results: Nurses expressed responsibility for finding deviations in children but described an equilibrium of giving children time to develop without delaying referrals. Nurses had profound competence and intuition, but subjective intuition of assessment evoked a feeling of uncertainty. Nurses were sensitive and open-minded to different and contradictory parental reactions. Reactions were difficult and frustrating to manage, and communication needed to be versatile and flexible to achieve a partnership. When uncertain in an assessment they obtained complementary additional information from the child's preschool teacher. Nurses had several collaborators inside and outside the Child Health Services team and felt successful when correctly referred but frustrated with extended waiting times and protracted interplay.

Conclusions: The results suggest further education for nurses about neurodevelopmental disorders and communication tools like Motivational Interviewing. Furthermore, screening for assessing neurodevelopmental disorders, guidelines in referral management and a care coordinator for multiple referrals should be implemented.

Practice implications: Improvements in Child Health Services nurses' competence, screening methods and referral management could lead to more efficient care interventions and support that can promote health and well-being in the short and long-term for children and families.