Fowler Cathrine, Schmied Virginia, Dickinson Marie, Dahlen Hannah Grace
Centre for Midwifery, Child & Family Health, University of Technology Sydney, Broadway, NSW, Australia.
School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia.
J Clin Nurs. 2017 Feb;26(3-4):524-534. doi: 10.1111/jocn.13478. Epub 2016 Sep 20.
To investigate staff perception of the changing complexity of mothers and infants admitted to two residential parenting services in New South Wales in the decade from 2005-2015.
For many mothers with a young child, parenting is difficult and stressful. If parenting occurs within the context of anxiety, mental illness or abuse it often becomes a high-risk situation for the primary caregiver. Residential parenting services provide early nursing intervention before parenting problems escalate and require physical or mental health focused care.
A qualitative descriptive design using semi-structured interview questions was used as phase three of a larger study. Data were gathered from 35 child and family health nurses and ten physicians during eight focus groups.
Three main themes emerged: (1) dealing with complexity; (2) changing practice; and (3) appropriate knowledge and skills to handle greater complexity.
There was a mix of participant opinions about the increasing complexity of the mothers presenting at residential parenting services during the past decade. Some of the nurses and physicians confirmed an increase in complexity of the mothers while several participants proposed that it was linked to their increased psychosocial assessment knowledge and skill. All participants recognised their work had grown in complexity regardless of their perception about the increased complexity of the mothers.
Australian residential parenting services have a significant role in supporting mothers and their families who are experiencing parenting difficulties. It frequently provides early intervention that helps minimise later emotional and physical problems. Nurses are well placed to work with and support mothers with complex histories. Acknowledgement is required that this work is stressful and nurses need to be adequately supported and educated to manage the complex presentations of many families.
调查2005年至2015年这十年间，新南威尔士州两家寄宿育儿服务机构中工作人员对收治的母婴日益复杂情况的认知。
对于许多有幼儿的母亲来说，育儿既困难又有压力。如果育儿是在焦虑、精神疾病或虐待的背景下进行，那么对主要照顾者来说，这往往会成为一种高风险状况。寄宿育儿服务在育儿问题升级并需要专注于身心健康的护理之前，提供早期护理干预。
作为一项更大规模研究的第三阶段，采用了使用半结构化访谈问题的定性描述性设计。在八个焦点小组中，收集了35名儿童和家庭健康护士以及10名医生的数据。
出现了三个主要主题：（1）应对复杂性；（2）实践的变化；（3）处理更大复杂性所需的适当知识和技能。
对于过去十年寄宿育儿服务机构中母亲情况日益复杂这一点，参与者们意见不一。一些护士和医生证实母亲的复杂程度有所增加，而一些参与者则认为这与他们心理社会评估知识和技能的提高有关。所有参与者都认识到，无论他们对母亲复杂程度增加的看法如何，他们的工作复杂性都有所增加。
澳大利亚的寄宿育儿服务在支持面临育儿困难的母亲及其家庭方面发挥着重要作用。它经常提供早期干预，有助于将后期的情感和身体问题降至最低。护士非常适合与有复杂病史的母亲合作并提供支持。必须认识到这项工作压力很大，护士需要得到充分的支持和培训，以应对许多家庭的复杂情况。
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