Measuring the Development and Well-being Longitudinal Outcomes of Children from Birth to Two Years following Increased Public Health Nurse Interventions
Citation:Mary O'Rourke, 'Measuring the Development and Well-being Longitudinal Outcomes of Children from Birth to Two Years following Increased Public Health Nurse Interventions'
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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.
Author: O'Rourke, Mary
Qualification name:Doctor of Philosophy
Type of material:Thesis
Availability:Full text available