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The Hungarian health visitor network, established in 1915, is a unique system in Europe. Health visitors are highly qualified healthcare professionals whose traditional role is to promote and improve the physical, mental, and social well-being of families. They are specialised in women's health, pregnancy, mother, infant and child care, as well as the health protection of adolescents. Consequently, their function covers all stages of womens' lives.

Pojavnost psihičkih promjena u razdoblju babinja sve je češća. Psihičke promjene mogu se manifestirati kao blage poteškoće, ali i kao ozbiljni psihički poremećaji koji zahtijevaju liječenje. Baby blues, postporođajna depresija, postporođajna psihoza i anksiozni poremećaji su promjene koje se mogu pojaviti u periodu puerperija. Najblaža i najčešća poteškoća je Baby blues, odnosno postporođajna tuga, koja kratko traje te prolazi bez posljedica za majku i njeno dijete. U većini slučajeva liječenje nije potrebno, dovoljna je podrška okoline i obitelji. Postporođajna depresija ozbiljan je poremećaj kojeg je potrebno liječiti. Simptomi postporođajne depresije su osjećaj tuge, gubitak interesa, nesanica, nemir i dr. Liječenje uključuje farmakoterapiju te alternativne postupke. Postporođajna psihoza je rijedak, no najteži oblik poslije porođajnih poremećaja te može imati veoma ozbiljne posljedice za majku i njeno dijete (moguć je čak i smrtni ishod). Liječi se farmakoterapijom i alternativnim metodama, ali je ponekad potrebna i hospitalizacija na odjelu psihijatrije. Anksiozni poremećaji skupina su poremećaja koja se dijeli na panične poremećaje, opsesivno kompulzivne, posttraumatske stresne poremećaje i druge specifične fobije. Uzrok nastanka anksioznih poremećaja uglavnom su genetski faktori, neželjena trudnoća, nespremnost majke za ulogu majčinstva te iznenadne hormonalne promjene. Veliku ulogu u prevenciji psihičkih poteškoća poremećaja ima patronažna sestra čija je zadaća educirati žene i njihove obitelji, prije i nakon samog poroda, te svojim savjetima i vještinama doprinositi prevladavanju stresnog razdoblja nakon poroda i početne prilagodbe. Tijekom izrade završnog provedena je anketa putem društvenih mreža Facebook („Međimurske mame i trudnice“..) te je prikupljeno 134 odgovora od travnja do svibnja 2019. godine. Rezultati su pokazali da 67,9% sudionica nije imalo psihičkih promjena nakon porođaja. No, 32,3% sudionica je imalo psihičke promjene, od čega je prva po učestalosti baby blues (17,2%), nakon nje slijedi postporođajna depresija (7,5%) te anksiozni poremećaj (6%). Sama dob ne utječe na nastanak promjena, dok razumijevanje i podrška obitelji imaju velik utjecaj. Kvalitetna edukacija i informiranost majke je veoma bitna, no važno je da su informacije provjerene i točne. Uloga patronažne sestre koja svojom edukacijom i savjetima može prevenirati i pravovremeno prepoznati određene poteškoće, ključna je i od velikog značaja. The occurance of psychic changes in the midwifery period is increasingly common. Mental changes can manifest as mild difficulties, but also as serious psychiatric disorders that require treatment. Baby blues, postpartum depression, postpartum psychosis and anxiety disorders, are changes that can occur in the puerperium period. The mildest ant the most common difficulty is baby blues or postpartum grief, which last for a short time and passes without consequence for the mther and her child. In the most cases treatment is not required, support from the environment and the family is enough. Postpartum depression is a serious disorder that needs to be treated. Simptoms of postpartum depression are feelings of sadness, loss of interest, insomnia, restlessness, etc. Treatment includes pharmacoterapy for alternative procedures. Postpartum psychosis is rare but the most serious form of postpartum disorders and can have very serious consequences for the mother and her child (even fatal outcome is possible). It is treated with pharmacotherapy and alternative methods, but sometimes requires hospitalization in the department of psychiatry. Anxiety disorders are a group of disorders, that is divided into panic disorders, obsessive compulsive, post-traumatic stress disorders and other specific phobias. The cause of anxiety disorders are mainly genetic factors, unwanted pregnancies, unprepared mothers for the role of motherhood and sudden hormonal changes. A large role in the prevention of mental health problems is played by a health visitor whose task is to educate women and their families, before and after birth and contribute with advice and skills to overcome postpartum stress and inital adjustment. During the preparation of the final survey was conducted trought social network Facebook („MeĊimurske mame i trudnice“, etc.) collected was 134 responses from April to May 2019. Results have shown 67,9% of participants did not have any psychological changes after birth. Nevertheless, 32,3% have manifested certain psychological changes, with baby blues being the most common ( 17,2%) followed by postpartum depression (7,5%) and anxiety disorder (6%). The age itself does not affect the change, while understanding and family support do. Quality education and awareness of the mother is very important , but it is important that the information is verified and accurate. The role of a health visitor, throught her education and advice, can prevent and identify certain difficulties in a timely manner is crucial and of great importance.

