Care-experienced young people's views and experiences of accessing general practice and dental services and attending health reviews in England: a qualitative study.
Dental practice
General practice
Looked after
Out-of-home care
Primary care
Journal
BMC primary care
ISSN: 2731-4553
Titre abrégé: BMC Prim Care
Pays: England
ID NLM: 9918300889006676
Informations de publication
Date de publication:
29 Aug 2024
29 Aug 2024
Historique:
received:
11
04
2024
accepted:
09
08
2024
medline:
31
8
2024
pubmed:
31
8
2024
entrez:
29
8
2024
Statut:
epublish
Résumé
Children in care and care leavers have worse health outcomes than their peers without care experience. This study addresses an evidence gap in exploring care-experienced young people's views and experiences of accessing general practice and dental services and attending health reviews in England. We conducted a qualitative study using podcasting as a creative medium. We recruited young people from two sites: one in South England (A) and one in greater London (B). We held two paired discussions in site A and two focus groups in site B, with 14 participants in total. Participants were aged between 13 and 22 years and were diverse in gender, ethnicity, and care experiences. Data were analysed thematically using candidacy theory as a theoretical framework. Mental health was a prevailing concern for participants, but general practice was not considered a place to discuss it. Most participants reported distant relationships with primary healthcare professionals and considered opening-up to a professional to be risky, for example, it could result in an unknown/unwanted outcome. A lack of time and personal connection in appointments, and experiences of feeling judged, dismissed, or misunderstood, hindered young people's ability to disclose mental health or relationship concerns. Participants reported variation in the timeliness and location of services, with salient examples of extensive waiting periods for braces. Participants perceived annual health reviews to be largely inconsequential. Any primary care presentation by a care-experienced young person should trigger additional professional curiosity. To build rapport and trust, professionals should not underestimate the power of active listening, being reliable and honest, and small acts of thoughtfulness, for example, ensuring medical letters are provided promptly. Carers and other trusted professionals should help care-experienced young people to understand the role of primary care and support them with access. Health reviews may not be of value to all young people in care. Further research is needed to examine primary healthcare access for care-experienced young people with significant safeguarding and healthcare needs.
Sections du résumé
BACKGROUND
BACKGROUND
Children in care and care leavers have worse health outcomes than their peers without care experience. This study addresses an evidence gap in exploring care-experienced young people's views and experiences of accessing general practice and dental services and attending health reviews in England.
METHODS
METHODS
We conducted a qualitative study using podcasting as a creative medium. We recruited young people from two sites: one in South England (A) and one in greater London (B). We held two paired discussions in site A and two focus groups in site B, with 14 participants in total. Participants were aged between 13 and 22 years and were diverse in gender, ethnicity, and care experiences. Data were analysed thematically using candidacy theory as a theoretical framework.
RESULTS
RESULTS
Mental health was a prevailing concern for participants, but general practice was not considered a place to discuss it. Most participants reported distant relationships with primary healthcare professionals and considered opening-up to a professional to be risky, for example, it could result in an unknown/unwanted outcome. A lack of time and personal connection in appointments, and experiences of feeling judged, dismissed, or misunderstood, hindered young people's ability to disclose mental health or relationship concerns. Participants reported variation in the timeliness and location of services, with salient examples of extensive waiting periods for braces. Participants perceived annual health reviews to be largely inconsequential.
CONCLUSIONS
CONCLUSIONS
Any primary care presentation by a care-experienced young person should trigger additional professional curiosity. To build rapport and trust, professionals should not underestimate the power of active listening, being reliable and honest, and small acts of thoughtfulness, for example, ensuring medical letters are provided promptly. Carers and other trusted professionals should help care-experienced young people to understand the role of primary care and support them with access. Health reviews may not be of value to all young people in care. Further research is needed to examine primary healthcare access for care-experienced young people with significant safeguarding and healthcare needs.
Identifiants
pubmed: 39210261
doi: 10.1186/s12875-024-02569-0
pii: 10.1186/s12875-024-02569-0
pmc: PMC11360303
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
318Subventions
Organisme : National Institute of Health and Care Research
ID : PR-PRU-1217-21301
Organisme : National Institute of Health and Care Research
ID : PR-PRU-1217-21301
Organisme : National Institute of Health and Care Research
ID : PR-PRU-1217-21301
Organisme : National Institute of Health and Care Research
ID : PR-PRU-1217-21301
Organisme : National Institute of Health and Care Research
ID : PR-PRU-1217-21301
Informations de copyright
© 2024. The Author(s).
Références
Health Soc Care Community. 2022 Jul;30(4):e1406-e1414
pubmed: 34411355
Trauma Violence Abuse. 2021 Apr;22(2):265-276
pubmed: 31043121
J Public Health (Oxf). 2023 Nov 29;45(4):863-869
pubmed: 37525519
BMC Fam Pract. 2013 Dec 30;14:202
pubmed: 24373254
BMC Med Res Methodol. 2006 Jul 26;6:35
pubmed: 16872487
J Intellect Disabil Res. 2016 Jun;60(6):571-82
pubmed: 27097932
Child Abuse Negl. 2017 Mar;65:212-225
pubmed: 28189959
BMC Health Serv Res. 2019 Apr 29;19(1):269
pubmed: 31035997
Epidemiol Psychiatr Sci. 2023 May 16;32:e35
pubmed: 37190768
J Immigr Minor Health. 2020 Feb;22(1):156-174
pubmed: 31444614
J Gen Intern Med. 2019 Jun;34(6):1048-1052
pubmed: 30912031
BMC Health Serv Res. 2019 Mar 28;19(1):195
pubmed: 30922372
BMJ Open. 2024 May 30;14(5):e081620
pubmed: 38816045
Trauma Violence Abuse. 2022 Jan;23(1):255-264
pubmed: 32686611
Soc Psychiatry Psychiatr Epidemiol. 2021 Jul;56(7):1115-1145
pubmed: 33779782
Pediatrics. 2015 Oct;136(4):e1142-66
pubmed: 26416934
Arch Dis Child. 2023 Oct;108(10):783-788
pubmed: 36650031
BMC Med Educ. 2018 Dec 20;18(1):315
pubmed: 30572900
Acta Paediatr. 2016 Apr;105(4):416-20
pubmed: 26684221
Child Care Health Dev. 2017 Mar;43(2):182-191
pubmed: 27896832
J Paediatr Child Health. 2021 Jan;57(1):132-139
pubmed: 32949433
Community Dent Oral Epidemiol. 2017 Dec;45(6):529-537
pubmed: 28681920
J Trauma Dissociation. 2021 Oct-Dec;22(5):636-652
pubmed: 33446088
Dent J (Basel). 2024 Feb 08;12(2):
pubmed: 38392241
Health Expect. 2016 Apr;19(2):322-30
pubmed: 25703741
J Adolesc. 2017 Jan;54:1-8
pubmed: 27838545
Dent J (Basel). 2024 Feb 09;12(2):
pubmed: 38392242
Br J Gen Pract. 2021 Sep 30;71(711):e744-e752
pubmed: 33950851
BMC Public Health. 2020 May 20;20(1):735
pubmed: 32434479
BMJ Open. 2017 Feb 20;7(2):e014198
pubmed: 28219960
Int J Equity Health. 2013 Mar 11;12:18
pubmed: 23496984
Community Dent Health. 2023 Aug 31;40(3):154-161
pubmed: 37162290
J Health Serv Res Policy. 2002 Jul;7(3):186-8
pubmed: 12171751