Does customised care improve satisfaction and positively enable parents in sustained home visiting for mothers and children experiencing adversity?

Kanda, Kie; Blythe, Stacy; Grace, Rebekah; Elcombe, Emma; Kemp, Lynn

doi:10.21203/rs.3.rs-1667539/v1

Cited by 1 publication

(1 citation statement)

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“…A previous study (Kanda et al, 2022b) found that home-visiting nurses were actively engaged in ensuring the care they provided had high fidelity to the programme in terms of scheduled content but also engaged in adaptation and customization of the care based on maternal risks. Furthermore, mothers who were provided with customized care in response to their risks had a higher level of satisfaction with the care provided and a sense of enablement (Kanda et al, 2022a). It is clear that well-trained nurses have high levels of competency in creating variations of care whilst remaining true to the core elements of an evidence-based programme.…”

Section: Backg Rou N Dmentioning

confidence: 99%

‘Everything's adaptable’: A qualitative study of how nurses make decisions in sustained home‐visiting care with mothers and children experiencing adversity

Kanda

Blythe

Grace

et al. 2023

Journal of Advanced Nursing

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AimsTo explore nurse decision‐making processes in the delivery of sustained home‐visiting care for mothers of young children who are experiencing adversity.DesignQualitative descriptive research design using focus group interviews.MethodsThirty‐two home‐visiting nurses participated in four focus group interviews exploring their decision‐making in the care they provide to families. The data were analysed using a reflexive thematic analysis approach.ResultsFour steps of a recurring stepwise decision‐making process were identified: (1) information gathering; (2) exploring; (3) implementing; (4) checking. The facilitators and barriers to effective decision‐making processes were also identified and included elements relating to good relationship skills, a good attitude, high quality training and mentoring and resources.ConclusionThe findings indicate that a recurring stepwise process of decision‐making requires both analytical and intuitive approaches. The intuition required by home‐visiting nurses is to sense unvoiced client needs and identify the right time and way to intervene. The nurses were engaged in adapting the care in response to the client's unique needs while ensuring the fidelity of the programme scope and standards. We recommend creating an enabling working environment with cross‐disciplinary team members and having well‐developed structures, particularly the feedback systems such as clinical supervision and case reviews. Enhanced skills to establish trusting relationships with clients can help home‐visiting nurses make effective decisions with mothers and families, particularly in the face of significant risk.ImpactThis study explored nurse decision‐making processes in the context of sustained home‐visiting care, which has been largely unexplored in the research literature. Understanding the effective decision‐making processes, particularly when nurses customize or individualize the care in response to the client's unique needs, assists with the development of strategies for precision home‐visiting care. The identification of facilitators and barriers informs approaches designed to support nurses in effective decision‐making.

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Section: Backg Rou N Dmentioning

confidence: 99%