Pflegekinderhilfe in der Sozialen Arbeit

Foster child support is an expanding field of work: In youth welfare offices and the foster child services of independent institutions, in guardianship, expert assessments and family courts, specialists have to deal with the key questions relating to foster child support. In addition, there are the people affected: foster children, parents and foster parents, siblings and other family members. This book provides a well-founded introduction to this subject area and links important practical issues to international research findings. It analyses current developments in this respect in Germany, Austria and Switzerland and illustrates the variety of forms of care relationships with case studies. In this way, the importance of professional services and the courses of action open to them become clear.

Community Based Study of Awareness of Maternity Dangers Amongst Rural, Tribal Preconception and Pregnant Women

Background: Every pregnant woman faces risk of complications which can cause severe illness or even death of mother and /or baby. Creating awareness about maternity dangers is crucial for safe birth, safe future of mother and baby. Although it remains unclear how awareness translates into appropriate actions, chances of better outcome are there. Objectives: Community based study was carried out to know about rural, tribal preconception and pregnant women’s awareness and perceptions of maternity dangers. Material and Methods: After approval of institute’s ethics committee, study was conducted in tribal communities of 100 villages of hilly forestry region, where mother child services were initiated after creating health facility in one village. Randomly minimum 20 and 10 preconception, pregnant women each, from every village, total 2400 preconception, 1040 pregnant women of 15 to 45 years age were interviewed by research assistant with help of pretested tool. Results: Of 2400 Preconception women interviewed, 801 (33.4%) were aware of labour events, 298 (37.2%) mucoid discharge, 291 (36.3%) little bleeding, 212 (26.5%) labour pains. When asked about source of information, 300 (37.5%) said doctors, 291 (36.3%) Accredited Social Health Activists (ASHAs) and 210 (26.2%) nurse. Of 2400 preconception women, 1015 (42.29%) did talk of some maternity dangers, 403 (39.7%) said swelling over face and feet, 271 (26.7%) giddiness, 184 (18.13%) excessive vomiting and 157 (15.47%) bleeding, leaking with some overlap. Of 1040 pregnant women, 910 (87.5%) were aware of labour events and 870 (83.7%) some maternity dangers, 474 (54.5%) preterm pains, 118 (13.5%) leaking, 97 (11.1%) epigastric pain, 73 (8.4%) headache, 67 (7.7%) vaginal bleeding and 41 (4.7%) loss of fetal movements with some overlap. Conclusion: Only one third preconception and little more pregnant women had some awareness of maternity dangers, but it was scatchy.

Mapping Evidence of Impacts of COVID-19 Outbreak on Sexual and Reproductive Health: A Scoping Review

Introduction: The emergence of the coronavirus disease 2019 (COVID-19) pandemic has rapidly transformed the pre-existing worldwide sexual and reproductive health environment. The provision and supply of contraceptives, and a wide variety of sexual health, new-born, and maternal health services have been seriously affected. Thus, this scoping review mapped the available evidence on the impacts of the COVID-19 outbreak on sexual and reproductive health. Methods: Arksey and O’Malley’s methodological framework guided this scoping review. A search was conducted from the following databases: Embase, PubMed, CINAHL, Scopus, WOS, and AJOL. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) chart and PRISMA extension for scoping reviews (PRISMA-ScR) checklist were used to document the review process. The McMaster critical review checklist was used to determine the quality of the included studies. Thematic analyses were conducted using NVivo version 12. Results: Three studies showed evidence on the impact of COVID-19 and family planning services, six studies reported on maternal and child services and eleven studies reported on sexual health (sexual behavior). Limited access to family planning use, reduction in multiple sexual partnership, decreased transactional sex, and maternal and child services disruption were some impacts reported in the included studies. Conclusion: This study has demonstrated the impacts of COVID-19 on family planning access, multiple sexual partnership, transactional sex, and disruption of maternal and child health services. Interventions that will consider the immediate availability of and access to all sexual and reproductive health services should be prioritized.

