Objectives To identify evidence underpinning key elements that contribute to best practice models for sustained child health home visiting for families with vulnerabilities in Australian settings.
Background A comprehensive literature review conducted by the Australian Research Alliance for Children and Youth (ARACY) in 2012 identified that evidence to support a best practice child health home visiting model in Australia was lacking or contradictory. Home visiting programs require a rigorous evidence base to support the inclusion of key elements necessary to promote optimal outcomes for families experiencing parenting challenges.
Study design and methods This scoping review utilised the nine-step Joanna Briggs Institute scoping review framework. PubMed, CINAHL, Maternity and Infant Care, Google Scholar and government sites were searched for eligible publications between January 2011 and December 2019 that reported on Australian-based home visiting programs provided by child health nurses aimed to support families with vulnerabilities.
Results The importance of factors associated with effective programs, identified in the original ARACY reviews, were reinforced, together with key program elements including – a positive nurse relationship, family partnership, information tailored to the family’s needs, continuity of carer, and programs targeted to families most likely to benefit. Being embedded in universal services, program flexibility and nurse availability and responsiveness were also identified as key elements by contemporary programs.
Conclusion This review identified contemporary evidence supporting key elements for successful home visiting programs and demonstrated the importance of maintaining program content and intervention fidelity in order to achieve intended outcomes.
Background There has been discussion in the literature regarding family-centred care and whether it is being utilised in the manner in which it is intended, or if it is idealistic and difficult to implement in practice. This paper examines perceptions about caring for children and their parents – the cornerstone of family-centred care – of health professionals working with children and working with their families in rural community settings.
Methods The tool was a widely, internationally used questionnaire Working with Families, consisting of demographic questions and two questions that explore participants’ perceptions of working with children and their parents. Participants were health professionals working in child and family health services within a rural health service in New South Wales, Australia. Invitations and information were emailed, and consent implied by completion of Working with Families.
Findings In 2018, 57 participants responded, with over half identifying as registered nurses; the remainder were allied health professionals. No doctors chosse to participate in the survey. The majority were female, and 94% had been in their community role working with children and families for at least 5 years. The overall finding was that health professionals rate working with children higher than working with their parents – mean difference 0.36 (95% CI:0.24, 0.48; p<0.001).
Conclusion This study found that health professionals gave a statistically significant more positive score for working with children than with their parents. This adds to the argument that family-centred care as a way to care for children when they access health services is problematic. The conclusions support the argument that it is time to review family-centred care and trial a new model, child-centred care, in health situations.
Adolescence is a difficult time for the young person as they adjust to the many physical, sexual, emotional and social changes in their lives. They have unique healthcare needs and, as a result, hospitalisation can be an emotive experience for the adolescent, and challenging for the healthcare providers. Patient and Family Centred Care (PFCC) is a partnership between healthcare providers and the patient and their family. This partnership’s core concepts include dignity, respect, information sharing, participation and collaboration. PFCC recognises and values the roles the patient and family have in working together with the healthcare team to achieve better health outcomes, as well as subsequent increased staff satisfaction. This paper discusses the experience of a 14-year-old female admitted to an eight-bed adult intensive care unit (ICU) following surgery at a metropolitan private hospital. It explores the concept of PFCC and how its implementation would have led to better patient and family satisfaction.
Background A high proportion of Queensland children diagnosed with type 1 diabetes presented in diabetic ketoacidosis (DKA) over the last 2 decades. The Statewide Diabetes Clinical Network (SDCN) prepared a campaign to reduce paediatric DKA at diagnosis.
Aims and objectives The overall aim was to prepare the awareness campaign. The specific project objectives were to:
Explore parents’ knowledge of prodromal high blood glucose symptoms requiring medical review.
Understand where and from whom parents seek child healthcare and advice.
Design Anonymous, self-completed survey.
Setting and participants A link to the survey was posted on the Playgroup Queensland’s Facebook page. The target audience were parents of children in Queensland.
Results One hundred and two parents responded. Parents only prioritised two of the four prodromal symptoms of high blood glucose levels when asked to choose which common childhood complaints would prompt them to present to the GP. Most parents accessed their GP for healthcare, although some reported difficulties in getting appointments and cost as barriers. Respondents also accessed community child health and used the personal health records to source information and advice.
Conclusion The results suggest parents may not know the prodromal signs of high blood glucose levels in children. This could lead to delays in seeking a medical assessment and, in turn, the high number of children presenting in DKA at diagnosis. It is anticipated interventions aimed at improving parents’ knowledge of prodromal signs will lead to earlier presentations for treatment and ultimately reduce the incidence of DKA at diagnosis.