The Parent Support Team (PST) is an intensive early intervention home visiting programme delivered by child and family health nurses to families with infants aged 0–6 months experiencing psychosocial and health vulnerabilities. In contrast, mainstream services provide universal clinic-based care and scheduled developmental checks. This mixed-methods study aimed to: (1) describe demographic and psychosocial characteristics, service activity and well-baby check attendance among PST clients compared with mainstream service clients; (2) evaluate changes in maternal depressive symptoms following PST engagement; and (3) explore client experiences, including perceived outcomes and facilitators and barriers to change.
Convergent parallel mixed-methods study.
Retrospective data were extracted from electronic medical records for PST clients (909 mothers; 1038 children) and mainstream service clients (17,707 mothers; 21,764 children) between August 2019 and December 2022. Quantitative analyses described demographics, psychosocial characteristics, service use and maternal depressive symptoms. PST client experience surveys (166 mothers) were analysed using descriptive statistics and thematic analysis.
PST clients demonstrated greater psychosocial complexity and higher maternal depressive symptoms at entry than mainstream clients. PST mothers had more frequent service contacts and maintained stronger engagement with services after discharge. The proportion of mothers with clinically significant depressive symptoms decreased following programme participation. Survey findings indicated improved parenting confidence and practical skills. Positive outcomes were attributed to nurse qualities, opportunities to discuss concerns, a holistic care approach and the service model. Reported barriers included accessibility, scope of education topics and communication challenges.
The PST programme effectively engages vulnerable families, supports maternal mental health and promotes sustained connection with child and family health services.
Intensive early intervention home visiting programmes may improve outcomes for families with complex needs and warrant broader implementation.
SRQR guidelines were followed.
None.
Exploring the concept of patient agitation in the intensive care unit.
Patient agitation in the intensive care unit is of widespread concern and linked to negative outcomes for patients, staff, and family members. There is currently no consensus on what constitutes agitation in the intensive care context, hindering effective and tailored prevention and management.
Concept Analysis.
Walker and Avant's eight-step concept analysis approach.
A comprehensive search was carried out in the databases MEDLINE, PsychINFO and CINAHL. A total of 32 papers published between 1992 and 2023 were included, reviewed, and analysed to explore definitions, attributes, antecedents and consequences of patient agitation.
Patient agitation in the intensive care unit is characterised by excessive motor activity, emotional tension, cognitive impairment, and disruption of care, often accompanied by aggression and changes in vital signs. Antecedents encompass critical illness, pharmacological agents and other drugs, physical and emotional discomfort, patient-specific characteristics and uncaring staff behaviours. Consequences of agitation range from treatment interruptions and poor patient outcomes to the psychological impact on patients, families, and staff.
Agitation in the intensive care unit is a complex issue which significantly impacts patient treatment and clinical outcomes. For healthcare professionals, patient agitation can contribute to high workloads and job dissatisfaction. Due to the complex nature of agitation, clinicians must consider multifaceted strategies and not rely on medication alone. Further research is needed to fully understand patient agitation in the ICU. Such understanding will support the development of improved strategies for preventing and managing the behaviours.
A clearer understanding of patient agitation supports the development of tailored interventions that improve patient care, guide ICU training, and inform future research.
This concept analysis was developed with input from a patient representative.
To identify research gaps by mapping what is known about the barriers and enablers to pre-registration nursing students identifying signs of suicidal distress in healthcare consumers and providing clear pathways of support.
Scoping review.
This scoping review was conducted using Arksey and O'Malley's (2005) five stage framework and the Levec et al. (2010) extensions of this framework.
The Cumulative Index of Nursing and Allied Health Literature (CINAHL) Complete and Ovid MEDLINE databases were searched to identify relevant articles, keywords and search terms to inform the full search strategy for CINAHL. This search strategy was then adapted for Scopus, PsychInfo, Emcare, Medline and ERIC, searched in November 2024.
Studies eligible for inclusion (N = 28) represented research from 14 countries; most (53.5%, n = 15) used a quantitative design, 11 (39.3%) were qualitative and two (7.1%) used a mixed-methods design. Barriers found from the scoping review included a low level of knowledge of suicidality, stigma preventing students from assessing and acting on suicidal ideation, and a lack of confidence in providing care to healthcare consumers expressing suicidality. Enablers included lived experience, exposure to individuals expressing suicidal ideation and education, simulation and role play. This review also contributes to the existing literature about the relationship of nursing to existing suicide prevention frameworks and suggests revision of these frameworks to address staff attitudes and beliefs, as well as lived and living experience.
Nurses are ideally placed to assess and respond to suicidality among healthcare consumers, and preparation should begin during pre-registration studies. Our scoping review indicates that further research work is needed to address the barriers to working with healthcare consumers expressing suicidality and to enhance the enablers to provide safe care.
Addressing the barriers and enablers to pre-registration nursing students providing safe care for healthcare consumers expressing suicidality is essential. Further research is required to address the barriers and enhance the enablers identified in this scoping review.
What problem did the study address? This scoping review summarised the literature on pre-registration student ability to work with healthcare consumers expressing suicidality, identifying barriers and enablers. What were the main findings? Barriers include poor knowledge of suicidality, stigma, fear and a lack of confidence in working with healthcare consumers expressing suicidality. Enablers include lived experience, exposure to clinical settings where healthcare consumers express suicidality and simulation and education. Where and on whom will the research have an impact? The research will have an impact on providers of pre-registration nursing degrees, where the inclusion of content addressing suicidality and exposure to settings where individuals express suicidal ideation is shown to improve attitudes and knowledge of suicidality assessment.
PRISMA checklist for scoping reviews.
This study did not include patient or public involvement in its design, conduct or reporting.