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Working in Partnership in the Antenatal Period
What do child and family health nurses do?
Lynn Kemp
Acting Director, CHETRE, Liverpool Hospital, and Research Centre for Primary Health Care & Equity, University of New South Wales, Liverpool NSW
Lisa Eisbacher
Sydney South West Area Health Service (SWAHS), Sydney NSW
Lisa McIntyre
Sydney South West Area Health Service (SWAHS), Sydney NSW
Kerry O'Sullivan
Sydney South West Area Health Service (SWAHS), Sydney NSW
Jane Taylor
Sydney South West Area Health Service (SWAHS), Sydney NSW
Trish Clark
Sydney South West Area Health Service (SWAHS), Sydney NSW
Elizabeth Harris
CHETRE, UNSW Research Centre for Primary Health Care & Equity, University of New South Wales, Liverpool NSW
Abstract
Background
There is strong evidence that comprehensive sustained home visiting
programs, commencing antenatally can improve child and maternal
outcomes for vulnerable families. Community child and family health
nurses, who traditionally engage with families post-birth, are well
placed to provide interventions in the antenatal period. There is,
however, little information on what home visiting nurses do,
particularly in the antenatal period. An Australian trial of sustained
nurse home visiting provides the opportunity to explore what child and
family health nurses actually do in this new area of antenatal
intervention.
Method
Nurses completed a checklist following each home visit detailing the
interventions undertaken. Descriptive analysis was undertaken to
describe the frequency of each of interventions. Factor analysis was
undertaken to group the interventions into clusters. Further analysis
was undertaken to determine if the clusters of interventions were
associated with the frequency of home visits or characteristics of the
mothers/families.
Result
Four clusters of interventions were identified: comprehensive range
of physical and psychosocial care for most families; ongoing management
of lower risk needs for mothers who were young, unsupported or had a
history of mental health problems; preventive care for first-time
mothers; and management of high risk needs (drugs and alcohol and
domestic violence) in conjunction with other professionals.
Discussion and conclusion
The interventions undertaken reflect the conceptual framework of the
program. Nurses are delivering a comprehensive range of physical and
psychosocial care to most women and families in the antenatal period,
with some groups of women receiving additional support related to
differing areas of needs.
Keywords
child and family health nursing, home visiting, antenatal intervention
References
Carr SM (2001) Nursing in the community - impact of context on the practice agenda, Journal of Clinical Nursing 10: 330-336.
Darbyshire P and Jackson D (2004) Children, families and nursing: spotlights, shadows and places in between, Contemporary Nurse 18(1-2): viii-xii.
Davis H and Spurr P (1998) Parent Counselling: an Evaluation of a Community Child Mental Health Service, Journal of Child Psychology and Psychiatry and Allied Disciplines 39: 365-376.
Elkan R, Kendrick D, Hewitt M, Robinson JJA, Tolley K, Blair M, Dewey M, Williams D and Brummell K (2000) The effectiveness of domiciliary health visiting: a systematic review of international studies and a selective review of the British literature, Health Technology Assessment 4(13): 1-339.
Gomby DS (1999) Understanding evaluations of home visitation programs, The Future of Children 9(1): 27-43.
Hanks CA and Smith J (1999) Implementing nurse home visitation programs, Public Health Nursing 16(4): 235-245.
Hebbeler KM and Gerlach-Downie SG (2002) Inside the black box of home visiting: a qualitative analysis of why intended outcomes were not achieved, Early Childhood Research Quarterly 17: 28-51.
Jack G (2000) Ecological influences on parenting and child development, British Journal of Social Work 30: 703-720.
Kemp L, Anderson T, Travaglia J and Harris E (2005) Sustained nurse home visiting in early childhood: exploring Australian nursing competencies, Public Health Nursing 22(3): 254-259.
MacLeod J and Nelson G (2000) Programs for the promotion of family wellness and the prevention of child maltreatment: a meta-analytic review, Child Abuse and Neglect 24: 1127-1149.
McNaughton DB (2000) A synthesis of qualitative home visiting research, Public Health Nursing 17(6): 405-414.
McNaughton DB (2004) Nurse home visits to maternal-child clients: a review of intervention research, Public Health Nursing 21(3): 207-219.
Olds DL, Eckenrode J, Henderson CR, Kitzman H, Powers J, Cole R, Sidora K, Morris P, Pettitt LM and Luckey D (1997) Long-term effects of home visitation on maternal life course and child abuse and neglect - fifteen-year follow-up of a randomized trial, Journal of the American Medical Association 278(8): 637-643.
Roggman LA, Boyce LK, Cook GA and Jump VK (2001) Inside home visits: a collaborative look at process and quality, Early Childhood Research Quarterly 16: 53-71.
Tabachnick BG and Fidell LS (2001) Using Multivariate Statistics 4th edn, Needham Heights MA: Allyn & Bacon.
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