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Health Visitors (health + visitor)

Distribution by Scientific Domains

Medical Sciences	66%
Humanities and Social Sciences	30%

Distribution within Medical Sciences

Nursing General	71%
Consumer Health General	7%

Selected Abstracts

Counselling Skills for Nurses, Midwives and Health Visitors

JOURNAL OF CLINICAL NURSING, Issue 9 2005
Catherine McCabe
[source]

Outcome of Newborn Hearing Screening Programme delivered by health visitors

CHILD: CARE, HEALTH AND DEVELOPMENT, Issue 5 2008
S. Basu
Abstract Background The Newborn Hearing Screening Programme (NHSP) was introduced in England in 2001 to detect congenital hearing loss in the newborn. The screen is either hospital- or community-based. Objectives This is the first large-scale study of community-based NHSP published in the United Kingdom which aims to evaluate the performance of the community-based screen and compare it against national targets for NHSP and the outcome of national pilot projects. Method Hearing screening data recorded for 10 074 well babies between March 2004 and December 2005 were analysed. Babies who were admitted to the Special Care Baby Unit were excluded. The case notes of all children who failed the initial hearing screen, either unilateral or bilateral, were reviewed retrospectively. Specific performance measures include coverage rate, referral rate and yield. Reasons for failure to complete the screen were identified. Results The community programme met all the standards set by the NHSP and the results are comparable with the average of the pilot sites reported in 2004. Conclusion The data demonstrate that a community-based hearing screening programme conducted by Health Visitors meets all the current national standards and could be implemented across wider areas in this country. Its advantages include a low false positive rate and convenience for parents living in rural areas. The babies identified can be diagnosed and rehabilitated in a time which meets national standards. [source]

,Do I don't I call the doctor': a qualitative study of parental perceptions of calling the GP out-of-hours

HEALTH EXPECTATIONS, Issue 4 2000
Anna M. Houston BSc MA RGN RM RHV
The purpose of this study was to investigate how parents use the GP out-of-hours service. There was a lack of information about how parents managed childhood illness and what strategies they put in place to help them to cope before calling the GP. The investigation of parental perceptions was based on a qualitative design using in-depth interviews of 29 families from a semi-rural location in the south-east of England. All parents said they found dealing with a sick child out-of-hours stressful and were concerned to make the right decision for their child. Furthermore, parents usually employed a reasonable strategy in attempting to manage the child's illness. This study demonstrated that the decision to call the doctor was not taken lightly. Many parents had implemented useful strategies prior to calling the doctor. However, most parents were also aware of their limitations and feared doing the wrong thing. It would seem that on occasion this fear combined with factors such as a lack of social support and loss of parental confidence resulted in calling the doctor out of hours to seek ,peace of mind'. A rethink is needed among health professionals about the ,problem' of out-of-hours calls. GPs could actively seek to empower parents by educating them about minor illness during visits and consultations. It is not enough to offer reassurance to parents that their children are fine. Health visitors and other health professionals who come into contact with young families may help to educate and empower. [source]

A Study of Perceptions of Facial Hemangiomas in Professionals Involved in Child Abuse Surveillance

PEDIATRIC DERMATOLOGY, Issue 1 2003
Aina V. H. Greig M.A., F.R.C.S.
They can mimic the appearance of bruises and parents report false accusations of child abuse by strangers. We investigated perceptions of facial hemangiomas in two professional groups involved in child abuse surveillance. Thirty health visitors and 30 primary school teachers were sent a clinical case questionnaire about a child with an involuting facial hemangioma with a color photograph of the lesion. Nineteen health visitors (63%) and 18 primary school teachers (60%) responded. Seventy-four percent of the health visitors and 11% of the teachers correctly diagnosed a hemangioma. Fifty percent of the teachers were unable to decide on a diagnosis. However, only one health visitor (5%) and one teacher (5%) thought that the lesion was a nonaccidental injury and would involve a child protection advisor. About one-third of health visitors and one-third of teachers expressed concerns that the child could suffer psychologically from teasing by peers at school and about one-third of health visitors were also concerned about the psychological effects of the lesion on the child's parents. Health visitors and teachers were most unlikely to mistake the facial hemangioma in this study for a nonaccidental injury. [source]

Parents' use and views of the national standard Personal Child Health Record: a survey in two primary care trusts

