Child health service's response to early feeding and behaviour problems: changes in parental perceptions 1970-93

Objective: This health systems study was done to measure changes over time concerning parents' perceptions of feeding and behavioural problems in chil dren 6-18 mo of age, parents' willingness to use child health services and their evaluation of the advice received. Method: The study had a repetitive cross-sectional design. Three largely identical surveys were performed in 1970, 1988 and 1993. Questionnaires were sent to a random sample of all par ents of children 6-18 mo living in Uppsala, Sweden. Results and conclusions : The frequency of different perceived feeding and/or behavioural problems was stable or declined between 1970 and 1988, but increased in 1993. For mo st problems, inclination to seek help and perceived benefit of advice decre ased between 1970 and 1988, but increased again in 1993. The parents sought more help and perceived the advice they received as more beneficial when t he service was in the hands of paediatric nurses (1970) or of district nurs es focusing on the care of infants and preschool children (1993) than when the district nurses also had responsibilities for adults and the elderly (1 988). No correlation was seen with societal and sociodemographic trends. Al though the cross-sectional (hence non-experimental) design of the study mak es it impossible to prove causality, the findings suggest that parents' wil lingness to use the child health service and their evaluation of that servi ce may depend in part on organization, including the degree to which nurses with "first-line" contacts are focused on paediatric services.