The nursing role in out-patient child and adolescent mental health services

Whilst nurses in the UK have been working in out-patient settings in the speciality of child, adolescent and family psychiatry for nearly 20 years, they are frequently unclear about what is their nursing contribution to the multidisciplinary team. This paper reports a qualitative study of perceptions of the nursing role in child and adolescent mental health teams of 11 clinicians from six different clinics. Whilst other disciplines were each able to define what was unique about their role, there was found to be no consensus as to what nurses brought by virtue of their nursing background. There is a risk that if nurses cannot develop a clearer rationale for their role, or be better able to articulate what they do in these teams, that role might be lost.     

Utilization of parenting groups and consultation services as parenting support services by Japanese mothers of 18 month old children

Aim: To clarify the factors related to the utilization of parenting groups and consultation services by mothers with children aged 18 months. Methods: This was a cross‐sectional study using a self‐report questionnaire survey at health examinations in five health centers of an urban city in Tokyo, Japan, from July to September 2003. The final study population was comprised of the 371 mothers who provided information on both demographics and the utilization of services. Results: Of these 371 mothers, 166 participated in parenting groups since the birth of their 18 month old child. Logistic regression analyses indicated the following factors related to such participation: past experience in the use of services provided by the local government, trust in the specific group, and worries about their children. Participation in the parenting groups was not related to child‐rearing anxiety or mental health status. The participants indicated that the groups provided friends and child‐rearing information and alleviated stress. Worries about children and past experience in the use of public services would enhance the utilization of services. Conclusion: It is essential for service‐providers to offer services specific to the situation or desires of mothers. Mothers might need both consultation services and support groups to reinforce the mother–child relationship, for social support, and to freely discuss worries with both professionals and peers.     

Community Outreach and Engagement Strategies from the Wisconsin Study Center of the National Children's Study

The purpose of this methods article was to describe and evaluate outreach and engagement strategies designed to initially build county‐wide awareness and support for the National Children's Study (NCS or the study) and subsequently to target the segment communities where recruitment for the study occurred. Selected principles from community outreach, social marketing, and health care system and personal referral formed the foundation for the strategies. The strategies included a celebration event, community advisory board, community needs assessment, building relationships with health care providers and systems, eliciting a network of study supporters, newsletters, appearances at local young family‐oriented events (health fairs, parades), presentations to local community leaders, community forums, “branding” with assistance from a women‐owned local marketing firm, and mailings including an oversized, second‐touch postcard. Six months after study launch, approximately 4,600 study‐eligible women were asked in a door‐to‐door survey if and how they became aware of the study. On average, 40% of eligible women reported being aware of the study. The most frequently cited strategy to cultivate their awareness was study‐specific mailings. Awareness of the NCS increased by 7.5% among those receiving a second‐touch postcard relative to controls (95% CIs [4.9, 10.7] z = 5.347, p < 0.0000, d = 0.16). Community outreach and engagement strategies, in particular the oversized postcard as a second‐touch effort, may be used effectively by researchers for participant recruitment and by public health nurses for delivery of important population‐focused messages.     

Thai mothers and children and the home observation for measurement of the environment (home inventory): pilot study

The HOME Inventory is a measure of home stimulation available to children. The purposes of the study were to: (a) examine the psychometric properties of a Thai-translated HOME (Infant/Toddler), (b) compare Thai mean HOME scores with three groups (Hmong, Eskimo, HOME normative sample in the state of Washington) reported in the literature. A convenience sample from Mahasarakham public health centers in northeastern Thailand was assessed using 36 dyads of mothers and toddlers, 13-35 months. The internal consistency was 0.81 for the total scale; F-tests of the HOME total scale and subscale means showed significant differences between Thai and three other groups. Scheffe tests which showed Thai means on three subscales (Maternal Involvement, Responsivity, Restriction) were not significantly different from the Washington sample, but were significantly lower on three subscales (Play, Organization, Stimulation). Further study is needed on the use of home assessment instruments by nurses and others working in multicultural settings.     