CHILD: CARE, HEALTH AND DEVELOPMENT, Issue 6 2007
S. Walton
Abstract Background The Personal Child Health Record (PCHR) is a booklet given to parents in the UK, following the birth of a child, to be used as the main record of their growth, development and uptake of preventative health services. The national standard PCHR has been available since April 2004. The aim of this survey was to explore parental views of the ,new' PCHR, their experiences in receiving it, and its subsequent use, focusing on specific issues of current debate among health professionals. Methods A parental questionnaire (n = 89) was administered in July 2004, in 10 child health clinics located in two primary care trusts; one in central London and the other in Buckinghamshire. Results Nearly all parents (98%) reported that they used the PCHR as a record of their child's health and development and 92% reported that they ,always' took it with them when seeing healthcare staff about their child. Some parents (22%) indicated that they had not been given a satisfactory explanation as to how to use the PCHR, at the time it was issued to them. Parents reported that health visitors were more likely than other health professionals to use the PCHR both to obtain information about their child and to record information. The majority of respondents (78%) were happy for the level of maternal education to be documented in their child's PCHR. Conclusions Parents used, appreciated and liked the design of the national standard PCHR. Health visitors and primary care staff used the PCHR more than secondary care staff. The potential benefits of the PCHR will only be maximized if other healthcare professionals respond by using it. [source]

Genetics education in the nursing profession: literature review

JOURNAL OF ADVANCED NURSING, Issue 2 2006
Sarah Burke BA MA
Aim., This paper reports a literature review exploring genetics education for nursing professionals. The aim was to contribute to the debate about the future direction of such education. Background., Advances in genetics science and technology have profound implications for health care and the growing importance and relevance of genetics for everyday nursing practice is increasingly recognized. Method., A search was conducted in February 2005 using the CINAHL and Google Scholar databases and the keywords nurse, midwife, health visitor, education and genetics. Papers were included if they were published in English between 1994 and 2005 and included empirical data about genetics education in nursing. In addition, attempts were made to access the grey literature, with requests for information on research, for example, to members of the Association of Genetic Nurses and Counsellors and searches of relevant websites. Findings., Agreement on the relevance of genetics for nursing practice is extensive. Empirical evidence of the learning needs of practitioners highlights widespread deficits in knowledge and skills, and low confidence levels. Provision of nursing education in genetics is patchy and insubstantial across a number of countries, further hampered by lack of strategic development. Significant progress has been made in the identification of learning outcomes for nurses. Research on the delivery of genetics education is limited, but the role of skills-based training, use of clinical scenarios, and importance of assessment have all been identified as factors that can promote learning. Conclusion., Whilst areas of good performance were revealed, many studies identified gaps in professional competence and/or education. New initiatives are underway to support genetics education and its integration into professional practice, but further research is needed on the most effective forms of educational delivery, and an international collaborative approach to this should be considered. [source]

Clients' perceptions of support received from health visitors during home visits

JOURNAL OF CLINICAL NURSING, Issue 7 2005
Caroline Plews BA
Aims and objectives., The current study sought to identify how many mothers from 149 visits carried out by seven health visitors identified support as a feature of the visit, whether this type of support was unique to the health visitor and what support meant to them. These responses were then compared with the taxonomies of social support from the social support literature. Background., Some studies of client perceptions describe support as an element of home visits by health visitors. However, the importance, relevance and impact on the client of this support are not described in detail. Social support theory suggests that there are tangible benefits to people's well-being and their ability to cope with various challenges that may arise from individuals' perceptions of receiving support. Design., Qualitative study using semistructured interviews. Methods., Seven volunteer health visitors recruited 149 women into the study. These clients were interviewed by the researcher, usually within one week of the home visit by their health visitor. The discussions were audio-taped and the resulting transcripts analysed using content analysis. Findings., Thirty-seven women identified receiving support which they said was only available from the health visitor. The relevance of this support to the mother and the impact on her well-being varied within the group suggesting differing perceptions of support by clients according to their personal situation. There was a correspondence between the descriptions of support given by the women and the taxonomies of social support from the social support literature. Conclusion., For some interactions between clients and their health visitors the existing theory of social support may provide an explanation of how health visitors contribute to clients' perceived ability to cope and well-being. Relevance to clinical practice., Social support may be defined as a possible outcome of health visiting. This concept will have use within educational programmes to demonstrate to students how health visiting can have an impact on clients' well-being. Similarly, the concept could be used to investigate and record health visiting practice. [source]

Family Disruption and Support in Later Life: A Comparative Study Between the United Kingdom and Italy

