Friday, 26 July 2013: 10:15 AM
Megan Aston, RN, PhD1
Sheri Price, RN PhD1
Josephine B. Etowa, RN, PhD2
Adele Vukic, RN, MN1
Linda Young, BSc, MPA3
Janis Kay, RN, MN3
Christine Hart, RN, BA, BScN, IBCLC3
Kathy Inkpen, RN, BScN4
Pat Randel, BA, MSc1
(1)School of Nursing, Dalhousie University, Halifax, NS, Canada
(2)School of Nursing, University of Ottawa, Ottawa, ON, Canada
(3)Capital District Health Authority, Public Health Services, Dartmouth, NS, Canada
(4)Department of Health and Wellness, Halifax, NS, Canada
Learning Objective 1: Participants will understand the experiences of public health nurses and mothers participating in targeted and universal early home visiting programs
Learning Objective 2: Participants will understand how public health nurses and mothers challenged and redefined health outcomes and surveillance during early home visits
Purpose: Health promotion and protection of mothers, babies and their families in the early post partum period is essential for life-long health. Public health nurses provide early home visiting (EHV) for mothers, which has been proven to positively impact physical, social, emotional, and mental health outcomes of mothers and babies. Most of the research has focused on high risk or ‘targeted’ groups of mothers rather than ‘universal’ mothers. Further information is required to understand how mothers and families who are considered to be ‘universal’ are coping, many of whom may also be identified as ‘targeted’ and experiencing poor health outcomes. There is a significant gap in understanding which program best optimizes health outcomes for all families. The purpose of this research was to explore how universal and targeted EHV programs for mothers and babies were organized, delivered, and experienced through the everyday practices of PHNs, mothers, and managers in Nova Scotia
Methods: Feminist poststructuralism was used to collect and analyze data through semi-structured face-to-face interviews with 16 PHNs, 16 mothers, and 4 managers.
Results: The use of discourse analysis provided a lens to understand the beliefs and practices associated with the targeted and universal EHV programs. Mothers and PHNs praised, critiqued, and challenged various aspects of each of the programs. However, differences between the programs also created tensions and misunderstandings of the work of PHNs constructed through social and institutional discourses. Different types of families were stereotyped and much of the work of PHNs was invisible. This presentation will highlight four themes: 1) Mothering as a social and medical construct 2) Defining support 3) Redefining health outcomes 4) Shifting surveillance
Conclusion: Findings suggest that EHV programs need to be reorganized to better support the 21st century mother, baby and family.
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