Disabled children and adolescents may be outsiders in the community.

BACKGROUND: Most children with neurogenic bladder and bowel dysfunctions suffer from myelomeningocele and shunted hydrocephalus. Fewer such births and better treatment have led to more children reaching adulthood. Increased knowledge about their lived experiences can direct support to help them. AIM: The study aims to investigate how children and adolescents aged between 10 and 18 years old with neurogenic bladder and bowel dysfunction live their everyday life. METHODS: Hermeneutic phenomenology was appropriate to investigate the participants' experiences in depth. Thirteen qualitative interviews were analysed by coding line-by-line in order to find the essence and themes that underpin their responses. FINDINGS: The major theme being an outsider in the community, was built upon the themes, constraint and togetherness. Constraint was caused by their need for regular clean intermittent catheterization, bowel movement, aids and assistance from others, which identified a participant as being an outsider. They were only partially outsiders because they were inside the community and they enjoyed togetherness in their everyday life from their families, peers and other significant people. They appeared to be rather unaware of their problems. LIMITATIONS: The wide range of participants' ages was a limitation, as these young people develop a great deal between these ages; in order to guarantee confidentiality, the participants were too few to divide into groups. CONCLUSIONS: These young people would be helped if supported more towards independence by people inside their circle. Today, support is usually given by personal assistants and by the use of advanced techniques. Less support is given for development towards independence. Competent health-care professionals working together with the parents should have the opportunity to provide such valuable support.

How child health care nurses view a mother-infant relationship. A qualitative study.

Too many children in Sweden grow up under difficult circumstances. Every child should have the opportunity to grow up to be a confident person. We know today that the new-born child is able to influence its surroundings. The main purpose of child health care in Sweden is to reduce mortality, morbidity and disability in children, and also to reduce any detrimental effects on the family. Child Health Care (CHC)-nurses provide community and security for parents and children in developing relationships. The aims of this study were to identify how CHC-nurses view a mother-infant relationship, and how they can improved this relationship. Ten CHC-nurses were interviewed about mother-infant relationships. Verbatim transcripts were analysed using constant comparative analysis. The emerging core category was interplay. Under this construct there were two categories; maternal ability and signals from the infant. Different substantive codes were given under these categories, viz. body language, vocal language, poor health, expectations and life situation. In describing how to improve the mother-infant relationship, promoting an understanding of interplay was the core category. Three categories/strategies were perceived; visualize, respect and demonstrate. The results were then compared with the literature. This study indicates that interplay is of greatest importance in a mother-infant relationship.

Maternal expectations of the child health nurse.

The main aim of this study was to identify what first-time mothers in Sweden expected of Child Health Nurses. A further aim was to investigate what help and support was received by the new mothers and whether they felt that anything was missing. Twenty new mothers were interviewed according to grounded theory and the data were analyzed by the constant comparative method. It was found that first-time mothers expected Child Health Nurses to have faith in a new mother's own strength and to be accessible, approachable and knowledgeable, providing advice and support. New mothers indicated that they had experienced most of these characteristics, especially accessibility and approachability, but some felt that there were deficiencies (e.g. a lack of continued interest in their own bodies and health, as well as a lack of support when they ceased to breast-feed). The Child Health Service was taken for granted by new mothers. First-time mothers indicated that they appreciated the service, particularly those mothers who did not have a good social network. However, some of the new mothers expressed negative feelings regarding the Child Health Service provided.