Uncovering psychosocial needs: Perspectives of Australian child and family health nurses in a sustained home visiting trial

Kardamanidis, Katina; Kemp, Lynn; Schmied, Virginia

doi:10.5172/conu.33.1.50

Cited by 18 publications

(14 citation statements)

References 8 publications

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“…The fact that women allow the midwife or nurse into their homes denotes a high level of trust in these universal health services. If this trust is respected and developed by the midwife/nurse, then women are more likely to be open and trust the nurse further [42] and where there is trust women are more likely to disclose their experience [15,18,42-44]. Therefore, it is important for clinicians engaging in this process to build a positive relationship with the woman, always remaining aware that women are wary of criticism, interference or surveillance [45].…”

Section: Discussionmentioning

confidence: 99%

Digging over that old ground: an Australian perspective of women’s experience of psychosocial assessment and depression screening in pregnancy and following birth

et al. 2013

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BackgroundThere is increasing recognition of the need to identify risk factors for poor mental health in pregnancy and following birth. In New South Wales, Australia, health policy mandates psychosocial assessment and depression screening for all women at the antenatal booking visit and at six to eight weeks after birth. Few studies have explored in-depth women’s experience of assessment and how disclosures of sensitive information are managed by midwives and nurses. This paper describes women’s experience of psychosocial assessment and depression screening examining the meaning they attribute to assessment and how this influences their response.MethodsThis qualitative ethnographic study included 34 women who were observed antenatally in the clinic with 18 midwives and 20 of the same women who were observed during their interaction with 13 child and family health nurses after birth in the home or the clinic environment. An observational tool, 4D&4R, together with field notes was used to record observations and were analysed descriptively using frequencies. Women also participated in face to face interviews. Field note and interview data was analysed thematically and similarities and differences across different time points were identified.ResultsMost participants reported that it was acceptable to them to be asked the psychosocial questions however they felt unprepared for the sensitive nature of the questions asked. Women with a history of trauma or loss were distressed by retelling their experiences. Five key themes emerged. Three themes; ’Unexpected: a bit out of the blue’, ‘Intrusive: very personal questions’ and ‘Uncomfortable: digging over that old ground’, describe the impact that assessment had on women. Women also emphasised that the approach taken by the midwife or nurse during assessment influenced their experience and in some cases what they reported. This is reflected in the themes titled: Approach: ’sensitivity and care’ and ’being watched’.ConclusionsThe findings emphasise the need for health services to better prepare women for this assessment prior to and after birth. It is crucial that health professionals are educationally prepared for this work and receive ongoing training and support in order to always deliver care that is empathetic and sensitive to women who are disclosing personal information.

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Section: Discussionmentioning

confidence: 99%

Digging over that old ground: an Australian perspective of women’s experience of psychosocial assessment and depression screening in pregnancy and following birth

et al. 2013

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“…Both the ‘engagement work’ of the nurse and the engagement by women and families raise ethical issues about the actual intent of the service, what families are seeking and most importantly, how this is achieved and how boundaries are established in the developing relationship [37]. This was echoed by Kardamanidis [27] who found in interviews with CFHNs providing sustained nurse home visiting, that women were more likely to disclose sensitive information when time was taken to build a trusting relationship than if simply asked a series of prescribed questions. Although there was some evidence of adaptation of psychosocial assessment processes in response to women with limited English, for example; modification of EPDS, the issues of conducting psychosocial assessment across cultures and building relationships with women who require language support, however, remains unresolved.…”

Section: Discussionmentioning

confidence: 99%

Negotiating policy in practice: child and family health nurses’ approach to the process of postnatal psychosocial assessment

Rollans

Schmied

Kemp³

et al. 2013

BMC Health Serv Res

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BackgroundThere is growing recognition internationally of the need to identify women with risk factors for poor perinatal mental health in pregnancy and following birth. In the state of New South Wales, Australia the Supporting Families Early policy provides a framework of assessment and support for women and families and includes routine psychosocial assessment and depression screening. This study investigated the approach taken by Child and Family Health Nurses (CFHNs) following birth to assessment and screening as recommended by state policy. This was a qualitative ethnographic study that included 83 CFHN and 20 women. Observations occurred with thirteen nurses; with 20 women, in the home or the clinic environment. An additional 70 nurses participated in discussion groups. An observational tool (4D&4R) and field notes were used to record observations and analysed descriptively using frequencies. Field notes, interview data and discussion group transcripts were analysed thematically.MethodsThis was a qualitative ethnographic study that included 83 CFHN and 20 women. Observations occurred with thirteen nurses; with 20 women, in the home or the clinic environment. An additional 70 nurses participated in discussion groups. An observational tool (4D&4R) and field notes were used to record observations and analysed descriptively using frequencies. Field notes, interview data and discussion group transcripts were analysed thematically.ResultsCFHNs demonstrated a range of approaches to assessment and screening. Psychosocial assessment was conducted in 50% (10 out of the 20) of the interactions observed; however, all the women were screened using the Edinburgh Depression Scale. Four major themes that represent the approach taken to the assessment process were identified: ‘Engagement: getting that first bit right’, ‘Doing some paperwork’, ‘Creating comfort’ and ‘Psychosocial assessment: doing it another way’. Nurses utilised other skills such as observing the women interacting with their baby, taking note of non verbal communication and using intuition to develop a clinical decision.ConclusionOverall, nurses’ took a sensitive and caring approach to assessment and screening, however, there were differences in interpretations of the policy recommendations across the two sites. Nurses adopt a flexible, relationship-based approach to the assessment process; however, they experience tension when required to incorporate structured psychosocial assessment processes. To undertake assessment and screening effectively, CFHNs require ongoing support, training and supervision to maintain this sensitive and emotionally challenging work.

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“…In the other articles of the Local Citation Score, they do not present a citation relation [26,38,39,40,41,42].…”

Section: Discussionmentioning

confidence: 99%

Family Health Medical Practices and Nursing Care: a Bibliometric Approach

et al. 2017

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Objective: To map scientific production on family health and nursing.Methods: This is a bibliometric study carried out in the ISI Web of Knowledge/Web of Science TM in the temporal cut between the years 1957 and 2016, using the following search topics: "family health" and "nursing". The search results were analyzed according to the temporal evolution of the publications records; The most prominent magazines; The most productive authors; The articles with the highest number of citations and the most productive institutions and citation relations among the most cited groups of articles in global and local relations.

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Uncovering psychosocial needs: Perspectives of Australian child and family health nurses in a sustained home visiting trial

Cited by 18 publications

References 8 publications

Digging over that old ground: an Australian perspective of women’s experience of psychosocial assessment and depression screening in pregnancy and following birth

Digging over that old ground: an Australian perspective of women’s experience of psychosocial assessment and depression screening in pregnancy and following birth

Negotiating policy in practice: child and family health nurses’ approach to the process of postnatal psychosocial assessment

Family Health Medical Practices and Nursing Care: a Bibliometric Approach

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