9.5.2 Health visitors’ workload priorities and postpartum care decisions (167)

Janice Christie, Teaching fellow, School of Nursing and Midwifery, Queen's University, Belfast, Northern Ireland, United Kingdom Co authors: Brenda Poulton & Brendan Bunting j.christie@qub.ac.uk

Abstract:

Systematic reviews have produced evidence that antenatal and postpartum home visitation by public health nurses can benefit families (Bull et al., 2004). Traditionally, health visitors and midwives within the UK have offered care to all families with young children. The latest Health for all Children report (Hall & Elliman, 2003) advocated family care based on professional judgement of ‘higher risk/need’. Little is known, however, about the basis of health visitors’ professional judgements. The aim of this study is to assess health visitors’ care priorities and basis of postpartum care decisions. This quantitative research collected survey data from health visitors working in one Health and Social Services Board in Northern Ireland during 2002. All 108 health visitors were invited to take part and 99 returned structured postal questionnaires. Survey questions concerned work priorities and postpartum care, based on a mid-range theory of postpartum care decisions developed during an earlier qualitative study. Data was analysed using descriptive, parametric and non parametric statistics using SPSS version 11. Health visitors gave child protection work highest (mean 9.9), and antenatal care lowest workload rating (mean 2.5). The professionals visited low-risk families on average 4.7 and higher-risk 5.8 times to 8 weeks postpartum. Paired t-test comparison of the mean frequency of postpartum home visitation found higher ‘preferred’ than ‘actual’ visitation patterns for low-risk families (except bottle feeding mothers with more than one child, 1.412, p=0.161). Health visitors were found to decide fortnightly or weekly home visits to low-risk families according to personal value placed on specific aspects of health visitor care. The study provides evidence for a proposed mid-range theory of postpartum care decisions and highlights variations within the health visiting workforce regarding workload and care priorities. These variations have the potential to affect service content and outcomes.

Biography:

Teacher of nursing in the community and research within nursing undergraduate curriculum at Queen's university Belfast. Worked for 15 years as a health visitor.