Views Of Health Visitors Research Articles

Views and experiences of health visitors on an early literacy promotion intervention

Background: The advantages of early literacy activities in promoting infant and child development have been well documented in the literature as well as the effectiveness of relevant interventions implemented by health professionals. Yet, data on the perceptions and attitudes of primary health care providers about the implementation process of such interventions remain scarce. Objective: The aim of this qualitative study was to explore the experiences and views of health visitors (n=13) in applying an early literacy promotion intervention during their practice in primary health settings. Methods: Data were collected through questionnaires with open ended questions and analyzed through thematic analysis. Results: Findings showed that parents welcomed the advice and were willing to introduce literacy-oriented activities with their children in their daily family routine. Parents’ and children’s receptiveness as well as health visitors’ own belief in the significance of the intervention were considered factors largely facilitating its implementation and success, despite time constrains and system level shortcomings. Continuing education was recommended both to provide constant support to health visitors, and also sensitize other members of the primary care team for program sustainability and expansion. Conclusions: The results of this study highlighted the importance of recording health professionals’ views, concerns and experiences on applying early literacy promotion so as to receive feedback on ameliorating relevant programs and maximizing their valuable impacts on infant and child development.

Promoting children\u2019s health when a parent has a mental health problem: a mixed methods study of the experiences and views of health visitors and their co-workers

BackgroundUnrecognised and untreated parental mental illness is a major adverse childhood experience with potentially life-long consequences for health and wellbeing. In the United Kingdom (UK) health visitors provide a universal health promotion service to children aged 0–5 years, which includes safeguarding. This preventive work is highly relevant to policy aims of improving outcomes for children living with adverse childhood experiences, but is currently under researched. The aim of this study was to explore how health visitors promote young children’s wellbeing when a parent has a mental health problem, and to co-produce strategies to improve child health outcomes.MethodsA mixed methods study was conducted, consisting of a cross-sectional survey and consensus workshops in Wales, UK. In phase 1 health visitors (n = 174) responded to an online questionnaire designed to explore the nature and scope of their preventive work with families experiencing mental ill health. For phase 2 providers of health and other support services (n = 38) took part in Nominal Group Technique workshops to co-produce strategies for better joint working to protect the wellbeing of children living with parental ill health.ResultsWe identified that health visitors routinely provide support to families where parents have a range of mental health problems, including severe mental illness. Most practice is focused on mothers with depression, and fewer respondents were confident about working with fathers. Unmet training needs were identified in relation to adult mental illness, particularly the impact upon children. Solutions to working more effectively with professional and voluntary agencies included raising awareness of professional roles and responsibilities, timely two-way communication, taking a strengths-based approach and maintaining a focus on the child.ConclusionsThis study provided evidence on the range of parental mental ill health encountered by health visitors and the strategies they use to protect children’s wellbeing. Increasing the effectiveness of joint working is key to improving outcomes for babies and young children, including greater use of voluntary sector services. This study has implications for those who commission and provide health and welfare services for children, and adult mental health services.

Childhood injury prevention: The views of health visitors and nursery nurses working in deprived areas

Aim The aim of this study was to ascertain the views of health visitors and nursery nurses about childhood injury prevention in deprived areas. Method A survey was carried out amongst 51 health visitors and 7 nursery nurses attached to practices (n=47) from deprived areas who participated in a large injury prevention randomised controlled trial. Results The response rate was 97%. The most commonly cited barrier to injury prevention work in deprived areas was finance/cost to families and this was mentioned by 59% (n=32) of the respondents. Parental attitudes and understanding was considered to be important for nearly half (48%, n = 26) the respondents. Their views about what actions could be initiated at national and local levels to improve injury prevention work in deprived areas are described. At a national level 52% (n=27) of respondents suggested public awareness should be raised, and 14 (25%) of these mentioned using television for this purpose. Approximately one-third (32%, n=17) commented that at a local level, parental awareness should be raised in as many places as possible. Conclusions Health visitors and nursery nurses who responded appear to focus on child injury prevention at the micro level rather than at a broader public health level. In addition, many commented on barriers or constraints placed upon them. Further support will be needed if they are to develop a family centred public health approach.

Professional relationships: CCN's and primary care nurses.

Children's community nursing is a relatively new service to provide nursing care to children in the community. Collaboration between new services and established community services is necessary to ensure children receive care from the most appropriate service. The views of health visitors, school nurses, district nurses and children's community nurses were sought to provide insight into collaborative processes. Focus groups were used to obtain participants' views of professional relationships. Each professional group viewed their relationship with the children's community service through the context of their own service. Expectations of children's community nurses by professionals were different for each professional group.

Health Visitors Work in a Multi-ethnic Society: a Qualitative Study of Social Exclusion

Health visiting is adopting an enabling model of practice, which may promote social inclusion, but is under pressure to justify itself. The article focuses on health visitors' work with Pakistani women and comparable white women in Glasgow, examining the nature of health visiting and women's responses to it. Health visitors' perspectives involve the appreciation of cultural differences, building relationships with clients, and some stereotyping of clients. Techniques include highly valued home visiting, and processes of negotiation with clients. Problems faced include difficulties with interpreters, lack of training, relationships with other professions, recent changes in the NHS, and issues of stress and personal safety. Women's views of health visitors are generally positive, especially concerning home visits, time spent with clients, and gate-keeping access to GPs. Negative views came mostly from white women, and concerned the more controlling models of health visiting. Thus, enabling health visiting practice was widely appreciated, and could act as an inclusionary force, facilitating access to and use of health services. Exclusion was operating at institutional level, towards minorities and women of lower socio-economic groups, but was being actively resisted by practitioners.

Supervision for health visitors dealing with sexual abuse

Child sexual abuse is a complex health issue. This study sought the views of health visitors involved in this work. In addition to focussing on the needs of children through child protection responsibilities, some health visitors worked with adults in attempting to resolve the sadnesses of child sexual abuse. The literature provided an evidence base to the concept of an ‘unseen’ loss of childhood protection and of the health visitors who worked to aid resolution, bereavement counselling principles appeared to provide an effective approach. Health visitor inhibitions were identified and for some health visitors, personal life had altered as a result of the work. The need for a confidante was identified to support practitioners affected by the work. Supervision was considered to offer a necessary structure and accountability for the exploration of complex health issues.