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Participants noted several limitations to safety netting including not knowing if it has been understood by parents or been effective; parental difficulty interpreting information and desire for face-to-face reassurance; and potential over-reassurance.
Health provider factors that have been associated with increased immunization drop-out rates include parental difficulty of access to healthcare services and inadequate supervision of healthcare staff at health facilities [ 4- 6, 8].
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Prolonged separation between parents and infants is believed to enhance parental difficulties in caring for their infant with implications for the parent-infant attachment relationship [ 49].
The authors set out the main parental difficulties or concerns encountered.
Parental difficulties in adequately caring for their children may develop into chronic stress factors, leading to psychoneuroimmunological dysfunction, which plays a significant role in the development of non-atopic asthma (Kaugars, Klinnert, & Bender, 2004).
The items in the parental version include difficulty eating, difficulty playing, difficulty speaking, difficulty sleeping, avoiding smiling due to pain, avoiding smiling due to appearance and affected self-confidence.
The KPCS tool, a 15-item perceived parental self-efficacy measure, is useful clinically in screening for parenting difficulties, targeting interventions and evaluating outcomes [ 64].
Children's behavior problems and parental adjustment difficulties tend to co-vary.
None of the respondents were screened in Path D for parental communication difficulties.
Parental socioeconomic difficulties due to prolonged unemployment or loss of income are also associated with increased addictive behaviours such as alcohol dependence and alcoholism, and family violence [ 13] which in turn increase the risk of children living in such family environments to develop poor mental and physical health in adulthood [ 21- 23].
Scoring of the PEDS categorizes children into one of fives paths: Path A: high risk for developmental problems Path B: moderate risk for developmental problems Path C: low risk for developmental problems but elevated risk for behavioural/emotional problems Path D: parental communication difficulties Path E: low risk of developmental and behavioural/emotional problems.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com