JOURNAL OF SOCIAL ISSUES, Issue 4 2007
Cecilia Tomassini
Global population aging has led to considerable disquiet about future support for frail older people; however, the determinants are poorly understood. Moreover, most industrialized societies have witnessed considerable changes in family behavior (e.g., rises in divorce and declining fertility). Such trends may have adversely affected the support systems of older people; nonetheless, only recently has research begun to address this issue. Employing data from the longitudinal British Household Panel Survey (1991,2003) and the 1998 Indagine Multiscopo sulle Famiglie "Famiglia, soggetti sociali e condizione dell'infanzia," we investigated the association between family disruptions due to divorce, separation, or death and three key dimensions of informal support: (i) frequency of contact with unrelated friends (among all respondents aged 65 years and over); (ii) co-residence with children (among unmarried mothers aged 65 years and over); and (iii) regular or frequent help received from children (e.g., household assistance including care) among parents aged 65 years and over. In addition, we conducted a comparative investigation of the relationship between family disruptions and the use of home care services (i.e., health visitor or district nurse; home help; meals-on-wheels) among parents aged 65 years and over. Our findings suggest that in a culture like the U.K.'s, where relations between kin are primarily influenced by individualistic values, support in later life appears to be primarily related to need, whereas in societies with a strong familistic culture (like Italy's), support is received irrespective of the older person's individual characteristics. [source]

A Study of Perceptions of Facial Hemangiomas in Professionals Involved in Child Abuse Surveillance

Rates and social patterning of household smoking and breastfeeding in contrasting European settings

CHILD: CARE, HEALTH AND DEVELOPMENT, Issue 5 2005
G. Papadimitriou
Abstract Objective To compare rates and social patterning of household smoking and breastfeeding in families with newborn infants in birth cohorts in Coventry, UK and Veria, North Greece. Methods Infants born in 1996 in Coventry, 1999 in Veria were recruited into birth cohort studies using similar methodologies. In Coventry recruitment was by family health visitor at the primary visit; in Veria, hospital-based paediatricians enrolled infants at the neonatal examination. Data were collected at the initial contact on household smoking, type of feeding, and household socio-demographic characteristics. Rates of initial breastfeeding and household smoking with 95% confidence intervals were estimated and breastfeeding and household smoking regressed on parental education and housing tenure in logistic regression models. Results Data were available on 2612 Coventry infants and 773 Veria infants. Rates of household smoking and breastfeeding were higher in Veria compared to Coventry. In Coventry, living in rented accommodation and lower maternal and paternal education were associated with household smoking and bottle feeding. Logistic regression models fitted on initiation of breastfeeding failed to show social patterning in Veria but more educated mothers showed a longer duration of breastfeeding. Only low paternal education was associated with household smoking after adjustment for maternal education and housing tenure. Conclusions Smoking and breastfeeding are more prevalent among households with young infants in Veria compared with Coventry. The social patterning of health-related behaviours noted in Coventry is less marked in Veria. The relevance of these findings for public health interventions in the contrasting settings is discussed. [source]

Variation in how mothers, health visitors and general practitioners use the personal child health record

CHILD: CARE, HEALTH AND DEVELOPMENT, Issue 4 2004
A. J. Hampshire
Abstract Background, In the UK, a national personal child health record (PCHR) with local adaptations is in widespread use. Previous studies report that parents find the PCHR useful and that health visitors use it more than other health professionals. This study was carried out in Nottingham, where the local PCHR is similar to the national PCHR. Objectives, To explore variation in use of the PCHR made by mothers with differing social characteristics, to compare heath visitors' and general practitioners' (GPs') use of the PCHR, and to compare health visitors' and GPs' perceptions of the PCHR with those of mothers for whose children they provide care. Methods, Questionnaires to 534 parents registered with 28 general practices and interviews with a health visitor and GP at each practice. A score per mother for perceived usefulness of the PCHR was developed from the questionnaire, and variation in the score was investigated by linear regression adjusted for clustering. Results, Four hundred and one (75%) questionnaires were returned. Three hundred and twenty-five (82%) mothers thought the PCHR was very good or good. Higher scores for usage of the PCHR were significantly associated with teenage and first-time mothers, but no association was found with mother's social class, education or being a single parent. There was no association between variation in the score and practice, health visitor or GP characteristics. Mothers, health visitors and GPs reported that mothers took the PCHR to baby clinic more frequently than when seeing their GP, and that health visitors wrote in the PCHR more frequently than GPs. Eighteen (67%) health visitors and 20 (71%) GPs said they had difficulty recording information in the PCHR. Conclusion, The PCHR is used by most mothers and is important for providing health promotion material to all families with young children. It may be particularly useful for first-time and teenage mothers. [source]

