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The high infant mortality rate of illegitimate children in Dualist Hungary urged politicians to create a modern state child welfare system for the protection of abandoned children whose upbringing became a national matter. Their main concern was providing adequate nutrition for infants and increase their chances of survival. The article examines how demographical concerns and national-political ideals influenced the evolution of the child welfare system in multi-ethnic Transylvania, first as part of the dual monarchy and after the First World War as a province of Romania. The Hungarian state children's asylums offered a variety of nursing programs for abandoned infants, where the foster-care system often resulted in their Magyarization at a later age. During the First World War, the new objective was the protection of infants together with mothers and the promotion of breastfeeding in order to ensure the viability of the Hungarian nation. National arguments were used in both time periods to support infant protection initiatives. In interwar Transylvania, the urban-rural ethnic distribution influenced the development of infant protection facilities: all state investments were channeled toward the "authentic" Romanian countryside, while in the "foreign" urban environment ethnic minorities focused on their own institutions. [ABSTRACT FROM AUTHOR]

Objectives  Type 2 diabetes impacts greatly on quality of life. Health-care providers must focus on efforts to detect, treat, and manage clients through supportive educative approach. This study aims to measure effectiveness of nurse-led home care interventions. Materials and Methods  This study among 103 diabetic subjects measured baseline blood pressure (BP), weight, and blood glucose levels. Information on compliance was obtained using a rating scale consisting of domains: dietary habits, exercise, rest, sleep, symptom management, prevention of complications, medication, and follow-up. Individualized comprehensive nursing interventions (education, testing, counselling) were provided, that were reinforced two times a week for 4 weeks, with minimum 7 home visits carried out by the researchers who are registered nurses and teaching faculty along with six interns of BSc nursing program. Post-tests were obtained at second and fourth weeks after start of intervention. Results  Significant improvement in blood sugar (p  < 0.05), systolic BP (p  < 0.001), and diastolic BP (p  < 0.001) was observed. There was no change in body mass index (BMI) (p  > 0.05). Post-hoc analysis found significant difference between pre-, post1- and post2-measures. Significant association was found between dietary habits and BMI (p  < 0.05) and diastolic BP (p  < 0.05). Compliance improved from 29 (28.2%) to 47(45.6%), partially compliant from 55 (53.4%) to 45 (43.7%) and noncompliant 19 (18.4%) to 11 (10.7%), with a clear improvement in each of the domains of compliance. Conclusion  Individualized comprehensive interventions delivered at the natural environment of families by registered nurses effectively improve compliance to diabetes management. [ABSTRACT FROM AUTHOR]

Copyright of Ethnological Forum / Etnoloska Tribina is the property of Etnoloska Tribina / Ethnological Forum and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Many health visiting services in England use the Promotional Guide system with mothers and fathers, an intervention to support their transition to parenthood, but there is little known about its use and effectiveness, especially with fathers. The aim of this study was to test the feasibility and acceptability of the Promotional Guide system with first-time fathers and pilot potential outcome measures to assess their mental health and wellbeing.Methods: A mixed methods prospective observational cohort study. Expectant first-time fathers were recruited from four London (UK) local authority boroughs. Data were collected through online pre and post intervention questionnaires, and semi-structured telephone interviews. Quantitative data were analysed using descriptive statistics and qualitative data were analysed using framework analysis.Results: Eighty-six fathers were interested in participating; 7 did not meet inclusion criteria and 79 were invited to complete the baseline questionnaire. Questionnaires completed by 45 men at both timepoints were included in the final analysis. Mean and standard deviations were calculated for all outcomes, showing a slight deterioration in the scores across all measures in the postnatal period compared to the antenatal. Ten of these men were also interviewed. Six major categories were identified: 1) Experience of health visitor contact, 2) Experience of Promotional Guides, 3) Experience of perinatal health services, 4) Experience of fatherhood, 5) Fathers' mental health and wellbeing, and 6) Experience of the research process. While antenatal and postnatal outcomes were collected from 45 first-time fathers, none had received the intervention in its entirety. This study identified major gaps in the implementation of the Promotional Guide system with fathers.Conclusion: This study assessed recruitment of first-time fathers, time to complete recruitment, and retention rates and identified outcome measures that could be used in a future definitive study. While it wasn't possible to examine the potential changes following the use of the Promotional Guide system, the study reported on the changes in the fathers' 'states' in the antenatal and postnatal period. It provided a narrative on whether first-time fathers found it acceptable to be asked about their mental health and wellbeing, highlighted their specific needs during their transition to fatherhood, and how they wanted to be supported. It also identified barriers to implementation of the Promotional Guide system by health visitors, which need to be addressed prior to any future research into this intervention. These findings have a number of implications for researchers, health professionals, health service managers, commissioners, policy makers and parents. [ABSTRACT FROM AUTHOR]

