Moules and Ramsay (1998) identify many areas for child health promotion. This includes smoking, exercise, diet and nutrition, sexual health, dental health, skin care and the sun, accidents, alcohol and drug abuse. As with the other branches of nursing, health promotion can take forms of primary, secondary or tertiary intervention. Interventions may depend on the age of the child. Younger children, for example pre school aged children will benefit form health promotion aimed at the parents. Health promotion activities may include: •Assessing needs
•Social support: providing support by creating groups, counselling sessions and creating opportunities for listening and building friendships •Providing education through different medians
•Detection of disorders and health problems via screening programmes •Providing practical help :providing access to information and knowledge, for example legal and economic advice •Community projects and community development
As children’s health is determined by a wide range of factors, addressing the wider determinants of health is viewed as been effective health promotion. Whichever method used the child’s health needs to be viewed holistically, Hall and Elliman (2003).
Explore issues of consent: Fraser Guidelines/ Gillick competencies
Caulfield (1996) p287, Individuals over eighteen years who have the mental capacity can make their own decisions regarding health care. The Family Law Reform Act also allows young people of the age sixteen to eighteen to also make their own decisions. Consent issues become more complex when dealing with individuals under the age of sixteen. National Society for the Prevention of Cruelty to Children NSPCC (2009) state Gillick competency and Fraser guidelines are used to assess whether a child under the age of sixteen is competent and mature enough to make their own decisions and understand the consequences of their decision regarding health care. The guidelines originated after a legal case between Victoria Gillick and her local health authority. Gillick took the authority to court in order to prevent her daughter under the age of 16 being able to receive contraceptive treatment and advice without parental consent. Gillick lost the case. In 1985 Lord Fraser produced guidelines specifically for contraceptive advice and treatment which stated treatment could be given to children under the age of 16 providing the advice was understood. Advice and treatment could be provided if the professional was unable to persuade the child to discuss contraception with their guardians, sexual intercourse would continue without contraception, mental and physical health may become at risk and it was in the young person’s best interest to receive contraceptive advice. Caulfield (1996) p287, If the child is assessed as being competent they have the right to consent. If the child is viewed as incapable of giving consent, the child’s parental guardians can do this on the child’s behalf. Conflicts can arise if the opinion of the child and guardian differ. For example, if the child is refusing treatment, parental guardians can override their child’s decision and consent to treatment. However if the difference of opinion is extreme and the health professional does not know how far the child’s wishes should be taken into account (For example refusal of life threatening surgery) a court can make the final decision. .
Explore the concept of family centred care
Mcewing, Kelsey, Richardson and Glasper (2003) p 88 identify children’s nursing to be based on a philosophy of family centred care. This approach of care focuses on the family as a whole instead of solely on the child. The nursing environment should encourage and enable the family to help care for the child. This is believed to benefit both the child and the family emotionally and physically. The family unit is maintained and it allows the parents to help...