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Table 6 Negotiating caregiver report of behavioural and family problems

From: Addressing the quality and scope of paediatric primary care in South Africa: evaluating contextual impacts of the introduction of the Practical Approach to Care Kit for children (PACK Child)

Nurse (N) or Caregiver (CG)

Nurse/caregiver talk

↑ High pitch

Underline – spoken with emphasis

[…] sequence of consultation not included

Use of PACK Child guide

N:

Is is his own mother still involved in his life?

Opens to contents page

 

(0.7)

 

CG:

↑Noo::

 

N:

[She doesn’t …]

 

CG:

[She’s her father] is her father is raising two kids of hers those two are working now. (1) Her father is also a FAS ((Fetal Alcohol Syndrome)) baby (1) I say every father gets his packet.

 

N:

Mhm

 

CG:

They gave him she had tw::o, three children minimum, by a gu:y, two boys and a a girl and she dropped the children by the father and she left (1) she’s now she is a year gone from there now.

 

N:

Mhm

 

CG:

And here he is if she comes she just come and then he fights with her (1.5) because she pu::lls him and they’ve got that anger. And and I tell her she mustn’t pull him because he don’t like people to pull him around, and she got a habit of that ‘Kom met my saam’, ‘come with me now’, you know? (1.5) so many times and I told him, ‘you mustn’t fight with a mother’ that is still your mom (1) irrespective.

 
 

(1.5)

 

N:

So you said he is got sore throat?

 
  1. In a Phase 3 facility a 12-year-old boy presents for an appointment with an ear problem. During the consultation the caregiver voluntarily discloses that the child has a history of Fetal Alcohol syndrome, takes Ritalin for behavioural problems (implying likely involvement of tertiary service because of limited access to Ritalin), and has a difficult relationship with a largely absent mother. Despite evidence that the nurse is listening to the caregiver’s concerns about family life, the nurse does not discuss the child’s use of tertiary or social services and she does not refer to the PACK Child guide which includes pages on how to manage behaviour and anger problems as well as potential child abuse