Background: Hospice patients with dementia are at increased risk for live discharge and long lengths of stay (>180 days), causing patient and family caregiver stress and burden. The location and timing of clinician visits are important factors influencing whether someone dies as expected, in hospice, or experiences a live discharge or long length of stay. Objective: Examine how home hospice and nurse visit frequency relate to dying in hospice within the Medicare‐intended 6‐month period. Design: Retrospective cohort study. Setting: Non‐profit hospice agency. Participants: Three thousand eight hundred and thirty seven patients with dementia who received hospice services from 2013 to 2017. Methods: Multivariable survival analyses examined the effects of receiving home hospice (vs. nursing home) and timing of nurse visits on death within 6 months of hospice enrollment, compared to live discharge or long length of stay. Models adjust for relevant demographic and clinical factors. Results: Thirty‐nine percent (39%) of patients experienced live discharge or long length of stay. Home hospice patients were more likely to experience live discharge or long length of stays (HR for death: 0.77, 95%CI: 0.69–0.86, p < 0.001). Frequency of nurse visits was inversely associated with live discharge and long lengths of stay (HR for death: 2.87, 95%CI: 2.47–3.33, p < 0.001). Conclusion: Nearly 40% of patients with dementia in our study experienced live discharge or a long length of stay. Additional research is needed to understand why home hospice may result in live discharge or a long length of stay for patients with dementia. Nurse visits were associated with death, suggesting their responsiveness to deteriorating patient health. Hospice guidelines may need to permit longer stays so community‐dwelling patients with dementia, a growing segment of hospice patients, can remain continuously enrolled in hospice and avoid burden and costs associated with live discharge. See related editorial by Hunt et al. in this issue. [ABSTRACT FROM AUTHOR]

Background: This study explored visiting nurses' knowledge and beliefs regarding pain management in community-dwelling older adults with moderate-to-severe dementia. Methods: A cross-sectional study design was used to collect data in 2019. A questionnaire was mailed to nursing managers at 1037 home-visiting nursing stations in Japan. Findings: The final analysis included 230 responses. The mean score on the knowledge and belief statements was 14 out of a possible 18, and respondents with more pain management training obtained a higher total score on knowledge than those without such training (p<.001). More than 95% indicated that they needed training on pain management for older adults with dementia. Conclusion: Visiting nurses in Japan require training in pain management for older adults with moderate-to-severe dementia. Despite its usefulness, the current pain management training programme should be improved to enable visiting nurses to manage dementia patients' pain more confidently. [ABSTRACT FROM AUTHOR]

Copyright of Croatian Nursing Journal is the property of University of Applied Health Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The qualities required for new graduates to become visiting nurses remain unclear. The present study aimed to clarify the qualities required for new graduate visiting nurses. Methods: Semi‐structured interviews were conducted with nine home‐visiting nurses. Content analysis was conducted by the transcribed data collected from visiting nurses. Results: Years of nursing experience were ranged from 16 to 50. In total, 23 attributes were extracted and categorized. Conclusion: Our findings indicated that the qualities required for new graduate visiting nurses were as follows: basic knowledge and skills required as professionals and appropriate attitudes as members of society. [ABSTRACT FROM AUTHOR]

