Engagement and Retention of Families in Universal Australian Nurse-Home-Visiting Services: A Mixed-Methods Study
Abstract
:1. Introduction
2. Background to the Study Design
- How knowledgeable are CFHNs in relation to their mandatory CAN reporting responsibilities?
- What are the practice responses of CFHNs when managing families with complex service needs?
- How do CFHNs engage and respond to families with complex service needs?
- What is the role of education and training in preparing CFHNs for complex care offered to vulnerable families?
- Do CFHN consult with colleagues when reporting child protection concerns?
- How are child protection concerns raised with the family?
- Does disclosure of concern for children affect continued engagement with the family?
- How do CFHN support families once child protection concerns are raised?
- How are families discharged from the service once they cease to engage?
3. Methods
3.1. Phase One: Approach to Quantitative Data Collection
3.2. Phase Two: Approach to Qualitative Data Collection
3.3. Approach to Data Analysis
4. Results
4.1. Phase One Results
4.2. Phase Two Results
“Honesty is vital, like if they are honest with the families they tell them, ‘I’m the mandatory reporter, this is what this means’, whatever, and yeah, with vulnerable families they have an honest conversation and very rarely will those families disengage because I think they value that honesty”(participant, focus group 2).
“It just became part of our practice in our team to run it past the NUM, have a discussion with her about making any notification or any phone calls to CWU as to why, what their plan is, what the nurse’s plan is to follow-up and what maybe is the outcome from the phone conversation that they had as well”(participant, focus group 3).
“I feel it’s more important to make the notification rather than discuss it with my NUM first if my—I’ve done the MRG, I’ve spoke to the Wellbeing Unit and it’s telling me the report should be made, then I’ll make a report. On saying that, I will always discuss it with my manager at some point”(participant, focus group 1).
“This one just— she just vanished…it was one text message to say, ‘No, I’m not available today, I’ve moved house, I don’t know my new address yet’. (Then) Phone number was disconnected, no address, nowhere to go and those ones when there was a lot of things in place… we felt like we were getting somewhere, we felt like there was a little shift…{Researcher: ‘so how did that feel?’} and that felt really awful. That felt really awful”(participant, focus group 1).
5. Discussion
5.1. Enrolment Phase: Honesty in Relationships
5.2. Retention Phase: The ‘Art of Managing Complexity’
5.3. Conclusion Phase: Uncertain Endings
6. Conclusions
6.1. Practical Implications
6.2. Contributions to the Field
- Progressive universalism: this type of service places nurses in a position of profound responsibility to address the complex needs of families. Consequently, advanced nurse practice is essential to adjust the dosage of universal health services to effectively engage parents, even in circumstances where they are hard to reach. This means engagement must be flexible and nurses need to be well resourced.
- Applying the Model of Parent Involvement allowed for a critical examination of both the role nurses play (provider factors) but also an examination of the universal health service (programme drivers).
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Mawhinney, B.; Fraser, J.A. Engagement and Retention of Families in Universal Australian Nurse-Home-Visiting Services: A Mixed-Methods Study. Int. J. Environ. Res. Public Health 2023, 20, 6472. https://doi.org/10.3390/ijerph20156472
Mawhinney B, Fraser JA. Engagement and Retention of Families in Universal Australian Nurse-Home-Visiting Services: A Mixed-Methods Study. International Journal of Environmental Research and Public Health. 2023; 20(15):6472. https://doi.org/10.3390/ijerph20156472
Chicago/Turabian StyleMawhinney, Belinda, and Jennifer A. Fraser. 2023. "Engagement and Retention of Families in Universal Australian Nurse-Home-Visiting Services: A Mixed-Methods Study" International Journal of Environmental Research and Public Health 20, no. 15: 6472. https://doi.org/10.3390/ijerph20156472