599 A Retrospective Outcome Analysis of the Involvement of Department of Child Services in Suspected Cases at a Major Regional Pediatric Burn Center

Introduction Cases of child abuse are an important manifestation of pediatric burns owing to their nature and all too common occurrence. In our institution, the Department of Child Services (DCS) is often frequently involved in minimally suspicious cases in conjunction with or even before the internal child protective team involvement. To our knowledge, there is no recent literature evaluating the outcome of DCS involvement in suspected cases in pediatric burn populations. Methods We performed a retrospective chart analysis of the pediatric burn patient database at our institution from 2017–2020. We identified 116 out of 565 patients who matched our criteria for the involvement of DCS. We collected the following information: age, race, address at time of injury, payer source, where DCS involvement was initiated, and the outcome of the investigation. Results We found that 20.5 % of all the pediatric burn patients admitted from 2017–2020 had DCS involvement. Of the total admitted patients only 3.8% were removed from the previous caregivers. The factors that were found to be statistically significant were male sex, age under 3 years, Caucasian child with single parent and living in an urban setting. A higher incidence was noted in the capital city area compared to the rest of the state. There was no statistical difference noted among races, location of DCS notification, and payer source. Conclusions We conclude that vigilance and early reporting is essential in detecting child abuse. Involvement of the multidisciplinary child protection team at our institution may reduce the burden on DCS. Screening out high risk factors such as age less than 3 years old, male sex, and single parent of Caucasian race may assist in detecting the non-accidental burn victims. We will target prevention educational outreach programs to the community to decrease the occurrence of child abuse in the future.

Racial and Socioeconomic Differences in Social Work and Department of Child Services Reporting Patterns for THC Positive Pregnant Women

Background and Hypothesis: Tetrahydrocannabinol (THC) is the most commonly used illicit substance during pregnancy. Little research, most with conflicting data, exists on its impact on the developing fetus or birth outcomes. Reporting THC positive urine drug screen (UDS) to social worker (SW) has been left to provider discretion. Similarly, SW has discretion in reporting to Department of Child Services (DCS) if the newborn tests negative for drugs at birth. We hypothesize that there are racial and socioeconomic differences in reporting patterns that result in non-white and publicly insured patients being reported to SW or DCS at higher rates than white or privately insured patients. Methods: Data were collected via Cerner and CareWeb chart abstraction of patients who delivered at IU Health hospitals between 1/1/16 to 12/31/17 and tested positive for THC, but no other drugs, during any stage of pregnancy. Data was entered into the secure and encrypted Redcap database. Demographic variables included mother’s age, race, ethnicity, insurance type, and number of previous pregnancies. Descriptive statistics were calculated for demographics by overall, SW, and DCS referral. p-values were calculated using Fisher’s Exact Test for small sample sizes and considered significant at the 0.05 level. The effects of age and number of previous pregnancies were analyzed using two-sample t-test for equal variances. Results: 152 patients met inclusion criteria for the analysis. The study population was mostly white (68.4%) and black (30.3%). Their insurance type was 74.3% public, 17.8% private, and 7.9% uninsured. The vast majority of cases were referred to SW (90.8%) and DCS (87.7%). Neither patient race nor insurance were associated with referral to SW (p=.80, p=.79) or DCS (p=.30, p=.25). Conclusion: There was no statistically significant association between demographic characteristics and referral patterns, though the study may be underpowered due to low non-referral rate. Addition of 2018-2019 data are planned.

The transition from children’s services to adult services for young people with attention deficit hyperactivity disorder: the CATCh-uS mixed-methods study