This empirical article investigates the underlying ideas and images of children and childhood in the practice of health visitors and preschool teachers. Theoretically the article is based on the interpretation that these ideas and images are essential to understand the governing of children, though that the ideas of the possible and available subject positions in society are considered to be powerful and productive. As a typology for differing ideas about children and childhood, the article uses the child images developed by Chris Jenks and further developed by Karen M Smith. Furthermore, the analysis draws on concepts of Michel Foucault and Nikolas Rose. The results are based on ethnographical fieldwork and interviews, and the article concludes that both an innocent and a responsible image of the child form the practice of the health visitors and preschool teachers. An innocent child image fills up most of the time, but when the health visitors and preschool teachers are seeking explicitly to intervene and influence the children, a responsible child image is clearly dominant. [ABSTRACT FROM AUTHOR]

In this study, we aimed to determine whether cognitive reevaluation of psychological distress in visiting nurses promotes the development of their professional identities and elicits feelings of mutuality of caring. In study 1,we administered a questionnaire survey to 371 visiting nurses. A covariance structural analysis showed that, although most of the visiting nurses suffered more psychological distress from caring for clients, their professional identities were further developed through feelings of mutuality of caring caused by the successive reevaluation of future care for clients. In study 2, we intervened visiting nurses via e-mail. The results showed that, in experimental conditions in which visiting nurses successively reevaluated their psychological distress while considering future care for clients, the nurses had higher scores for measures of professional identity. These results supported our hypothesis and demonstrated the effectiveness of successively evaluating patient care, to elicit feelings of mutuality, in developing the professional identities of visiting nurses, who experience various kinds of psychological distress. [ABSTRACT FROM AUTHOR]

Background: Previous intergenerational (parent to child) and transgenerational (grandparent to grandchild) studies have shown there is a link between parental and offspring birthweight.Objectives: The aim was to explore the association between the early-life weight gain of an individual and the adult height of their children and grandchildren.Methods: Study participants across three generations of the Hertfordshire Cohort Study (HCS) were included in this study. Health visitors recorded the birthweight (kg) and weight at 1 year (kg) of the original (F0 generation) HCS participants when they were born in Hertfordshire between 1931 and 1939. A conditional infant weight gain score for F0 participants was calculated using birthweight and weight at 1 year, and self-reported height (cm) of their children (F1 generation) and their grandchildren (F2 generation) was obtained from postal questionnaires. Due to the lack of clustering within family lines, linear regression analysis was used to compare intergenerational relationships.Results: Data were available from 139 F0, 148 F1, and 198 F2 participants. A positive association was found between parental birthweight (F0) and offspring adult height; on average, a 1 kg increase in F0 birthweight was associated with a 2.04 cm increase in F1 adult height (beta 2.04, 95% confidence interval [CI] -0.03, 4.10). A positive association was found between F0 conditional weight gain during the first year of life and offspring (beta 1.53, 95% CI 0.45, 2.62) and grandchild height (beta 1.06, 95% CI 0.03, 2.10). Positive associations were also found between F0 weight at 1 year and offspring (beta 1.83, 95% CI 0.79, 2.87) and grandchild height (beta 0.91, 95% CI -0.10, 1.91).Conclusion: This study demonstrates an association between grandparental weight gain in early life and the heights of their children and grandchildren. The results of these analyses highlight the importance of early-life weight gain on the adult stature of subsequent offspring. [ABSTRACT FROM AUTHOR]

The consolidation and expansion of the public health programs in Mexico during the course of the first half of the twentieth century was possible due to the work of numerous women in the different branches of nursing: as visiting nurses, hospital nurses and nurse assistants. The following pages will examine the importance that the training of visiting nurses acquired during the 1920s and 1930s for the Department of Public Health and the Rockefeller Foundation; the work that they carried out in favour of maternal and child health, as well as their participation during the smallpox vaccination campaigns in both urban and rural settings from the 1920s to the 1940s. Also, the pre-eminence that the modernization and construction of hospitals had as of the 1940s will be addressed, with the purpose to underline that the enlargement of the hospital system, alongside the increasing specialization of nursing, did not alter the perceptions and appreciations regarding their work in the realm of the state-led public health campaigns.