Social patterning and prediction of parent-reported behaviour problems at 3 years in a cohort study

CHILD: CARE, HEALTH AND DEVELOPMENT, Issue 5 2003
N. Spencer
Abstract Objective, To study the determinants of parent-reported behaviour problems at 3 years and the value of behaviour problems reported at 8 and 18 months as predictors of behaviour at 3 years Study design A whole year birth cohort Setting Coventry Main outcomes Parent-reported behaviour problems at 3 years Participants A total of 2580 infants were enrolled into the Coventry Cohort Study at the birth visit by their family health visitor. Data on parent-reported behaviour at all three ages (8 months, 18 months and 3 years) were available on 775 infants. Results Living in rented accommodation [adjusted OR 2.38 (95% CI 1.36, 4.21); OR, odds ratio; CI, confidence intervals] and living in a smoking household [adjusted OR 2.47 (95% CI 1.53, 3.99)] were independently associated with parent-reported behaviour problems at 3 years after controlling for other sociodemographic variables in logistic regression. The risk of behaviour problems at 3 years was increased in those reporting behaviour problems at 8 months [OR 3.77 (95% CI 1.73, 8.20)] and 18 months [OR 5.84 (95% CI 3.34, 10.23)] after adjustment for sociodemographic variables and other health problems. Behaviour at 8 months as a predictor of behaviour at 3 years had a sensitivity of 13.9%, a specificity of 95.7%, a positive predictive value of 32.6%, and positive and negative likelihood ratios of 3.23 and 0.90. For behaviour at 18 months, the sensitivity was 35.6%, the specificity 92.9%, the positive predictive value 42.9%, and positive and negative likelihood ratios 5.01 and 0.69. Conclusions Parent-reported behaviour problems at 8 and 18 months are highly specific but not particularly sensitive as predictors of behaviour problems at 3 years. Assuming the availability of an effective early intervention, use of a question such as that in the Warwick Child Health and Morbidity Profile at 8 and 18 months will identify, respectively, 21% and 36% of children at risk of parent-reported behaviour problems at 3 years. [source]

Experiences of seeking help from health professionals in a sample of women who experienced domestic violence

HEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 1 2003
Loraine Bacchus BSc MA PhD
Abstract The present paper describes a qualitative study of women who suffered domestic violence. The aim was to explore their experiences of seeking help from health professionals and assess their psychological health. Purposive sampling was used to select a subsample from a larger sample of women who were screened for domestic violence as part of a study undertaken at Guy's and St Thomas' Hospitals in London, UK. In-depth, semi-structured interviews were conducted with the subsample of women during the postpartum period (up to 14 months). Interviews were conducted in women's homes and general practitioners' (GPs) surgeries. The sample consisted of 10 women who had experienced domestic violence in the past 12 months (including the current pregnancy), and six women who had experienced domestic violence in the past 12 months but not the current pregnancy. The main outcome measures included: women's experiences of seeking help from health professionals; and assessment for postnatal depression, post-traumatic stress disorder (PTSD) and psychological distress. Women scored highly on measures of postnatal depression and PTSD. With regard to seeking help, there was a tendency for women to regard GPs, and accident and emergency staff as less helpful compared with health visitors in responding to domestic violence. Lack of privacy, continuity of care and time constraints were dominant themes which emerged from women's contacts with health professionals. Very few women voluntarily disclosed domestic violence to a health professional and even fewer were asked directly about domestic violence by one. It is important for health professionals to enquire about domestic violence in a sensitive manner and provide a response that takes into accounts the complexity of women's needs. Domestic violence training is necessary to equip health professionals with the knowledge and skills they need to respond to domestic violence more effectively. [source]