Background Attention deficit hyperactivity disorder was previously seen as a childhood developmental disorder, so adult mental health services were not set up to support attention deficit hyperactivity disorder patients who became too old for child services. To our knowledge, this is the first in-depth study of the transition of attention deficit hyperactivity disorder patients from child to adult health services in the UK. Objectives Our objectives were to explore how many young people with attention deficit hyperactivity disorder are in need of services as an adult, what adult attention deficit hyperactivity disorder services are available and how attention deficit hyperactivity disorder stakeholders experience transition from child to adult services. Design An interactive mixed-method design was adopted with three study streams: (1) a 12-month surveillance study with 9-month follow-up to find out how many young people required ongoing medication when they were too old for child services (929 surveys completed by children’s clinicians); (2) a mapping study to identify and describe services for young adults with attention deficit hyperactivity disorder (2686 respondents to online surveys for patients and health workers and freedom of information requests to service providers and commissioners); and (3) a qualitative study to explore key stakeholders’ experiences of transition from child to adult services (144 interviews with 64 attention deficit hyperactivity disorder patients, 28 parents and 52 health clinicians; 38 working in child or adult secondary health services and 14 general practitioners). Members of the public advised at each stage of the study. Results When corrected for non-response and case ascertainment, the annual number of young people with an ongoing need for medication for attention deficit hyperactivity disorder lies between 270 and 599 per 100,000 people aged 17–19 years. Among 315 individuals eligible for transition, 64% were accepted, but only 22% attended their first adult services appointment. Our interactive map describes 294 unique services for adults with attention deficit hyperactivity disorder across the UK, of which 44 are ‘dedicated’ attention deficit hyperactivity disorder services. Few services provide the full range of recommended provision; most focus on diagnosis and medication. Services are unevenly distributed across the UK, with nearly all ‘dedicated’ services being in England. Exploring stakeholders’ experiences revealed how invested the stakeholders are in continuing attention deficit hyperactivity disorder treatment and how the architecture of services affects transition. An association between attention deficit hyperactivity disorder, education and continuance of medication into young adulthood, plus parent involvement and feeling prepared for transition and adult life with attention deficit hyperactivity disorder, influenced investment. However, even with investment, how accessible adult services are, how patient needs fit with the remit of the adult service and the level of patient information available affect transition outcomes. The results also highlight how general practitioners can end up as care co-ordinators during transition by default. Limitations Transition estimates were based on those who want medication, so these indicate a minimum level of need. Conclusions Few of those who need ongoing support for attention deficit hyperactivity disorder successfully transfer to adult services, and a small proportion of those who transfer experience optimal transitional care. Adult attention deficit hyperactivity disorder service provision is patchy. Even among ‘dedicated’ services, few provide the whole range of National Institute for Health and Care Excellence-recommended treatments. Future work We need to evaluate various models of transitional care and adult attention deficit hyperactivity disorder provision, as well as develop and evaluate psychosocial interventions for young people and adults with attention deficit hyperactivity disorder. Trial registration Current Controlled Trials ISRCTN12492022. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 42. See the NIHR Journals Library website for further project information.

Evaluation of patient satisfaction with the quality of maternal and child services of health facilities in Ile-Ife, Osun State

Background/Aims An evaluation of patient satisfaction of the quality of healthcare facilities and services provides feedback to enhance improved service delivery. Patient satisfaction with care has been identified as one of the essential elements of quality care, which can be used to determine the quality of care being rendered in health centres. This study aimed to assess patient satisfaction with maternal and child services in health facilities in Ile-Ife, Osun State, Nigeria. Methods A quantitative cross-sectional study was carried out in Ile-Ife, Osun State, in all seven secondary health facilities and 45 selected primary healthcare centres. A total of 330 nursing mothers with babies aged 0–1 years old were selected through simple random sampling. A self-developed, structured, pre-tested satisfaction survey based on Donabedian and Linder-Pelz satisfaction model was used to explore nursing mothers' satisfaction with maternal and child healthcare services and the determinants of satisfaction. Data were analysed using descriptive statistics and t-tests at a significance level of 0.05. Ordered logistic regression was used to establish the significance of association between sociodemographic characteristics and satisfaction. Results The majority of clients were satisfied with maternal and child services in primary (76.7%) and secondary (55.1%) healthcare facilities, respectively. There was a significant difference between satisfaction at primary and secondary healthcare centres (P=0.012). The marital status and number of pregnancies of participants were significant determinants of clients' satisfaction with secondary healthcare facilities (P=0.035 and P=0.013, respectively). Conclusions There is high patient satisfaction with maternal and child healthcare services in both primary and secondary healthcare facilities in Ile-Ife. The majority of the health facilities have inadequate personnel for maternal and child healthcare services, which is one of the major factors contributing to high maternal and infant morbidity and mortality in Nigeria. However, many of the respondents may not have ever experienced high-quality services. Stakeholders in maternal and child services should improve on areas where poor satisfaction was reported.