Aim: The Japanese Comprehensive Strategy to Accelerate Dementia Measures, known as the New Orange Plan, aims to support people with dementia living in their communities. Home‐visit nurses (HVN) are expected to play an important role in this comprehensive support system. In this preliminary study, we explored caregivers' experiences before and after implementation of HVN care for persons with dementia who lived alone. Methods: This study was a qualitative descriptive design using in‐depth interviews with five family caregivers of persons with dementia who lived alone while receiving HVN. Thematic content analysis was undertaken. Results: Before receiving HVN, caregivers experienced anxiety and embarrassment due to the occurrence of dementia symptoms, and they also experienced considerable isolation and anguish after hearing the diagnosis. After initiating HVN, caregivers gained a feeling of security and an alleviation of psychological stress. They also gained a deeper understanding of the disease and appropriate care for dementia patients. Notably, caregivers perceived not only positive changes in themselves, but also in the recipients, such as improvements in symptoms and quality of life. Finally, caregivers realized that people with dementia can live alone if appropriate services are provided. Conclusion: HVN can have a positive impact on family caregivers involved in dementia care, as well as on the recipients' psychological status. Overall, the experience of HVN made the family caregivers more positive about home care for their family member with dementia. Although further case studies are needed to make definitive conclusions, we believe that HVN could play a key role in the forthcoming New Orange Plan. [ABSTRACT FROM AUTHOR]

Purpose: In Japan, many visiting nurses work carrying cell phones to respond to calls from users even at night (on-call work). The purpose of this study was to investigate whether on-call work affected heart rate variability (HRV) before bed and decreased sleep quality in visiting nurses even if their sleep was not interrupted due to actual calls.Methods: Thirty-one visiting nurses (mean age, 49.8 years; standard deviation, 6.3 years) were asked to record their 2.5-min resting HRV before bed, and to undergo one-channel sleep electroencephalography (EEG) and subjective sleep evaluations upon waking (Oguri, Shirakawa, and Azumi Sleep Inventory) at home for 4-5 consecutive days, including both on-call and non-on-call days. Paired data sets of outcome measures, including HRV parameters, sleep macrostructure variables, and subjective sleep quality scores between on-call and non-on-call days were compared; the most recent measurements for each category were used for each subject.Results: There were no differences in HRV measures and objective sleep EEG variables. A significant increase in “sleepiness on rising” and a decrease in “feeling refreshed” were observed on on-call days (P = 0.019 and 0.021, respectively), and younger subjects (≤ 51 years old) demonstrated a significant reduction in “sleepiness on rising” (significant interaction effect, P = 0.029).Conclusions: Adverse effects of on-call work on sleep quality in most visiting nurses are thought to be subjective, and relatively young nurses tend to notice a decrease in sleep quality. On-call work itself does not appear to be a substantial stressor that could affect HRV and sleep structure. [ABSTRACT FROM AUTHOR]

Nurse home visiting (NHV) offers a potential platform to both address the factors that limit access to services for families experiencing adversity and provide effective interventions. Currently, the ability to examine program implementation is hampered by a lack of detailed description of actual, rather than expected, program development and delivery in published studies. Home visiting implementation remains a black box in relation to quality and sustainability. However, previous literature would suggest that efforts to both report and improve program implementation are vital for NHV to have population impact and policy sustainability. In this paper, we provide a case study of the design, testing, and implementation of the right@home program, an Australian NHV program and randomized controlled trial. We address existing gaps related to implementation of NHV programs by describing the processes used to develop the program to be trialed, summarizing its effectiveness, and detailing the quality processes and implementation evaluation. The weight of our evidence suggests that NHV can be a powerful and sustainable platform for addressing inequitable outcomes, particularly when the program focuses on parent engagement and partnership, delivers evidence‐based strategies shown to improve outcomes, includes fidelity monitoring, and is adapted to and embedded within existing service delivery systems. [ABSTRACT FROM AUTHOR]

