| dc.description.abstract | While there is extensive national and international literature promoting increased nurse home
visiting and interventions to antenatal and postnatal mothers, previous literature has focused
mainly on nurse teaching programmes, adequately staffed home visiting programmes and
maternal outcomes. Despite the indication that increased public health nurse (PHN) home
visits and increased referral rates to other professionals and support services have a positive
influence on mothers and their children, previous research is dated and there is a significant
lack of research on early childhood outcomes.
The purpose of this quantitative prospective cohort study was to measure the development
and well-being longitudinal outcomes of a sample of 154 children, from birth to two years of
age, following increased PHN home visits within the first six weeks following hospital discharge
and increased PHN interventions in the form of referrals accepted by respondents to other
professionals and support services over the same two year period. Data were recorded and
compared to respondents who received routine PHN care over four assessments. The
principal measure used in this study was the Development Assessment of Young Children to
measure child cognitive development, communication skills, social and emotional
development, physical development and skills in adaptive behaviour. This study included a
further seven measures to capture pertinent child, maternal and paternal variables.
The first wave of data was gathered by the researcher within 3 - 6 weeks of birth, wave two
when the infant was aged 4 - 7.5 months, wave three at 9 - 14 months and wave four at 23 -
24 months. Analysis was based on descriptive and exploratory testing, t-testing, crosstabulation
and repeated measures ANOVA from wave one to wave four.
Respondent mothers ranged in age from 19 to 47 years with a mean age of 33 years. The
majority of mothers reported good health, however when their children were 2 years old, a
number of mothers experienced deterioration in physical (12%) and mental (15%) health. Up
to 70% of mothers had a third level education and were employed in a professional capacity.
The majority of respondents were able to manage on their income in the early postpartum
period, however they were noted to struggle financially when their child was aged two years.
Gestational age of infants ranged from 33 to 42 weeks, 3% were born prematurely and 2.4%
were reported to have complex needs. Birth weight ranged from 2.8 to 4.5 kg with a mean
birth weight of 3.5 kg. The majority of children, 73%, lived with married parents in their own
home.
Statistical analysis supported the first study hypothesis, showing increased PHN home visits
received by 76% (n=115) of the sample had a significant positive effect on child development
iii
and well-being outcomes. Analysis also upheld the second study hypothesis, supporting the
significant positive effect of increased PHN referral rates over four timelines to other
professionals and support services. Combining the influence of both increased PHN home
visits and increased referral rates the study revealed a statistically significant improvement in
child outcomes.
Findings in this study have implications for PHN practice at a national level, suggesting that
current guidelines limiting the number of core visits to postnatal mothers should be revised to
ensure each mother is supported to enable her child to reach their full cognitive,
communication, social, emotional and physical potential. | en |
