Holland Margaret L, Christensen Julie J, Shone Laura P, Kearney Margaret H, Kitzman Harriet J
J Obstet Gynecol Neonatal Nurs. 2014 Jan-Feb;43(1):61-70. doi: 10.1111/1552-6909.12263. Epub 2013 Dec 19.
To describe mothers' reasons for leaving a home visiting program early.
Qualitative descriptive study using semistructured interviews of mothers who dropped out of the Nurse-Family Partnership (NFP) and two focus groups with nurses and nurse supervisors at an NFP site.
A New York State site of a NFP home visitation program for low-income new mothers designed to improve the physical and emotional care of children.
Participants included 21 mothers, 8 nurses, and 3 nurse-supervisors.
Semistructured interviews and focus groups were used to collect data, which were analyzed using content analysis.
The program was not perceived to fit a mother's needs when she was overwhelmed with other responsibilities, the nurse did not meet her expectations, the content was not of interest, or the mother did not desire visits after the infant was born. Nurses and mothers described the need for mothers to have organizational and communication skills, such as keeping track of appointments, calling to reschedule, articulating needs, and asking for assistance. Disruptive external influences included nurse turnover and unstable living situations, including frequent moves and crowded housing. Each of these types of barriers had potential to interact with the others, creating complex combinations of challenges to retention.
NFP retention might be improved by reframing program relevance to individual mothers and increasing maternal organizational and communication skill development.
描述母亲提前退出家访项目的原因。
采用定性描述性研究方法，对退出护士-家庭伙伴关系项目（NFP）的母亲进行半结构式访谈，并与一个NFP站点的护士和护士主管开展两个焦点小组访谈。
纽约州一个针对低收入新妈妈的NFP家访项目站点，该项目旨在改善儿童的身心护理。
参与者包括21位母亲、8名护士和3名护士主管。
采用半结构式访谈和焦点小组访谈收集数据，并运用内容分析法进行分析。
当母亲被其他责任压得喘不过气来时，该项目被认为不符合其需求；护士未达到其期望；内容无趣；或者母亲在婴儿出生后不想接受家访。护士和母亲们描述了母亲具备组织和沟通技能的必要性，比如记录预约时间、打电话重新安排时间、清楚表达需求以及寻求帮助。干扰性的外部影响包括护士人员流动和不稳定的生活状况，如频繁搬家和居住空间拥挤。这些类型的障碍中的每一种都有可能与其他障碍相互作用，形成留住参与者面临的复杂挑战组合。
通过重新调整项目与个体母亲的相关性，并加强母亲组织和沟通技能的培养，可能会提高NFP项目的留存率。
