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Table 1 Table of themes, categories, and codes identified by Group 1 and Group 2

From: Comparing Two Early Child Development Assessment Tools in Rural Limpopo, South Africa

Theme

Category

Code

Definition

Exemplar

Intrinsic Cultural Assumptions

Resource Management

Time Management

Describes how the tool will effect nurse’s time management in their daily practice

“We are always in a rush. It's not very practical for the clinic”

Community Health Workers

Describes involvement or training of community health workers in assessment and implementation

“We're going to need more workers. We're going to need more people to be hired.”

Financial Restrictions

Describes concerns related to costs of using the tool

“It will be a challenge buying.”

Cultural Adaptations

Language Assumption

Describes language difference between English and their native languages

“If it's changed to say, Tsonga, then people around here might understand it.”

Resource Assumption

Describes aspects of the tool that nurses cannot easily access

“We give them a stick and the children play with the mud and cup.”

Patient and Parent Factors

Perceptions of Care

Nurse’s beliefs about the attitudes of parents when they visit the clinic

“Even the mothers, when they come to the clinic, they do not give themselves time for the clinic.”

Parent-Child Perception

Nurse’s beliefs about how parents and children interact in the context of child development

“Children now a days, children are afraid of their parents.”

Enhanced Patient Interaction

Describes improved patient care due to tool utilization

“I can not hurry to take the child to give medication, I can be able to first to see that this child is normal.”

Inadequate Knowledge of Child Development Within the Community

Current Practice

Current Practice

Describes current child health assessment and referral techniques

“And when we tried to play with her, she just stared. And when we called her, she don't respond. And then I refer her to my seniors. And then they referred her to the hospital … ”

Health Knowledge Deficit

Describes known or perceived child health knowledge deficits of community members

“It is important for us to educated the home-based carer, to educate the people in the community to know the importance of child health in the community.”

Usability

Setting

Describes or compares CAT/CLAMS or ASQ usability in different settings

“Once a person gets to understand perfectly it can be very practical, especially in [pediatric] wards. Here nurses, we are always looking at the time.”

Scoring

Describes difficulty with scoring the tool

“I think that's the complicated part, the scoring.”

Documentation

Describes difficulty with documenting child development assessment

“It is too much for the grannies, these old aged people will not be able to fill out the forms.”

Usability

When nurses directly address the usability of the tool

“It's very easy and practical.”

New Knowledge

New Knowledge

Describes skills or learning from training that can be used on patients

“Today I am learning so then after that, I can assess the sickness.”

Secondary Outcomes

Describes benefits of assessment tool to areas other than child development

“I think it's going to help because they don't bring the child generally, they only bring the child when it is critically ill.”