Safeguarding and protecting children: where is health visiting now?
ABSTRACT This paper aims to reinforce the importance of a well funded health visiting service in safeguarding and protecting children. While the issues involved in safeguarding and child protection have not really changed in essence, in recent years the practice context, organisational climate and policy drivers have. This paper briefly outlines health visitors' work with children and families, reiterating the profession's track record in safeguarding and protecting children work and discussing how important the health visitor role is and how eroded it has become. The small body of research evidence in this area is discussed, current policy drivers examined and obstacles to good safeguarding practice described. Health visitors' work in child protection is important, and part of a continuum of public health activity including universal preventative work, identifying and working with vulnerable children and their families, and protecting children from abuse and neglect.
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ABSTRACT: BACKGROUND: Given the significance of reliably detecting cases where mother-infant relationships are not developing successfully, it is important that initial assessment processes are as sensitive and specific as possible. OBJECTIVES: This study sought to examine the processes by which health visitors identify problems in mother-infant relationships in the post-natal period. DESIGN: Mixed methods. SETTINGS: Two universities and two primary care trusts. PARTICIPANT: In Phase One 17 first-time mothers and their 6- to 16-week-old infants were recruited. In Phase Two, a sample of 12 health visitors participated. METHODS: The study incorporated two data collection phases. In Phase One, each mother's interaction with her baby was video-recorded for 20min in an observation laboratory. The video-recordings were coded and resultant data were analysed to derive a number of quantitative measures of interaction quality, including mothers' responsiveness and sensitivity to their infants as rated by the Global Ratings Scales (GRS) of Mother-Infant Interaction. In Phase Two, 12 health visitors rated and assessed 9 clips of the video-recorded mother-infant interactions. The rationales for their ratings were then explored through in-depth interviews. Health visitor ratings of the video clips were compared to the GRS ratings. The relationship between the main focus of each health visitor rating, as reported in the interview, and the consistency of ratings with the GRS ratings were then investigated. RESULTS: Correlations between individual health visitors' ratings and the GRS ratings ranged from .17 to .83 and were statistically significant in only four cases. There was a weak relationship with health visitors' years of experience (r(s)=.47, NS). When explaining their judgements, health visitors tended to comment on the mother's behaviours or the relationship between the mother and baby and often ignored the behaviour of the baby. There was a highly significant relationship between the consistency of health visitor/GRS ratings and the number of references to the baby in the health visitors' explanations (r(s)=.75, p=.005). CONCLUSION: This study contributes to the understanding of how health visitors make assessments of mother-infant interactions. The frequent lack of attention and reference to the baby's behaviour suggests an area for further training.International journal of nursing studies 09/2012; 50(1). DOI:10.1016/j.ijnurstu.2012.08.008 · 2.25 Impact Factor
Book: Why Health Visiting? A review of the literature about key health visitor interventions, processes and outcomes for children and families. Department of Health Policy Research Programme. King's College, London, National Nursing Research Unit. Available: http://www.kcl.ac.uk/nursing/research/nnru/publications/index.aspx .[Show abstract] [Hide abstract]
ABSTRACT: Cowley S, Whittaker K.A, Grigulis A, Malone M, Donetto S, Wood H, Morrow E, Maben J. (2013) This literature review was commissioned to support the Health Visitor Implementation Plan 2011-2015: A Call to Action (Department of Health 2011). That document sets out plans increase the number of health visitors employed by around 50% (4200 additional health visitors by 2015), to mobilise the profession and to align delivery systems with new NHS architecture and local government children’s services (including Sure Start Children’s Centres). The Implementation Plan describes how the new health visiting service should include delivery of the existing Healthy Child Programme (HCP) and integrate with services for children, families, mental health and public health. Such a large undertaking brings in its wake a number of research questions, and we engaged with policy customers through the Policy Research Programme to create and refine the key questions for this review. Study Aims The overarching question for the review was: What are the key components of health visitor interventions and relationships between the current health visiting service, its processes and outcomes for children and families? Available: http://www.kcl.ac.uk/nursing/research/nnru/publications/index.aspx .02/2013; NNRU.