Developing Clinical Terms for Health Visiting in the United Kingdom

INTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 2003
June Clark
BACKGROUND The UK health visiting service provides a universalist preventive health service that focuses mainly on families with young children and the elderly or vulnerable, but anyone who wishes can access the services. The principles of health visiting have been formally defined as the search for health needs, the stimulation of awareness of health needs, influencing policies that affect health, and the facilitation of health-enhancing activities. The project is currently in its fourth phase. In phase 1, 17 health visitors recorded their encounters with families with new babies over a period of 3 months; in phase 2, 27 health visitors recorded their encounters with a wider range of clients (769 encounters with 205 families) over a period of 9 months; in phase 3, the system is being used by a variety of healthcare professionals in a specialist program that provides intensive parenting support; phase 4 is developing a prototype of an automated version for point-of-contact recording. UK nursing has no tradition of standardized language and the concept of nursing diagnosis is almost unknown. Over the past decade, however, the government has initiated the development of a standardized terminology (Read codes) to cover all disciplines and all aspects of health care, and it is likely that the emerging SNOMED-CT terminology (a merger of the Read codes with the SNOMED terminology) will be mandated for use throughout the National Health Service (NHS). MAIN CONTENT POINTS The structure and key elements of the Omaha System were retained but the terminology was modified to take account of the particular field of practice and emerging UK needs. Modifications made were carefully tracked. The Problem Classification Scheme was modified as follows: ,All terms were anglicized. ,Some areas , notably relating to antepartum/postpartum, neonatal care, child protection, and growth and development,were expanded. ,The qualifiers "actual,""potential," and "health promotion" were changed to "problem,""risk," and "no problem." ,Risk factors were included as modifiers of "risk" alongside the "signs and symptoms" that qualify problems. The Intervention Classification was modified by substituting synonymous terms for "case management" and "surveillance" and dividing "health teaching, guidance, and counseling" into two categories. The Omaha System "targets" were renamed "focus" and a new axis of "recipient" was introduced in line with SNOMED-CT. The revised terminologies were tested in use and also sent for review to 3 nursing language experts and 12 practitioners, who were asked to review them for domain completeness, appropriate granularity, parsimony, synonymy, nonambiguity, nonredundancy, context independence, and compatibility with emerging multiaxial and combinatorial nomenclatures. Review comments were generally very favourable and modifications suggested are being incorporated. CONCLUSIONS The newly published government strategy for information management and technology in the NHS in Wales requires the rapid development of an electronic patient record, for which the two prerequisites are structured documentation and the use of standardized language. The terminology developed in this project will enable nursing concepts to be incorporated into the new systems. The experiences of the project team also offer many lessons that will be useful for developing the necessary educational infrastructure. [source]

The work of health visitors and school nurses with children with psychological and behavioural problems

JOURNAL OF ADVANCED NURSING, Issue 4 2008
Philip Wilson
Abstract Title., The work of health visitors and school nurses with children with psychological and behavioural problems Aim., This paper is a report of a study to describe the workload of health visitors and school nurses in relation to children and young people with psychological, emotional or behavioural problems, and to identify perceived challenges, obstacles and sources of satisfaction associated with this aspect of their work. Background., There is little published information on the work performed by non-specialist community nurses with children and young people who have psychological, emotional and behavioural problems. Method., We analysed data from a survey conducted in 2002 , 2003 of 1049 Scottish professionals working with children and young people. Data included quantitative responses and free-text describing the cases seen by respondents. Responses from a sub-sample of 71 health visitors and 100 school nurses were analysed using a combination of descriptive statistics and analysis of themes emerging from the text. Findings., Although community-based nurses saw a relatively small number of children with psychological, emotional or behavioural problems each week, dealing with these problems took up a disproportionate amount of time. The commonest types of problem were self-harm, externalizing behaviours and family difficulties. Few respondents had received specific training in child and adolescent mental health but most expressed a wish to receive such training. Conclusion., The work of health visitors and school nurses in caring for children with mental health problems is substantial and important. Development of their public health role should not be at the expense of this important contribution. There is a need for rigorous evaluation of nursing mental health interventions among children and young people. [source]

