Responding to families with complex needs: a national survey of child and family health nurses.
OBJECTIVE
The aim of this study was to explore the extent to which Australian child and family health nurses work with families with complex needs and how their practice responds to the needs of these families.


BACKGROUND
Many families with young children face challenges to their parenting capacity, potentially placing their children at risk of poorer developmental outcomes. Nurses increasingly work with families with mental health problems, trauma histories and/or substance dependence. Universal child health services must respond effectively to these challenges, to address health inequalities and to promote the best outcomes for all children and families.


METHODS
The descriptive study used cross-sectional data from the first national survey of child and family health nurses in Australia, conducted during 2011.


METHODS
Survey data reported how often, where and how child and family health nurses worked with families with complex needs and their confidence in nursing tasks.


RESULTS
Many, but not all, of the 679 respondents saw families with complex needs in their regular weekly caseload. Child and family health nurses with diverse and complex caseloads reported using varied approaches to support their clients. They often undertook additional professional development and leadership roles compared with nurses who reported less complex caseloads. Most respondents reported high levels of professional confidence.


CONCLUSIONS
For health services providing universal support and early intervention for families at risk, the findings underscore the importance of appropriate education, training and support for child and family health professionals. The findings can inform the organization and delivery of services for families in Australia and internationally.
Centre for Midwifery, Child and Family Health, University of Technology Sydney, Broadway, New South Wales, Australia.
Chris
http://orcid.org/0000-0002-3833-3076
C
Rossiter
School of Nursing and Midwifery, Western Sydney University, Penrith South DC, New South Wales, Australia.
Virginia
V
Schmied
School of Nursing and Midwifery, Western Sydney University, Penrith South DC, New South Wales, Australia.
Lynn
L
Kemp
Centre for Midwifery, Child and Family Health, University of Technology Sydney, Broadway, New South Wales, Australia.
Cathrine
C
Fowler
Maternal Child Health, Institute of Urban Indigenous Health, Bowen Hills, Queensland, Australia.|School of Nursing, Midwifery and Social Work, University of Queensland, St Lucia, Queensland, Australia.
Sue
S
Kruske
Centre for Midwifery, Child and Family Health, University of Technology Sydney, Broadway, New South Wales, Australia.
Caroline S E
CS
Homer
D000328:Adult; D000368:Aged; D001315:Australia; D002648:Child; D002669:Child Welfare / Q000706:statistics & numerical data; D002983:Clinical Competence / Q000592:standards; D003430:Cross-Sectional Studies; D005192:Family Health / Q000706:statistics & numerical data*; D022143:Family Nursing / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role; D000072222:Nurses, Pediatric / Q000706:statistics & numerical data; D010371:Pediatric Nursing / Q000706:statistics & numerical data*; D011368:Professional-Family Relations; D012944:Social Support; D055815:Young Adult
Australia; child and family health nurses; child health; complex needs; disadvantaged families; early intervention; infants; maternal health; universal services