Working in partnership in the antenatal period: what do child and family health nurses do?

Abstract

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. 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. 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. 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.