Examining the Synergy of Practice: The Irish Public Health Nurse's Potential From the First Postnatal Visit and Beyond

Public health nurses in Ireland are charged with conducting a home visit to every postnatal mother within 48 hours of hospital discharge. This represents the beginning of a long-term relationship, not only with the mother and newborn child but also with the family. This article fundamentally demonstrates the essential work of the public health nurse in promoting the health of the baby within a family. In this article, the expertise the public health nurse uses in the first visit is examined in the context of 3 competencies: communication, partnerships with the family, and partnerships with individual family members. This expertise provides the foundation for a long-term therapeutic relationship with the family to the essential benefit of the baby’s early childhood growth and developmental milestones. Consequently, the first postnatal visit by public health nursing in Ireland represents a synergy of practice, which provides the foundation for enduring family relationships focused on potentializing both individual family members’ health and the family as a dynamic unit.

Sickness absence, marginality, and medically unexplained physical symptoms: a focus-group study of patients' experiences

PURPOSE

Medically unexplained physical symptoms (MUPS) form a major cause of sickness absence. The purpose of this study was to explore factors which may influence further marginalization among patients with MUPS on long-term sickness absence.

METHODS

Two focus-group discussions were conducted with a purposive sample of 12 participants, six men and six women, aged 24-59 years. Their average duration of sickness absence was 10.5 months. Participants were invited to share stories about experiences from the process leading to the ongoing sickness absence, with a focus on the causes being medically unexplained. Systematic text condensation was applied for analysis. Inspired by theories of marginalization and coping, the authors searched for knowledge of how patients' positive resources can be mobilized to counteract processes of marginality.

RESULTS

Analysis revealed how invisible symptoms and lack of objective findings were perceived as an additional burden to the sickness absence itself. Factors that could counteract further marginalization were a supportive social network, positive coping strategies such as keeping to the daily schedule and physical activity, and positive attention and confidence from professionals.

CONCLUSIONS

Confidence from both personal and professional contacts is crucial. GPs have an important and appreciated role in this aspect.

Promoting physical activity in older adults by education of home visitors

The objectives were to investigate in older adults (1) whether regular preventive home visits are associated with change or stability in physical activity and (2) whether education of home visitors influences stability and change in physical activity. The design was a prospective controlled randomised follow-up study with randomization at municipality level (17 intervention and 17 control municipalities) and outcomes measured at individual level. Visitors in the intervention-municipalities received regular education during 3 years. The effect of the intervention was measured by a questionnaire survey among 1,913 old persons living in the 34 municipalities at baseline and 4½-year follow-up. Changes in physical activity were measured through self-reported frequencies of vigorous physical activity. All logistic regression analyses were stratified by sex and age group (75 and 80 years old). There was no effect of receiving preventive home visits on change in physical activity among the men and among the 75-year-old women. Among the physically active 80-year-old women those who accepted and received more than four preventive home visits were more likely to go on being physically active compared to women who did not receive preventive home visits. Among the sedentary 80-year-old women those living in the intervention municipalities tended to increase their physical activity compared to the control women. These results were not seen in the old men. Preventive home visits as part of daily routine in primary care and education of home visitors and general practitioners may promote physical activity in older women.

Educational intervention toward preventive home visitors reduced functional decline in community-living older women

OBJECTIVE

To investigate whether immediate effects of a 3-year educational intervention in primary health care were confirmed 18 months after the end of the intervention.

STUDY DESIGN AND SETTING

A controlled 3-year intervention study in 34 Danish municipalities with randomization and intervention at municipality level. The 17 intervention municipality visitors received regular education, and GPs were introduced to a short assessment program. The effect was measured at the individual level by questions about functional ability at the end of the intervention period and 1(1/2) years later; 4,060 older adults living in the municipalities participated. We adopt the approach introduced by Dufouil et al. (2004) and treat dropouts due to death differently from dropouts from other reasons.

RESULTS

Educational intervention to primary care professionals was associated with better functional ability in surviving women at the end of the intervention (odds ratio [OR]: 1.24, 95% confidence interval [CI]=1.07-1.45), from the end of the intervention until 1(1/2) years later (OR: 1.21, 95% CI=1.03-1.44) and during the total study period (OR: 1.22, 95% CI=1.06-1.42). No effects were seen in men.

CONCLUSION

The effect of a brief, feasible educational intervention for primary care professionals is sustained in women 1(1/2) years after the end of the intervention.

In their own words: coping processes among women aging with multiple sclerosis

SUMMARY People with multiple sclerosis (MS) employ a variety of coping mechanisms throughout the process of managing their disease. This study describes the coping processes used by women aging with MS. Participants in the study included 23 women living in the Chicago area aged 55 years or older and diagnosed with MS for a minimum of 15 years. Data were gathered through in-depth semi-structured qualitative interviews. Findings suggest that participants who reported integrating MS into their lives, had confidence in their abilities to cope with stress, and had a positive outlook on life appeared to employ action-oriented strategies to cope with their disease. Findings from the study offer ideas and direction for occupational therapy interventions for women aging with multiple sclerosis.