Jennifer A. Fraser

A randomized, controlled trial of nurse home visiting to vulnerable families with newborns.

Objective: This project aimed to evaluate the impact of a home visiting programme that targeted families where the child, for environmental reasons, was at great risk of poor health and developmental outcomes.

Parenting and Conduct Problems in Children: Australian Data and Psychometric Properties of the Alabama Parenting Questionnaire

A wealth of research has shown links between parenting style and child behaviour, and the development of conduct problems in young children. Unfortunately, the most common and well-researched measures of parenting do not tap specific dimensions of parenting clearly related to risk for conduct problems in children. Recently, the development of the Alabama Parenting Questionnaire (APQ) appears to have overcome this problem. It has several subscales that were designed to correspond to empirically identified aspects of positive and negative parenting styles important to conduct problems. The current study evaluated the APO with a large community sample of 4- to 9-year-old Australian children. The results showed good internal consistency, validity, and test-retest reliability for the measure. Means, standard deviations, and proposed cut-off scores are presented. These data indicate the APQ is potentially a useful measure for clinicians and researchers working with Australian samples of children with conduct problems and their families.

Home visiting intervention for vulnerable families with newborns: follow-up results of a randomized controlled trial

OBJECTIVE This study aimed to: (1) Assess the community utility of a screening tool to identify families with child abuse or neglect risk factors in the immediate postnatal period (2) Determine the social validity and effectiveness of a home visiting program using community child health nurses and offering social work services for identified families, and (3) Identify factors in the immediate postnatal period associated with the childs environment that predict poor adjustment to the parenting role. METHOD A randomized controlled trial using a cohort of 181 families was undertaken to evaluate the impact of a home visiting program. Mothers were recruited in the immediate postnatal period and allocated either into the home visiting program or into a comparison group. The research design required self-identification into the study by providing positive responses to a range of risk factors. A repeated measures design was used to test parenting stress and maternal depression from the immediate postnatal period to 12-month follow-up and physical child abuse potential to 18-month follow-up. To test whether measures taken in the immediate postnatal period were predictive for poor adjustment to the parenting role, a linear regression model was used. RESULTS The screening procedure was shown to have utility in the context of recruitment to a research trial and mothers were willing to accept the home visiting program examined by this study from the immediate postnatal period. From as early as 6 weeks the program demonstrated ability to impact positively on maternal, infant, family, and home environment variables (testing 90 randomly allocated intervention vs. 91 comparison families). At follow-up, parental adjustment variables were not significantly different between groups (testing the remaining 68 (75.5%) intervention vs. 70 (76.9%) comparison families) and home environment assessment scores had converged. Predictive analysis of factors measured in the immediate postnatal period revealed an absence of any predictive value to demographic characteristics, which secondary prevention efforts typically target. CONCLUSIONS Follow-up evaluation did not demonstrate a positive impact on parenting stress, parenting competence, or quality of the home environment confirming the need to test early program success on longer term outcomes. Further, thestudy not only demonstrated that there was a relationship between maternal, family and environmental factors identified in the immediate postnatal period. and adjustment to the parenting role, but also challenged demographic targeting for child abuse and neglect risk. At the same time, the immediate postnatal period presented an exciting window of opportunity to access high-risk families who may otherwise have become marginalized from traditional services.

Promoting secure attachment, maternal mood and child health in a vulnerable population: A randomized controlled trial

Objective: To evaluate the efficacy of an early home‐based intervention on the quality of maternal–infant attachment, maternal mood and child health parameters in a cohort of vulnerable families.

Parenting interventions for childhood chronic illness A review and recommendations for intervention design and delivery

Every day, thousands of children suffer the effects of chronic health conditions and families struggle with illness management and children’s behavioural and emotional adjustment. Many parents experience difficulties with their caregiving role and lack confidence in their ability to manage their child’s illness and ensure the child’s well-being. While there is consistent evidence as to the extent and impact of childhood chronic illness, there is a paucity of evidence-based parenting approaches to help children with chronic health conditions and their families. This paper provides a narrative review of the current literature to examine relationships between chronic childhood illness, emotional and behavioural disorders and parenting. Key guidelines and recommendations for the development of evidence-based parenting programs for parents of children affected by chronic health conditions are provided.