Entrepreneurial nurses and midwives in the United Kingdom: an integrative review

JOURNAL OF ADVANCED NURSING, Issue 5 2007
Vari Drennan
Abstract Title.,Entrepreneurial nurses and midwives in the United Kingdom: an integrative review Aim., This paper is a report of an integrative literature review to investigate: (a) the extent of entrepreneurial activity by nurses, midwives and health visitors in the United Kingdom and (b) the factors that influenced these activities. Background., Internationally, social and commercial entrepreneurial activity is regarded as important for economic growth and social cohesion. Methods., Seventeen bibliographic databases were searched using single and combined search terms: ,entrepreneur$', ,business', ,private practice', ,self-employ$', ,intrapreneur$',social enterprise$',mutuals', ,collectives', ,co-op' and ,social capital' which were related to a second layer of terms ,Nurs$', ,Midwi$', ,Visit$'. ,Entrepreneur$' Private Midwi$, Independent Midwi$, and ,nursing workforce'. In addition, hand searches of non-indexed journals and grey literature searches were completed. The following inclusion criteria were: (a) describing nurses, midwife and/or health visitor entrepreneurship (b) undertaken in the UK, and (c) reported between January 1996 and December 2005. Results., Of 154 items included only three were empirical studies; the remainder were narrative accounts. While quality of these accounts cannot be verified, they provide as complete an account as possible in this under-researched area. The numbers of nurses, midwives and health visitors acting entrepreneurially were very small and mirror international evidence. A categorization of entrepreneurial activity was inductively constructed by employment status and product offered. ,Push' and ,pull' influencing factors varied between types of entrepreneurial activity. Conclusion., Empirical investigation into the extent to which nurses and midwives respond to calls for greater entrepreneurialism should take account of the complex interplay of contextual factors (e.g. healthcare legislation), professional and managerial experience and demographic factors. [source]

Primary mental health workers in child and adolescent mental health services

JOURNAL OF ADVANCED NURSING, Issue 1 2004
Wendy Macdonald BSc PhD
Background., The interface between primary care and specialist services is increasingly seen as crucial in the effective management of child and adolescent mental health (CAMH) problems. In the United Kingdom, a new role of primary mental health worker (PMHW), has been established in order to achieve effective collaboration across the interface through the provision of clinical care in primary care settings and by improving the skills and confidence of primary care staff. However, little is known about the development of this innovative role in service contexts. Issues raised during the early stages of implementation may have important implications for the preparation and development of professionals who undertake the role. Aims., The aim of this paper is to report on a study that examined key issues in implementation of the PMHW role in six health authorities in England. Methods., Case study evaluation was conducted, using thematic analysis of 75 qualitative interviews with key stakeholders from different professions (e.g. PMHWs, general practitioners, health visitors, psychiatrists and service managers) and representing different sectors (primary care, specialist services and community child health services). Findings., The study identified three models of organization (outreach, primary care-based and teams). Each was associated with different advantages and disadvantages in its effects on referral rates to specialist services and the development of effective working relationships with primary care providers. Problems associated with accommodation and effective integration of PMHWs with specialist services, and tensions caused by the two different roles that PMHWs could undertake (direct clinical care vs. consultation-liaison) were common across all sites. Conclusions., The PMHW role is an important development that may go some way towards realizing the potential of primary care services in CAMH. The implementation of new roles and models of working in primary care is complex, but may be facilitated by effective planning with primary care providers, clear goals for staff, and a long-term perspective on service development. [source]

Health visitors' understandings of domestic violence

JOURNAL OF ADVANCED NURSING, Issue 2 2003
Sue Peckover BSc MMedSci PhD RGN RHV
Background. Feminist work has made visible the extent and nature of domestic violence and the problems women face in having their experiences recognized by health and welfare professionals. Research has demonstrated that many health care professionals, including nurses, midwives and health visitors have little working knowledge about this issue. This impacts on their ability to recognize and respond to domestic violence within their practice. Aim. This paper is based upon a study of British health visitors, which explored their practice in relation to domestic violence. Drawing upon empirical data from interviews with health visitors, it explores their understandings of the extent and nature of domestic violence in the context of their work. Methods. Semi-structured interviews were undertaken with 24 health visitors selected by convenience and purposive sampling. Data collection took place during 1997,1998. The research draws on the theoretical perspectives of feminist poststructuralism. Findings. The findings demonstrate considerable differences between health visitors in their understandings of the extent of domestic violence in their caseloads and their recognition of different types of abuse experienced by women. There were also differences between participants in their willingness to name situations other than physical violence as abusive, as well as the extent to which they recognized domestic violence within different social groups. Conclusions. A feminist perspective provides critical insight into the professional knowledge base in relation to domestic violence, demonstrating the need for health visitors to develop their understandings further in order to respond appropriately to women and children experiencing domestic violence. This is discussed in the context of ongoing struggles for professional identity within an ever-changing arena of health and welfare provision. [source]

Evidence-based practice and health visiting: the need for theoretical underpinnings for evaluation

