The consultation as an interpretive dialogue about the child's health needs

Background. Though uniquely placed in the health care system, GPs only become aware of a small number of children with behavioural and emotional problems. Research evaluating the challenges and barriers in general practice for identifying children with problems is therefore important. Objectives. To identify and articulate GPs’ experiences and perceptions of the GP–parent dialogue about children’s health problems, in order to broaden our understanding of the challenges inherent to the dialogue. Methods. The GPs’ experiences and recollections were explored in a qualitative study comprising four focus group discussions and nine individual interviews. The focus of study was to explore GP consultations with children 0–5 years of age and their parent/s. Results. Though expressing a family-focused approach to the child consultation, the GPs often did not succeed in making the consultation family focused. The analysis revealed that the GPs often were ‘stuck’ in the traditional role of expert and this made it difficult for them to explore the child’s well-being. The consultation became more family focused when the GPs moved away from the role of expert. The GPs experienced that by sharing their uncertainty with parents, they often got more insight into the child’s everyday life and family circumstances. Conclusion. The study indicates that through open reflective dialogue the GP is able to assess the child and strengthen mutual trust in the doctor–parent relationship to the benefit of children with special needs