Background: In order to prevent postpartum depression many primary preventive programs were done. Psychological interventions are thought to be effective in decreasing the incidence of postnatal depression. Many studies aimed to evaluate the effect of Psychotherapy in treatment of postpartum depression. Methods: An electronic search was obtained in MEDLINE and EMBASE databases with search terms such as psychology, postpartum, depression, intervention, effectiveness. The primary search resulted in 128 studies which have been screened for eligibility. After exclusion of irrelevant, duplicated and review studies, 11 studies were included in the review as they met the inclusion criteria. Results: Psychotherapy decrease the likelihood of PPD and decrease postpartum depressive symptoms, increased awareness, depression reduction, general improvement and psychological health and prevention of PPD, improve depression, functioning and anxiety. Training for health visitors (HVs) intervention was found to be cost-effective in reducing the proportion of women at risk. It was only noted that there was no outcome difference between the CBA and the PCA groups. Health visitor (HV) training was noted to have preventive effect for depression. Conclusions: There is evidence to recommend that interventions carried in pregnancy can be effective in preventing postnatal depression. Interventions are mainly effective when grounded on psychological treatments and provided to women suffering from antenatal depression. [ABSTRACT FROM AUTHOR]

Background: Parental supervised brushing (PSB) when initiated in infancy can lead to long-term protective homebased oral health habits thereby reducing the risk of dental caries. However, PSB is a complex behaviour with many barriers reported by parents hindering its effective implementation. Within the UK, oral health advice is delivered universally to parents by health visitors and their wider teams when children are aged between 9 and 12 months. Nevertheless, there is no standardised intervention or training upon which health visitors can base this advice, and they often lack the specialised knowledge needed to help parents overcome barriers to performing PSB and limiting sugary foods and drinks. Working with health visitors and parents of children aged 9-24 months, we have co-designed oral health training and resources (Health Visitors delivering Advice in Britain on Infant Toothbrushing (HABIT) intervention) to be used by health visitors and their wider teams when providing parents of children aged 9-12 months with oral health advice. The aim of the study is to explore the acceptability of the HABIT intervention to parents and health visitors, to examine the mechanism of action and develop suitable objective measures of PSB. Methods/design: Six health visitors working in a deprived city in the UK will be provided with training on how to use the HABIT intervention. Health visitors will then each deliver the intervention to five parents of children aged 9-12 months. The research team will collect measures of PSB and dietary behaviours before and at 2 weeks and 3 months after the HABIT intervention. Acceptability of the HABIT intervention to health visitors will be explored through semi-structured diaries completed after each visit and a focus group discussion after delivery to all parents. Acceptability of the HABIT intervention and mechanism of action will be explored briefly during each home visit with parents and in greater details in 20-25 qualitative interviews after the completion of data collection. The utility of three objective measures of PSB will be compared with each other and with parental-self reports. Discussion: This study will provide essential information to inform the design of a definitive cluster randomised controlled trial. [ABSTRACT FROM AUTHOR]

Background: Medication management is the most challenging component of a successful transition from hospital to home, a challenge of growing complexity as the number of older persons living with chronic conditions grows, along with increasingly specialised and accelerated hospital treatment plans. Thus, many patients are discharged with complex medication regimen instructions, accentuating the risk of medication errors that may cause readmission, adverse drug events and a need for further health care. Aim: The aim of this study was to explore visiting nurses’ medication management in home health care after hospital discharge and to identify key elements in patient medication for improved patient safety. Method: Inspired by the ethnographic research cycle, participant observations and informal interviews were conducted at 12 initial visits by a nurse in a patient's home after hospital discharge. Data consisted of field notes and photographs from the patients’ homes, medication lists and medical records. Field notes were analysed in four steps. Findings: The analysis showed 12 stages in medication management in which nurses strove to adjust medication management to the patients’ actual health status by mediating on knowledge of the patient, information to the patient and on rules and regulations and by establishing order in medication lists and medications in the home. Conclusion: The nurse–patient relationship, the integration of care and the context of care challenged patient safety in visiting nurses’ medication management in patients’ homes after hospital discharge. The implications for practice were the following: to ensure nurses’ opportunities to continuously evolve their observation skills and skills in making sound clinical judgements; to establish interprofessional working processes which support the continuous assessment of patients’ needs and the adjustment of care and treatment; to clarify expectations to nurses’ responsibility and patients’ privacy. [ABSTRACT FROM AUTHOR]