On self-compassion and self-care in nursing: Selfish or essential for compassionate care?

Compassionate care in nursing is increasingly an international concern. While the literature to date has focussed on redressing a compassion and care deficit across the nursing discipline (Crawford et al., 2014, Dewar et al., 2014, Scott, 2014), we suggest here that due consideration be given to its relationship to self-care and self-compassion in nurses. After all, a deficit in these compromises nurses’ therapeutic use of self in the provision of compassionate care to patients.

Birthing Practices of Traditional Birth Attendants in South Asia in the Context of Training Programmes

Traditional Birth Attendants (TBA) training has been an important component of public health policy interventions to improve maternal and child health in developing countries since the 1970s. More recently, since the 1990s, the TBA training strategy has been increasingly seen as irrelevant, ineffective or, on the whole, a failure due to evidence that the maternal mortality rate (MMR) in developing countries had not reduced. Although, worldwide data show that, by choice or out of necessity, 47 percent of births in the developing world are assisted by TBAs and/or family members, funding for TBA training has been reduced and moved to providing skilled birth attendants for all births. Any shift in policy needs to be supported by appropriate evidence on TBA roles in providing maternal and infant health care service and effectiveness of the training programmes. This article reviews literature on the characteristics and role of TBAs in South Asia with an emphasis on India. The aim was to assess the contribution of TBAs in providing maternal and infant health care service at different stages of pregnancy and after-delivery and birthing practices adopted in home births. The review of role revealed that apart from TBAs, there are various other people in the community also involved in making decisions about the welfare and health of the birthing mother and new born baby. However, TBAs have changing, localised but nonetheless significant roles in delivery, postnatal and infant care in India. Certain traditional birthing practices such as bathing babies immediately after birth, not weighing babies after birth and not feeding with colostrum are adopted in home births as well as health institutions in India. There is therefore a thin precarious balance between the application of biomedical and traditional knowledge. Customary rituals and perceptions essentially affect practices in home and institutional births and hence training of TBAs need to be implemented in conjunction with community awareness programmes.

Professional telephone advice to parents with sick children: Time for quality control!

Objective: To assess the quality of professional telephone advice given to parents with sick children.

Personalization enhances learning anatomy terms.

Background: Personalizing computer-based instructional text with a conversational rather than formal style has been found to enhance learning substantially. Aim: An experimental study investigated whether a conversational style would enhance learning anatomy terminology from paper-based materials. Methods: Students were randomly assigned to experimental conditions, and hypotheses were tested with a multiple-choice test and self-report scales. Results: Studying personalized materials led to better performance on a terminology test and lower mental effort during testing than studying non-personalized materials. However, groups did not differ on ratings of interest/enjoyment. Conclusion: These results extend previous research by demonstrating learning gains following personalization using paper-based materials. However, the lack of effect on interest/enjoyment self-reports raises questions about previous theorizing on the role of this variable.

Extended parenting education in an early parenting centre: A mixed-methods study

This article reports findings from a process and impact study of a residential early parenting centre programme in Australia. The programme supports parents with young children under the age of three, referred from health and child protection services. Multiple sources of data were used from interviews, focus groups, direct observations, observer notes and a parenting sense of competence questionnaire. Qualitative data were analysed using thematic analyses, and paired t-tests were used to test data from the questionnaire. Three themes emerged from thematic analysis of the qualitative data: engaging families, building parenting capacity and transitioning back to the community. Parents’ perceptions of parent competence improved significantly between admission and discharge for participating families. Detailed accounts of the way in which nurses work to achieve positive outcomes in relation to parenting confidence and satisfaction in the short term have provided useful insights into often taken-for-granted support processes in working with referred parents. The complexity of the nurses’ role and implications for nursing practice in residential parenting centres are discussed. Future research is warranted to determine longer-term benefits of this programme being delivered in a residential early parenting centre.