BackgroundThere is evidence for the cost-effectiveness of health visitor (HV) training to assess postnatal depression (PND) and deliver psychological approaches to women at risk of depression. Whether this approach is cost-effective for lower-risk women is unknown. There is a need to know the cost of HV-delivered universal provision, and how much it might cost to improve health-related quality of life for postnatal women. A sub-study of a cluster-randomised controlled trial in the former Trent region (England) previously investigated the effectiveness of PoNDER HV training in mothers at lower risk of PND. We conducted a parallel cost-effectiveness analysis at 6-months postnatal for all mothers with lower-risk status attributed to an Edinburgh Postnatal Depression Scale (EPDS) score MethodsIntervention HVs were trained in assessment and cognitive behavioural or person-centred psychological support techniques to prevent depression. Outcomes examined: quality-adjusted life-year (QALY) gains over the period between 6 weeks and 6 months derived from SF-6D (from SF-36); risk-of-depression at 6 months (dichotomising 6-month EPDS scores into lower risk (ResultsIn lower-risk women, 1474 intervention (63 clusters) and 767 control participants (37 clusters) had valid 6-week and 6-month EPDS scores. Costs and outcomes data were available for 1459 participants. 6-month adjusted costs were £82 lower in intervention than control groups, with 0.002 additional QALY gained. The probability of cost-effectiveness at £20 000 was very high (99%).ConclusionsPoNDER HV training was highly cost-effective in preventing symptoms of PND in a population of lower-risk women and cost-reducing over 6 months.

Background Prevention of childhood obesity is a public health priority. Interventions that establish healthy growth trajectories early in life promise lifelong benefits to health and wellbeing. Proactive Assessment of Obesity Risk during Infancy (ProAsk) is a novel mHealth intervention designed to enable health professionals to assess an infant’s risk of future overweight and motivate parental behaviour change to prevent childhood overweight and obesity. The aim of this study was to explore parents’ and health professionals’ experiences of the overweight risk communication and behaviour change aspects of this mHealth intervention. Methods The study was conducted in four economically deprived localities in the UK. Parents (N = 66) were recruited to the ProAsk feasibility study when their infant was 6–8 weeks old. Twenty two health visitors (HVs) used a hand-held tablet device to deliver ProAsk to parents when their infants were 3 months old. Parents (N = 12) and HVs (N = 15) were interviewed when infants in the study were 6 months old. Interview data were transcribed and analysed thematically using an inductive, interpretative approach. Results Four key themes were identified across both parent and health visitor data: Engaging and empowering with digital technology; Unfamiliar technology presents challenges and opportunity; Trust in the risk score; Resistance to targeting. Most participants found the interactivity and visual presentation of information on ProAsk engaging. Health visitors who were unfamiliar with mobile technology drew support from parents who were more confident using tablet devices. There was evidence of resistance to targeting infants at greatest risk of future overweight and obesity, and both parents and health visitors drew on a number of reasons why a higher than average overweight risk score might not apply to a particular infant. Conclusions An mHealth intervention actively engaged parents, enabling them to take ownership of the process of seeking strategies to reduce infant risk of overweight. However, cognitive and motivational biases that prevent effective overweight risk communication are barriers to targeting an intervention at those infants most at risk. Trial registration NCT02314494. Date registered 11th December 2014. Electronic supplementary material The online version of this article (10.1186/s12889-019-6616-5) contains supplementary material, which is available to authorized users.

