Jane Drummond

Supporting parents : Can intervention improve parent-child relationships?

Healthy child development has been identified as one of the key determinants of health and resiliency in adulthood. This article reports on the results of two pilot studies of randomized controlled trials of parent support interventions aimed at improving the parent-child relationship and indirectly enhancing the resilience capacity among at-risk children. Participating children were at risk for mental health problems due to poverty and/or their parents’ lack of educational attainment, inexperience, and young age. The interventions were composed of parenting skills training and social support. Eighteen families participated in Supportive Intervention I, and 34 families participated in Supportive Intervention II. Results suggested that parent-child relationships were enhanced in both pilot studies. These promising findings offer direction for future research and for nurses and other interventionists providing support to young at-risk families.

Health literacy as an empowerment tool for low-income mothers.

Health literacy commonly refers to the extent to which one can access and accurately interpret healthcare information. Statistics reveal that limited health literacy is prevalent among those of lower socioeconomic status. When working with low-income mothers, it is recommended in this article that healthcare professionals operationalize a broader conceptualization of health literacy than assessment of reading levels and translating knowledge of risk factors for illness and disease. Nutbeams continuum of functional, interactive, and critical health literacy directs healthcare professionals to expand their health education mandate to encompass equipping low-income mothers with the necessary knowledge and skills to gain control over their lives and optimize the healthy development of their children. Tenets from social cognitive theory, principles from interdependence theory, and strategies from Freires empowerment education model are integral to successful progression along Nutbeams health literacy continuum.

Merging social networking environments and formal learning environments to support and facilitate interprofessional instruction.

This study describes the redesign of an interprofessional team development course for health science students. A theoretical model is hypothesized as a framework for the redesign process, consisting of two themes: 1) the increasing trend among post-secondary students to participate in social networking (e.g., Facebook, Second Life) and 2) the need for healthcare educators to provide interprofessional training that results in effective communities of practice and better patient care. The redesign focused on increasing the relevance of the course through the integration of custom-designed technology to facilitate social networking during their interprofessional education. Results suggest that students in an educationally structured social networking environment can be guided to join learning communities quickly and access course materials. More research and implementation work is required to effectively develop interprofessional health sciences communities in a combined face-to-face and on-line social networking context.

Establishing Therapeutic Relationships With Vulnerable and Potentially Stigmatized Clients

Grounded theory was employed to elucidate how public health nurses (PHNs) develop therapeutic relationships with vulnerable and potentially stigmatized clients, specifically, single mothers living in low-income situations. We named the emerging theoretical model Targeting Essence: Pragmatic Variation of the Therapeutic Relationship, after discovering that although PHNs strove to achieve relational goals, their attention was primarily focused on the goal of ascertaining concerns foremost on the hearts and minds of mothers, and that PHNs had to accomplish these goals within short practice timeframes. The study’s focused context elicited a nuanced explanation of the dynamic relationship-building process derived from subjective relationship experiences of PHNs and single mothers living in low-income situations. We believe Targeting Essence will serve as an effectual relationship-building model, enabling PHNs to know essentially what mothers want and need, and enabling mothers to know essentially that their PHN can be trusted not to render judgment.

Effectiveness of teaching an early parenting approach within a community‐based support service for adolescent mothers

A single blind, pre-test, post-test design was used to test the effectiveness of the Keys to Caregiving Program in enhancing adolescent mother-infant interactions. Participants were sequentially allocated to groups in order of referral. The outcome was the enhancement of maternal and infant behaviors that exhibited mutual responsiveness as measured by the Nursing Child Assessment Teaching Scale. Issues with recruitment and collaboration with the community agencies made achieving a desirable sample size difficult. Pre-tests and post-tests were completed for 13 participants. While the sample size was insufficient to confidently establish whether or not the Keys to Caregiving produced a between groups treatment effect, mothers within the treatment group evidenced significantly greater contingent responsiveness over time than those within the control group.

