Burdened Children as Next of Kin and the General Practitioner

Sub study 1, qualitative analysis of data from focus group interview with GPs on their experiences in caring for children as next of kin to parents with mental health illness, substance abuse or serious somatic illness, is completed and the article is published in Scandinavian Journal of Primary Health Care February 2014. The GPs were in a good position to identify the children, give the parents support and help the children in participating in multidisciplinary collaboration. They told about barriers to help these children within the frames of the consultation, and many avoided to mention the children's situation in the consultations being afraid the doctor-patient rapport could be destroyed. We found it most convenient to interview the children (sub study 3) before the parents (sub study 2). For ethical reasons we recruited from existing support groups for children as next of kin. The leaders got consent from the children and parents (for children younger than 16 years) for the group to participate. It turned out to be difficult to recruit younger children; the parents said their children had enough burdens. We got 20 participants 6-25 years of age. Focus group interviews were done May 2013 to March 2014, analysis is done and the article was published in Scandinavian Journal of Primary Health 2016. Data for sub study 2 was semi structured interviews with parents in the target group about what they consider as good GP service to their children. The participants were recruited by their GPs. We have done 12 interviews, and we consider this to be enough data to get valid results. The analysis is done and the article was published in BMC Family Practice 2016. The winter 2015 we prepared a survey, sub study 4, who was send as quest back to all Norwegian GPs April 2015. The analysis is going on, and we plan til submit the article to an international peer reviewed journal March 2017. The research group meet ca. every second month, and the international network every half a year. The research student had one month?s study stay at Department for General Practice at the University of Melbourne October 2014, and established contacts with researcher in the department and COPMI (Children of Parents With Mental Illness). She took part and had a presentation at a research seminar arranged by COPMI in Prato June 2015. Members of the research group are regularly in contact with researchers at Department for Research in General Practice at the University of Copenhagen who have children in general practice as their research topic, exchanging experiences both substantially and methodologically. -

Children of parents suffering from mental health illnesses, substance abuse or severe somatic illnesses are vulnerable and at risk of psychosocial and somatic illnesses. In addition they often tell about stigma, shame and fear, feelings of responsibility, loneliness, and depression during childhood. They are in need of coordinated and comprehensive care, with a solid base in primary care. Little is known about how the general practitioners can contribute in identifying and establishing well-functioning su pport for these children and their families. The objective of this researcher project is to generate knowledge on how general practitioners can aid children as next of kin. This topic will be addressed seen from the perspective of three groups: the burde ned children, their parents, and the general practitioners. Data will be collected from focus group interviews with children as next of kin 10-15 years of age and experienced general practitioners, in-depth interviews with parents from the target groups a nd a e-mail based survey to all registered Norwegian general practitioners based on the hypotheses from the results of the analyses of the qualitative data. The qualitative data will be analysed by means of a phenomenological approach by a four step proce dure developed by Malterud. The quantitative data will be analysed using appropriate statistical methods. The results of these studies will lay a scientific ground for developing specific tools and guidelines for how general practitioners can aid children as next of kin where the perspectives of the children and parents are central. To meet the special needs of these children, health promotion and disease prevention are of great importance. The project group is interdisciplinary and international, althoug h the core group is based in Norway. In a later project, not within this grant application, we plan intervention studies in general practice to evaluate the effect of these guidelines and tools.