Measuring the Development and Well-being Longitudinal Outcomes of Children from Birth to Two Years following Increased Public Health Nurse Interventions
Year: 2018
Type: dissertation
Study design: Observational Study
Abstract: While there is extensive national and international literature promoting increased nurse home \nvisiting and interventions to antenatal and postnatal mothers, previous literature has focused \nmainly on nurse teaching programmes, adequately staffed home visiting programmes and \nmaternal outcomes. Despite the indication that increased public health nurse (PHN) home \nvisits and increased referral rates to other professionals and support services have a positive \ninfluence on mothers and their children, previous research is dated and there is a significant \nlack of research on early childhood outcomes. \nThe purpose of this quantitative prospective cohort study was to measure the development \nand well-being longitudinal outcomes of a sample of 154 children, from birth to two years of \nage, following increased PHN home visits within the first six weeks following hospital discharge \nand increased PHN interventions in the form of referrals accepted by respondents to other \nprofessionals and support services over the same two year period. Data were recorded and \ncompared to respondents who received routine PHN care over four assessments. The \nprincipal measure used in this study was the Development Assessment of Young Children to \nmeasure child cognitive development, communication skills, social and emotional \ndevelopment, physical development and skills in adaptive behaviour. This study included a \nfurther seven measures to capture pertinent child, maternal and paternal variables. \nThe first wave of data was gathered by the researcher within 3 - 6 weeks of birth, wave two \nwhen the infant was aged 4 - 7.5 months, wave three at 9 - 14 months and wave four at 23 - \n24 months. Analysis was based on descriptive and exploratory testing, t-testing, crosstabulation \nand repeated measures ANOVA from wave one to wave four. \nRespondent mothers ranged in age from 19 to 47 years with a mean age of 33 years. The \nmajority of mothers reported good health, however when their children were 2 years old, a \nnumber of mothers experienced deterioration in physical (12%) and mental (15%) health. Up \nto 70% of mothers had a third level education and were employed in a professional capacity. \nThe majority of respondents were able to manage on their income in the early postpartum \nperiod, however they were noted to struggle financially when their child was aged two years. \nGestational age of infants ranged from 33 to 42 weeks, 3% were born prematurely and 2.4% \nwere reported to have complex needs. Birth weight ranged from 2.8 to 4.5 kg with a mean \nbirth weight of 3.5 kg. The majority of children, 73%, lived with married parents in their own \nhome. \nStatistical analysis supported the first study hypothesis, showing increased PHN home visits \nreceived by 76% (n=115) of the sample had a significant positive effect on child development \niii \nand well-being outcomes. Analysis also upheld the second study hypothesis, supporting the \nsignificant positive effect of increased PHN referral rates over four timelines to other \nprofessionals and support services. Combining the influence of both increased PHN home \nvisits and increased referral rates the study revealed a statistically significant improvement in \nchild outcomes. \nFindings in this study have implications for PHN practice at a national level, suggesting that \ncurrent guidelines limiting the number of core visits to postnatal mothers should be revised to \nensure each mother is supported to enable her child to reach their full cognitive, \ncommunication, social, emotional and physical potential.
Author: Mary Kay O’Rourke
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2811254798