Background: Supporting early mother-infant relationships to ensure infants' future health has been recommended. The aim of this study was to investigate whether video feedback using the Marte Meo method promotes a healthy early relationship between infants and vulnerable first-time mothers. Video feedback or usual care was delivered by health visitors during home visits in Danish municipalities.Methods: This quasi-experimental study included pre- and post-tests of 278 vulnerable families. Mothers were allocated to an intervention group (n = 69), a comparison group (n = 209) and an exactly matched video subsample from the comparison group (n = 63). Data consisted of self-reported questionnaires and video recordings of mother-infant interactions. Outcomes were mother-infant dyadic synchrony (CARE-Index), maternal confidence (KPCS), parental stress (PSS), maternal mood (EPDS) and infant socialemotional behaviours (ASQ:SE). The data were analysed using descriptive and linear multiple regression analysis.Results: The levels of dyadic synchrony in the intervention group had significantly improved (p < 0.001) at follow-up with a mean score of 9.51 (95%CI;8.93-10.09) compared with 7.62 (95%CI;7.03-8.21). The intervention group also showed a higher level of maternal sensitivity with a mean score of 9.55 (95%CI;8.96-10.14) compared with 7.83 (95%CI;7.19-8.46) in the matched video subsample (p < 0.001). With respect to infant cooperation, similar improvements were found with a mean score of 9.43 (95% CI;8.88-9.99) in the intervention group compared with 7.73 (95%CI;7.13-8.33) in the matched video subsample from the comparison group (p < 0.001). Furthermore, mothers in the intervention group reported significantly lower levels of parental stress with a mean score of 32.04 (95%CI;30.13-33.94) compared with 35.29 (95%CI;34.07-36.52) in the comparison group (p = 0.03), as well as higher levels of maternal confidence with a mean score of 41.10 (95%CI;40.22-41.98) compared with 40.10 (95%CI;39.65-40.56) in the comparison group (p = 0.04). No significant differences were found in EPDS and ASQ:SE.Conclusion: The findings support the assumption that video feedback using the Marte Meo method early after birth may strengthen the relationship between infants and vulnerable firsttime mothers as well as improve maternal psychosocial functioning. Further research applying random assignment is needed to strengthen these conclusions; further research is also needed to assess any long term effects of the video feedback intervention using the Marte Meo method.Trial Registration: This study was registered on 24 January 2013 in ClinicalTrials.gov with the identifier: NCT01799447 . [ABSTRACT FROM AUTHOR]

Background Ensuring and improving long-term care services that use limited healthcare resources more efficiently is a major concern for many aging societies. Objectives The aim of this study was to investigate the relationship between use of home-visit nursing services and all-cause hospitalization in a home-visit nursing-recommended group. Design A retrospective cohort study. Setting Population-based sample of long-term care insurance beneficiaries from the long-term care insurance 2002–2013 claims database in South Korea. Participants Long-term care insurance beneficiaries who need one or more types of nursing care were defined as the home-visit nursing −recommended group (n = 4173). Measurements The dependent variable in this study was all-cause hospitalization in the home-visit nursing-recommended population. Multivariate Cox proportional hazards regression analysis was used to identify the association between home-visit nursing service use and all-cause hospitalization. Results A total of 3.8% of the subjects used home-visit nursing services. When participants who used home-visit nursing services were set as the reference group, participants who did not use home-visit nursing services had a higher risk of hospitalization (hazard ratio [HR] = 1.25, 95% confidence interval [CI] = 1.07–1.47). Additionally, participants who did not use home-visit nursing services and who did not have a caregiver showed a marked increase in the risk of hospitalization (HR = 6.81, 95% CI = 1.17–39.66). Participants who did not use home-visit nursing services with greater comorbidity showed a considerable increase in risk of hospitalization (HR = 1.36, 95% CI = 1.09–1.70). Conclusions Non-use of home-visit nursing services was associated with an increased risk of all-cause hospitalization in the home-visit nursing-recommended population. The present results suggest that the use of home-visit nursing services reduced the risk of hospitalization. Moreover, home-visit nursing may play an essential role in reducing hospitalization risk in the absence of caregiver support. [ABSTRACT FROM AUTHOR]

