Oda D S, O'Grady R
School of Nursing, University of California, San Francisco 94143-0608.
J Community Health Nurs. 1994;11(3):165-75. doi: 10.1207/s15327655jchn1103_5.
The purpose of this exploratory study was to identify the pattern of public health nursing service provided to substance-using mothers and their infants. To determine the effectiveness of public health nursing in a later randomized clinical trial (subsequent study), the first essential step was to identify clearly the nursing services that would constitute the intervention. For consistency, a clinical-practice checklist was developed by the public health nurses (PHNs) with the assistance of the investigators. Over a 6-month period, six PHNs made home, telephone, and office or clinic visits to mothers and their infants who were referred for follow-up due to a positive toxicology screen test at the time of delivery. For this client group (N = 28), the PHNs made one or two home visits to 17 mothers (61%), one or two telephone visits to 12 mothers (43%), and one or two office or clinic visits to 5 mothers (2%). Nearly one third of the time (29%), home-visit attempts were unsuccessful, and the client attrition rate was 50%. Polydrug use was common in this group, with 71% using two or more substances at the time of delivery. Referrals to substance-abuse treatment programs were usually not accepted by the clients, and many referrals were made for medical care and infants supplies. The most frequently mentioned area for advocacy was housing. Overall, public health nursing services were provided in a very limited time span of client availability.
这项探索性研究的目的是确定为使用毒品的母亲及其婴儿提供的公共卫生护理服务模式。为了在随后的随机临床试验（后续研究）中确定公共卫生护理的有效性，首要的关键步骤是明确构成干预措施的护理服务。为保持一致性，公共卫生护士（PHNs）在研究人员的协助下制定了一份临床实践清单。在6个月的时间里，6名公共卫生护士对因分娩时毒理学筛查呈阳性而被转诊接受随访的母亲及其婴儿进行了家访、电话访视以及办公室或诊所访视。对于这个客户群体（N = 28），公共卫生护士对17名母亲（61%）进行了一到两次家访，对12名母亲（43%）进行了一到两次电话访视，对5名母亲（2%）进行了一到两次办公室或诊所访视。近三分之一的时间（29%），家访尝试未成功，客户流失率为50%。该群体中多药滥用情况常见，71%的人在分娩时使用两种或更多物质。客户通常不接受转介到药物滥用治疗项目，许多转介是为了医疗护理和婴儿用品。最常提到的倡导领域是住房。总体而言，公共卫生护理服务是在客户可接受的非常有限的时间段内提供的。
