The Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Monash, VIC, 3168, Australia.
Int J Ment Health Syst. 2012 Aug 13;6(1):11. doi: 10.1186/1752-4458-6-11.
Australia's Early Parenting Services support families and intervene early in mental health problems in parents. The Victorian Early Parenting Strategy, a platform for government policy recommended a stronger evidence base for early parenting services. Tweddle Child and Family Health Service (TCFHS) is a not-for-profit public sector early parenting centre, which provides residential, day stay, home visiting and outreach programs. This study aimed i) to examine the health, social circumstances and presenting needs of clients attending the Tweddle Day Stay Program (DSP) with infants under 12 months old and ii) to assess the parent mental health and infant behaviour outcomes and the factors associated with program success.
A cohort of clients was recruited prior to admission and followed-up 8 weeks after discharge. Data were collected using standardised measures in a study specific questionnaire at baseline, participant's Tweddle records and a follow-up telephone interview. Health, social circumstances and presenting needs of clients were described. Changes in parents' symptoms of depression and infants' sleep and settling between admission and follow-up were calculated. Multiple regression analyses were conducted to examine factors associated with changes in primary outcomes.
Of the total 162 clients who were eligible and invited to participate, 115 (72%) were recruited. Parents admitted to the DSP had worse general self-reported physical and mental health than community samples. Infants of DSP participants were no more likely to be premature or have low birth weight, but significantly more unsettled than other community samples. Participants' mental health and their infants' behaviours were significantly improved after DSP admission. In multivariate analysis, higher depression score at baseline and greater educational attainment were significantly associated with improvements in parents' mental health. Worse unsettled infant behaviours and longer time between discharge and follow up were significantly associated with improvements in infant sleep and settling.
Tweddle DSPs appear to respond effectively to the needs of families presenting with substantial physical and emotional health morbidity and a range of vulnerabilities by treating parental mental health and infant behaviour problems together. DSPs offer important potential benefits for prevention of more serious family problems and consequent health care cost savings.
澳大利亚的早期育儿服务为家庭提供支持,并在父母的心理健康问题出现早期进行干预。维多利亚州的早期育儿战略是政府政策的平台,建议为早期育儿服务提供更强大的证据基础。Tweddle 儿童和家庭健康服务中心(TCFHS)是一个非营利性的公共部门早期育儿中心,提供住宿、日间停留、家访和外展计划。本研究旨在:i)研究参加 Tweddle 日间停留计划(DSP)的 12 个月以下婴儿的父母的健康、社会环境和主要需求;ii)评估父母的心理健康和婴儿行为结果,以及与计划成功相关的因素。
在入院前招募了一组参与者,并在出院后 8 周进行随访。使用标准的评估工具,在基线时收集参与者的 Tweddle 记录和随访电话访谈,在特定于研究的问卷中收集数据。描述了客户的健康、社会环境和主要需求。计算了入院和随访之间父母抑郁症状和婴儿睡眠及安定的变化。进行多元回归分析,以检验与主要结果变化相关的因素。
在符合条件并被邀请参加的 162 名客户中,有 115 名(72%)参与了研究。参加 DSP 的父母自我报告的一般身心健康状况比社区样本差。DSP 参与者的婴儿并非更有可能早产或低出生体重,但明显比其他社区样本更不稳定。参与者的心理健康和婴儿的行为在参加 DSP 后显著改善。在多变量分析中,基线时更高的抑郁评分和更高的教育程度与父母心理健康的改善显著相关。更严重的婴儿行为不稳定和出院与随访之间的时间间隔更长与婴儿睡眠和安定的改善显著相关。
Tweddle DSP 似乎通过共同治疗父母的心理健康和婴儿行为问题,有效地满足了那些身体和情感健康状况不佳以及存在一系列脆弱性的家庭的需求。DSP 为预防更严重的家庭问题和由此产生的医疗保健成本节省提供了重要的潜在益处。