Background: The health visitors’ role in many countries is changing. In Scotland, the role has undergone substantial changes through the introduction of an enhanced health visiting programme, which includes increased, structured home visits. This evaluation was conducted within NHS Ayrshire and Arran, one of the 14 Scottish Health Boards. Our aim was to understand and explain how, and why, the programme could contribute to improving health and wellbeing outcomes for children and families. Methods: We used a realist evaluation approach, conducted in three phases. In phase one, eight managerial staff involved in developing and implementing the programme provided data, which were used to develop initial programme theories. In phase two, the programme theories were tested using qualitative data from 25 health visitors and 22 parents. The programme theories were refined through analyses and interpretation of data in phase three. Results: The home visiting context provided by the programme interacted with the mechanisms of the programme and produced outcomes such as early identification of health and wellbeing issues amongst families who needed more support, leading to referral and engagement with sources of additional help. The home visits facilitated development of parent-health visitor relationships, and parents considered health visitors as their first point of contact on children’s wellbeing and developmental-related issues. Moreover, the programme provided more clarity to health visitors’ role, which in turn enhanced partnership working. However, there were aspects of the programme that may require further development. For instance, both parents and health visitors were concerned about the wide gaps between some home visits. Conclusions: The enhanced health visiting programme increased opportunities for monitoring and early identification of health and wellbeing concerns. It created structures for a more efficient partnership working and ensured that the needs of children and families were supported. These benefits need to be evaluated further in an effectiveness study. [ABSTRACT FROM AUTHOR]

The aim was to investigate the prevalence of using the reactive approach to patient safety event prevention in home-visit nursing agencies and explore factors associated with this approach. Multiple logistic regression analysis was conducted to investigate possible reactive approach-related factors. Two hundred forty-five agencies (71.0%) reported using the reactive approach to prevent event recurrence. Use of the reactive approach in agencies was significantly associated with having administrators who had attended an education course before employment in an administrative position (odds ratio = 1.95). To increase patient safety knowledge and awareness, administrator candidates must attend a course on home-visit agency management. Nursing researchers and policy makers should reexamine and adjust prerequisites for administrator registration at home-visit nursing agencies in Japan. [ABSTRACT FROM AUTHOR]

Copyright of Enfermería en Cardiologia is the property of Asociacion Espanola de Enfermeria en Cardiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

ABSTRACT Health visitors need competences to promote healthy early parent-infant relationships. The aims of this study were to explore whether there are differences between groups of health visitors with and without additional parenting program education in terms of their knowledge of infant-parent interaction and their observation and assessment skills of such interactions. The cross-sectional study included 36 health visitors' certified Marte Meo therapists and 85 health visitors without additional parenting program education. Health visitors' observation skills were measured assessing five video-recorded mother-infant interactions. A questionnaire was used to measure their intention, self-efficacy, and knowledge. More certified Marte Meo therapists than health visitors without additional parenting program education reported a significantly higher mean level of knowledge of the early relationship, 6.42 (95% CI; 6.18-6.66) versus 5.05 (95% CI; 4.86-6.10), p = .04; and more certified Marte Meo therapists than health visitors without additional parenting program education reported a higher mean level of knowledge of infant self-regulation, 2.44 (95% CI; 2.18-2.71) versus 1.83 (95% CI; 1.62-2.03), p < .001. In the latter group, 54% (95% CI; 0.43-0.64) reported a significantly higher need for further education versus 22% (95% CI; 0.11-0.39), p = .001. Compared to health visitors without any parenting program education, health visitors certified as Marte Meo therapists reported a significantly higher frequency of correct assessment of mothers' sensitivity in two of five video-recordings, with 77.78% (95% CI; 0.61-0.87) compared to 45.88% (95% CI; 0.35-0.57) in Video 3, p = .001, and 69.44% (95% CI; 0.52-0.82) compared to 49.41% (95% CI; 0.39-0.60) in Video 4, p = .04, respectively. The results of the present study support the use of video-based education of health visitors to increase their knowledge of and skills in assessing parent-infant interactions. Randomized controlled trials are needed to determine whether the improved level of health visitors' knowledge and observation skills may be assigned to participation in the Marte Meo education program. [ABSTRACT FROM AUTHOR]