JOURNAL OF ADVANCED NURSING, Issue 6 2000
Ruth Elkan BA(Hons)
Evidence-based practice and health visiting: the need for theoretical underpinnings for evaluation In this paper we argue that evidence-based practice, which is being introduced throughout the British National Health Service to make decisions about the allocation of limited resources, provides a welcome opportunity for health visitors to demonstrate their efficacy, skills and professionalism. However, the paper argues that to view health visiting as evidence-based is not to reduce health visiting merely to a technology through which scientific solutions are applied to social problems. Rather, health visiting needs to be viewed as a political movement, based on a particular model of society, which shapes the goals which health visitors pursue and influences the strategies they adopt to achieve their goals. The paper describes various models of health visiting as a way of showing how the goals of health visiting are always framed within a particular set of assumptions and causal explanations. The paper then turns to look at the issue of evaluating health visiting services. It is argued that evaluation should properly take account of the models which shape health visitors' goals and intervention strategies, and in turn, health visitors need to be explicit about the theoretical frameworks underpinning their interventions. Finally, it is argued that health visitors' knowledge and understanding of a range of models of society enables them to move between the various models to choose the most appropriate and effective means of intervention. Hence it is concluded that the emphasis on evidence-based practice provides health visitors with a valuable opportunity to show that their unique, professional skills and understanding are the preconditions for effective intervention. [source]

Practitioner assessments of ,good enough' parenting: factorial survey

JOURNAL OF CLINICAL NURSING, Issue 8 2009
Julie Taylor
Aim., The aim of this study was to measure health visitors' professional judgements on ,good enough' parenting and identify what factors and combinations of these are important when making such judgements. Background., The relationship between parenting and child health is unclear. Whilst agreement exists that ,good enough' parenting requires boundary setting, consistency and putting the child's needs first, attempting to define ,good enough' parenting in precise terms is complex. When faced with a complex situation, practitioners rely on relatively few factors to form judgements. Design., Factorial survey methods were employed using vignette techniques. Methods., Vignettes were constructed using previous research on those variables, which may influence nurses' judgements, for example, accommodation and child dentition. The level of factors was randomly varied. Two thousand vignettes were administered to a sample of 200 health visitors in two Health Boards who then made a judgement about this scenario. Analysis., Data were analysed through multiple regression with dummy variables and one-way analysis of variance. Regression equations for both good enough mothering and good enough parenting are reported. Results., The models used are significant predictors of parenting and mothering. Significant predictors on health visitor judgements' were boundary setting in sleep behaviours, type of housing inhabited and health behaviours. Although parenting and mothering are often conflated, health visitors appear to separate these aspects when making judgements based on type of housing. Conclusions., Most professionals can articulate what makes a ,good' parent, equally they may have strong views regarding what constitutes ,poor' parenting. The difficulty is in determining when parenting is ,good enough' to provide a child with a nurturing environment. Relevance to clinical practice., This study suggests that practitioners move their thresholds of what is ,good enough' depending on a narrow range of factors. Awareness of the factors, which influence individuals' judgements is important in safeguarding children. [source]

Clients' perceptions of support received from health visitors during home visits

An empowerment approach to needs assessment in health visiting practice

JOURNAL OF CLINICAL NURSING, Issue 5 2002
ANNA M. HOUSTON BSc
,,This paper examines the usefulness of an integrated approach to needs assessment using an empowerment framework, within a health visitor/client interaction, in the home setting. ,,It is intended to demonstrate the existence of a flexible approach to assessing need that is based on research about necessary processes for carrying out health visiting. ,,The design of the tool described in this paper allows the use of professional judgement as well as fulfilling commissioning requirements to address health outcomes. ,,Health promotion and empowerment are central to health visiting practice and should be reflected in the way needs are assessed. ,,Many NHS trusts have introduced a system of targeting and prioritizing health visiting through a system of questioning to assess needs. This may reveal the work that health visitors do, but may also inhibit the open, listening approach required for client empowerment. ,,Different methods of assessing need can be used that do not compromise the commissioning requirements, the health visitor's duty of care or professional accountability. ,,The empowerment approach is key to the philosophy of health visiting. ,,There are ways of approaching needs assessment that do not compromise the ethos of partnership-working in a health promoting way. [source]

Clinical supervision: what do we know and what do we need to know?