Bakgrund: Prevalensen av övervikt och fetma hos barn har ökat över hela världen de senaste årtionden. Primroseprojektet är ett forskningsprojekt som studerar möjligheten att förebygga barnfetma genom föräldrasamtal på barnavårdscentralen (BVC). Sjuksköterskans compliance till den interventionsmanual som används förväntas vara viktigt för resultatet. Syfte: Att inom ramen för Primroseprojektet bedöma hur föräldrar och BVC sjuksköterskor, i samband med att barnet genomgår hälsoundersökning vid tolv månaders ålder på barnavårdscentralen, följt Primrosemanualens instruktioner. Metod : Matdagbok och målformuleringsblad granskades utifrån om de var ifyllda enligt manualens instruktioner . Målformuleringsbladet poängsattes också utifrån den detaljnivå målen var formulerade. Resultat: Nästan 75 procent av de inkomna matdagböckerna var ifyllda på ett korrekt sätt. Resultatet av poängbedömningen av målformuleringsbladen visade att sjuksköterskan tillsammans med föräldern inte hade formulerat detaljerade mål i den omfattning som var önskvärd. Slutsats: Instruktionerna för hur matdagböckerna skulle fyllas i var tydliga. Den låga graden av detaljerade mål tror författarna beror på en bristande överensstämmelse mellan hur instruktionerna till sjuksköterskan var formulerade och de kriterier som skulle vara uppfyllda för att få poäng. Background: The prevalence of childhood overweight and obesity has increased worldwide during the last few decades. The Primrose project studies the potential to prevent child obesity by parental consultation at a child health centre. It is critical that the health visitor complies with the instruction manual for any intervention. Aim : Within the framework of the Primrose project, evaluate to what extent health visitors and parents have followed the instructions in the Primrose manual, during a health control at the age of twelve months. Method: The food diary and the goal formulation sheet were studied in order to evaluate whether they had been completed according to the manual. The latter was graded using a recommended point system related to the level of detail the goals were formulated. Result: Nearly 75% of the food diaries were completed in a correct manner. The evaluation of the points derived from the goal formulation sheets indicates that the health visitor, together with the parents, had not been able to formulate the goals in sufficient detail. Conclusion: The instructions for the completion of the food diaries are clear. The authors consider that the unsatisfactory result with the level of detail the goals were formulated is caused by the lack of agreement between the way the instructions were presented and the demands of the criteria that steer the point system.

Periconceptional folic acid use considerably reduces the risk of neural tube defects. The aim of this study was to measure the effect of the national and the local 'Folic Acid Campaign' on periconceptional folic acid use. Before (1995 survey) and 1 year after the campaign (1996 survey), the awareness and use of folic acid was measured among pregnant women in four regions of the Netherlands. To this end, pregnant women who visited the midwife, general practitioner or obstetrician for the first or second prenatal visit were asked to complete a questionnaire. The results showed that use of folic acid for any period around conception increased from 25.1% in 1995 to 53.5% in 1996. Appropriate use (4 weeks before until 8 weeks after conception) increased from 4.8% in 1995 to 21.0% in 1996. No additional effect of the local Folic Acid Campaign was found (adjusted odds ratio = 1.0; 95% confidence interval = 0.7, 1.4). It was possible to conclude that folic acid use at the recommended time increased considerably as a result of the national and the local Folic Acid Campaign, but the target (use in 46% of women wishing to conceive) was not achieved. New health education programmes are needed to increase further its use at the appropriate times.