Four responsibilities of the tuberculosis nurse, circa 1919

Specialization in public health nursing practice was beginning to occur early in the 20th century. In a 1919 paper published in The Public Health Nurse, Mary Van Zile argued that there were four essential functions of the tuberculosis nurse. Later that year, Janet Scott reported on the results of a partnership between the tuberculosis dispensary, the Lions Club, and other Oklahoma City community organizations, which illustrated the application of Van Zile's principles, and the expanding scope of public health nursing practice.     

Dropping out of maternal and child home visits

The purpose of this study was to examine the relationship between nurse and client characteristics and the reason for client termination from public health nursing maternal and child home visits. The results indicate that clients who dropped out of services received more contacts from the nurses, missed more appointments with the nurses, and were given advice from the nurses on more topics. They also differed from clients who continued with services until the nursing care plan goals were met in reference to marital status, mental illness, source of payment for services, and use of WIC and food stamps. Nurses whose clients were more likely to continue until goals were met were higher in conscientiousness, learned more from experience, and learned less from coworkers or learning on their own. They also worked more hours per week. These findings have implications for practice and research.     

The role of child health nurses in enhancing mothering know-how

Supporting early parenting and promoting family health is an important aspect of contemporary child health nursing in Australia. Recent studies suggest that within a service climate that increasingly funds targeted, population-based needs rather than universal needs, child health nurses are concerned about maintaining individual nurse-client relationships, particularly with individual families. There is however, limited evidence available to use in response to these concerns. In this paper the way a group of middle-class mothers of infants, who, in today's health service climate, may not be a target group for health services, develop their caregiving know-how, is discussed. The findings presented suggest that both expert and lay knowledge have a part to play in supporting women in their early mothering. Women such as these, in essence, need a clearing-house to help them sift through the overwhelming information they access, respond to, and turn into everyday practices that work. Well placed child health nursing services may achieve this. While there is significant support for this claim in the literature, mechanisms for effective support remains the challenge. A key may be found in nurses focusing on the promotion of communicative or interactive health literacy as an outcome of their programs.     

Supporting SIDS Families: The Public Health Nurse SIDS Home Visit

Sudden infant death syndrome (SIDS) death has a devastating effect on parents. There is no known cause, so parents experience guilt about what they might have done or not done to contribute to the death. Although some SIDS parents may receive support from family and friends, the public health nurse (PHN) has an important professional role in providing grief support, SIDS education, and offering SIDS resources and referrals. Based on years of clinical practice, we recommend the following: Perform the home visit as soon as possible. Show care and compassion. Personalize the baby by using his or her name and asking to see photographs. Reassure the parents that grief is a process which takes time. Educate about what SIDS is and what it is not. Increasingly, SIDS deaths occur in the presence of risk factors. Explain that risk factors are not causes of death. As an authority in health care, reassuring families that they did not cause their baby's death has a tremendous impact on relieving guilt. Putting newly bereaved SIDS parents in contact with other SIDS parents is one of the most helpful actions a PHN can take to help families.     

Developing a concept analysis of control for use in child and adolescent mental health nursing

The need to help children and young people with significant mental health problems develop a sense of personal control in their everyday lives, in a manner which does not endanger themselves or others, was recognized by nurse practitioners working in an English regional multidisciplinary child and adolescent mental health residential unit. A concept analysis of control was undertaken and used to develop a framework for analysing control. This deductive framework was modified iteratively by nurses who developed new knowledge from a qualitative exploration of current practice and the application of the evolving framework to practice problems. The paper describes this process and highlights three main findings: (i) the evolving attributes of the concept analysis helped nurses steer a course through the complexities of practice; (ii) the research highlighted and enabled nurses to confront the paradoxical nature of control; (iii) the process enabled nurses to recognize the mutuality of feelings aroused simultaneously when both the nurse and the child are challenged to maintain personal control.