JOURNAL OF NURSING MANAGEMENT, Issue 8 2006
A review, commentary
Aims, This study is addressed to nurses but the issues are of equal concern to both midwives and health visitors. Clinical supervision ideally both challenges nurses as well as help their practice. There is need to identify critical elements that help professional practice and understand more clearly the changing nature of supervisory relationships. Background, Clinical supervision in nursing is over a decade old in the UK and yet emerging nursing literature suggests that many ideas remain unfamiliar to nursing practice. The resistance shown by nurse towards clinical supervising remains perplexing. Moreover, ideas concerning clinical supervision have been applied without a substantive evidence base. Methods, The discussion draws on varied ideas concerning supervision, including those outside of nursing, to ask what do we know and still need to know about clinical supervision. This study suggests that, a single approach to clinical supervision could be unhelpful to nursing. Findings and conclusion, Nursing knowledge concerning many aspects of clinical supervision is increasing because of research. Much of the literature suggests that clinical supervision is scholarly activity requiring much the same attention to relationships as the therapeutic activities it supports. This discussion concludes with the idea that clinical supervision might work at its best as a quiet activity allowing nurses to think about nursing work in ways that suit individual learning styles. [source]

Paediatric community vision screening with combined optometric and orthoptic care: a 64-month review

OPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 1 2002
Lisa A. Donaldson
We report a new model of community-based secondary vision screening and demonstrate that a high proportion of children can be effectively managed in such a clinic without referral to the hospital eye service (HES). We performed a 64-month retrospective study of a secondary vision screening clinic providing the combined skills of an optometrist and orthoptist in a community setting. Particular attention was given to the diagnosis and management of children not referred to the HES. During this period, 1755 children were sent appointments and 74% (1300) attended the clinic. The community orthoptist and school nurses referred 53% of the patients and health visitors, general practitioners and community medical officers made 32% of the clinic referrals. Spectacles were prescribed for 41% of the children and 8% were prescribed patching. Sixteen per cent of the children were referred on to the HES. This model of care using the combined expertise of the orthoptist and optometrist is able to diagnose and manage the majority of children who have failed primary vision screening and avoids unnecessary referrals to the HES. [source]

A Study of Perceptions of Facial Hemangiomas in Professionals Involved in Child Abuse Surveillance

Infant abuse in Osaka: Health center activities from 1988 to 1999

PEDIATRICS INTERNATIONAL, Issue 2 2001
Michiko Kobayashi
AbstractBackground: In 1988, the first survey of child abuse in Japan was conducted in Osaka Prefecture as a joint effort between medical, health and welfare agencies. Ensuing surveys in 1988 revealed that infant abuse had a death rate of 10% in Health Center. Methods: In 1996 and 1999, surveys were performed on 130 and 215 abused children under 18 years of age. They were studied in terms of their activity of Health Center, including help, means of involvement by health visitors. Results: Fifty-five percent of children were detected via health centers. In 69% of cases, health visitors listened to parents and promptly contacted other agencies. Ninety-five percent of cases had home visits. The concerted effort of the health centers with allied disciplines in Osaka Prefecture yielded the following changes: the mortality rate decreased from 9.8% in 1988 to 2.3% in 1996, and institutionalized cases tripled from 13.7% in 1988 to 39.5% in 1999. The rate of admission to day care centers increased from 22.4% in 1988 to 58.7% in 1999. Along with the constant support of health visitors, day care centers provided secure support and protection for parents and infants. Conclusions: Effective prevention and treatment become possible only when treatment of the child's physical and psychological health, mental care for parents and tangible support for childrearing and daily life were undertaken in a concerted way. To this end, a systematic commitment of all child agencies, child guidance centers, as well as medical, health educational, welfare and other allied disciplines is required. [source]

An overview of the Scottish multidisciplinary child protection review

CHILD & FAMILY SOCIAL WORK, Issue 3 2004
Brigid Daniel
ABSTRACT Following the murder of a young child by her stepfather a ministerial review of child protection across Scotland was established. It was carried out by a multidisciplinary team of representatives from education, health-nursing, health-medical, police, social work and the Reporter to the Children's Hearing. The review comprised a number of subprojects and included a direct audit of the practice of all the key agencies. The views of the general public, parents, children and professionals were obtained via a set of consultation subprojects. The audit of practice was built around a set of individual, in-depth case studies. The cases were drawn from the spectrum of child care and protection cases by sampling from cases known to health visitors, education departments, the police and social work departments. The audit considered compliance with guidance, but the key focus was on outcomes for children. The findings indicated that although there were many examples of good practice with children, a significant number of children were left unprotected or their needs were not met. The issues were not unique to Scotland and are discussed under four key areas. The paper sets out the extent of chronic need amongst the child population that the audit revealed, looks at the messages from consultation about issues of accessing help for children or by children directly, and describes some shortcomings of the current system. Finally the paper analyses the ways that the different agencies interact and sets out a model for how the system can provide a protective network for children who are in need of protection and support. [source]