An integrated mid-range theory of postpartum family development: a guide for research and practice.

AIM: This paper is a report of a study to identify parents' perceptions of postpartum family experiences. BACKGROUND: There is a growing worldwide emphasis on family support. Government policy in the United Kingdom advocates a family-centred approach in which a core universal postbirth service is offered to all families with additional support for parents of children with complex needs. Health visitors provide family postpartum care without an agreed theory directing or standardizing practice. There is a need to identify parental experiences to define family-centred care. METHOD: A qualitative, exploratory approach was undertaken using a purposive sample of 17 postpartum families. Data were collected in one region of Northern Ireland in 2001-2002. Participants' experiences and views were accessed during two focus groups with a total of seven participants, and six in-depth interviews. Thematic analysis was conducted. FINDINGS: One core theme, 'thriving and surviving', and three main themes, 'baby nurture', 'life changes', 'coping and adapting resources', were identified to describe how parents developed during the first 8-week postpartum. These were influenced by the physical, the psychosocial and the environmental factors. The identified themes were mapped together to form an Integrated Mid-Range Theory of Postpartum Parent Development. CONCLUSION: As parents need to negotiate successfully both present coping and future development during the postpartum period, there is a need for professionals to offer services that are orientated to holistic short- and long-term well-being. The findings, further to additional research, may be used by health visitors and other professionals to direct universal postpartum care

Health visitor education for today's britain: Messages from a narrative review of the health visitor literature

Highlights •An aspirational ‘orientation to practice’ underpins all health visitors' work •Practice focuses on home visiting, forming relationships and needs assessments •Health visitors' knowledge, skills and abilities are central to effective practice •The large amount of the learning needed is not well covered by current preparation •A radical re-think of health visitor education is needed to accommodate the depth and breadth of knowledge skills and abilities required for practice Objectives This paper draws on a narrative review of the literature, commissioned to support the Health Visitor Implementation Plan (DH, 2011a), and aimed at identifying messages about the knowledge, skills and abilities needed by health visitors to work within the current system of health care provision. Design The scoping study and narrative review used three complementary approaches: a broad search, a structured search and a seminal paper search to identify empirical papers from the health visitor literature for review. The key inclusion criteria were messages of relevance for practice. Data Sources 378 papers were reviewed. These included empirical papers from the United Kingdom (UK) from 2004 – February 2012, older research identified in the seminal paper search and international literature from 2000- January 2016. Review Methods The review papers were read by members of the multi-disciplinary research team which included health visitor academics, social scientists and a clinical psychologist managed the international literature. Thematic content analysis was used to identify main messages. These were tabulated and shared between researchers in order to compare emergent findings and to confirm dominant themes. Results The analysis identified an ‘orientation to practice’ based on salutogenesis (health creation), human valuing (person-centred care) and viewing the person in situation (human ecology) as the aspirational core of health visitors' work. This was realised through home visiting, needs assessment and relationship formation at different levels of service provision. A wide range of knowledge, skills and abilities were required, including knowledge of health as a process and skills in engagement, building trust and making professional judgments. These are currently difficult to impart within a 45 week health visitor programme and are facilitated through ad hoc post registration education and training. The international literature reported both similarities and differences between the working practices of health visitors in the UK and public health nurses worldwide. Challenges related to the education of each were identified. Conclusions The breadth and scope of knowledge, skills and abilities required by health visitors makes a review of current educational provision desirable. Three potential models for health visitor education are described

Poverty and mental health: the work of the female sanitary inspectors in Bradford (c. 1901–1912)

This is the final version of the article. Available from Palgrave Macmillan via the DOI in this record.Although there are many excellent studies of the work of pioneer women public health officers, few accounts dwell on mental health issues or discuss any relationship that such staff might have understood to exist between poverty and mental health in the early twentieth century. This is a remarkable omission considering that social and feminist historians have highlighted the problems created by the way early practitioners sought to manage poverty and arguably the poor. Drawing on records created by Female Sanitary Inspectors (FSIs) in Bradford, this study chronicles distressing economic and social conditions but also reveals encounters between the staff and people experiencing mental health problems and mental health crises. The ways in which the FSIs chose to both make and deny links between the abject poverty witnessed in the slum districts and cases of mental disorder forms an important strand to the analysis that follows. Interestingly, it is the well-being of the staff that emerges as a persistent and even over-riding concern.This work was generously supported by Wellcome Trust Grant 074999. This was a personal fellowship entitled 'The Medical Officer of Health and the Organisation of Health Visiting as a Comprehensive Community Health Service, 1906-1974'

Teaching for reality

2.00SIGLELD:82/02645(Teaching) / BLDSC - British Library Document Supply CentreGBUnited Kingdo