Performance profile of an outcome measure: morbidity assessment index for newborns

Objective: Few tools have been optimised for use over the entire spectrum of neonatal morbidity and standardised for use in perinatal population and community health studies. The objective of this study was to determine the performance profile of the recently developed morbidity assessment index for newborns (MAIN score). This score was designed as a discriminative index of morbidity for the entire population of babies delivered >28 weeks gestation without a major congenital anomaly. Design and setting: MAIN score items were extracted retrospectively from the health records of 2892 consecutively born babies delivered beyond 28 weeks gestation in Edmonton area hospitals between June and December of 1999. Main results: The mean MAIN score in the general newborn population was 70.3 (95% confidence intervals 64.2 to 76.4). With the MAIN score tool, 84.6% of newborns scored from 0 to 150 (no/minimal morbidity), 11.3% from 151 to 500 (mild), 3.1% from 501 to 800 (moderate), and 1% had >800 (severe) score. The MAIN score tool was sufficiently sensitive to detect significant effects of low gestational age, low birth weight, male sex, caesarean delivery, tertiary hospital delivery, twins/triplets, non-vertex presentation, prenatal illicit drug use, and medical complications of pregnancy. Conclusion: The MAIN score fulfills the need for a simple, universal, yet sensitive and robust tool to provide a numerical index of early neonatal outcomes of prenatal care and adverse prenatal exposures in babies delivered beyond 28 weeks gestation. The performance of the MAIN score agrees well with the current medical awareness regarding the impact of adverse prenatal exposures on newborn morbidity.

Synchronous Problem-Based e-Learning (ePBL) in Interprofessional Health Science Education

Health Science teams are increasingly interprofessional and often require use of information communication technology. These shifts result in a need for health science students to learn online interprofessional teamwork skills early in their training. In response, one interprofessional communication skills course was remodelled from traditional Problem-based learning (PBL) to include learning in an online collaborative (team-based) environment (Elluminate). This study evaluates the types of interactions facilitated by an interprofessional e-problem-based learning (ePBL) activity. A qualitative analysis of recorded discussions in Elluminate yielded two major categories of results. First, the online learning environment was shown to facilitate small-group collaborative interactions by updating older tools, in terms of offering intuitive, accurate, and multiple communication tools, and enabling novel forms of interaction. Second, the online learning environment prompted discussion of technology-facilitated communication difficulties in a way that led to the remediation of these difficulties. These results suggest that, while there is a need for further research on the relationship between online synchronous (real-time) learning environments and collaborative learning, ePBL can enable positive and novel forms of student interaction and facilitate student learning.

Randomized Controlled Trial of a Family Problem-Solving Intervention

Adaptive problem solving contributes to individual and family health and development. In this article, the effect of the cooperative family learning approach (CFLA) on group family problem solving and on cooperative parenting communication is described. A pretest or posttest experimental design was used. Participant families were recruited from Head Start programs and exhibited two or more risk factors. Participant preschool children were screened to have two or more developmental delays. Direct behavioral observation measures were used to determine group family problem solving and cooperative parenting communication outcomes. Few group family problem-solving behaviors were coded, and they displayed little variability. However, intervention parents increased the length of time they played and extended the cooperative parent-child interactions. The evidence shows that CFLA has the potential to enhance parentalmodeling of cooperative behavior while engaged in play activities with preschoolers. Direct measurement of group family problem solving was difficult. Solutions are suggested.

Emotional and sexual sequelae following hysterectomy

This article explores the literature pertinent to emotional and sexual sequelae following hysterectomy. The relationship between the incidence of psychiatric depression and the response to a lost body part is described. Sexual facts and fallacies that abound in the literature are also discussed. Finally, nursing measures to alleviate the defined difficulties experienced by the hysterectomy patient are discussed.

Maternal Understanding of Infant Crying: What does a Negative Case Tell Us?

In this report, data analysis of a negative case is presented. The purpose of the original study was to delineate how 18 new mothers, both primiparous and multiparous, came to understand the crying of their infants. That process, which arose from the 17 congruent cases of the sample, is summarized here. Data analysis of the negative case validated the process developed from those cases, and demonstrated that further refinement of the original process is probably both necessary and useful for nursing. The elements of the concept of empathy were used to operationalize the refinement. Further, analysis of the negative data lead to the identification of three likely blocks to the process of maternal understanding of infant crying. Questions regarding the nature of blocks to the process of maternal understanding of infant crying, not dealt with in the original data analysis nor in the research reviewed, were posed.