Les visites à domicile en périnatalité : enquête auprès des puéricultrices de PMI en Haute-Garonne
20 Sep 2017-
TL;DR: In this article, a traversé menee en 2017 en Haute-Garonne, les results mettent en valeur l'impossibilite de realiser une prevention universelle a domicile and the necessite de cibler des facteurs de vulnerabilite.
Abstract: La visite a domicile (VAD) dans le domaine de la perinatalite est un outil universellement reconnu de prevention et de soutien a la parentalite. En France, ces VAD sont effectuees par la Protection maternelle et infantile (PMI) et il existe a ce jour peu d'etudes sur leurs pratiques. L'objectif de ce travail est de faire un etat des lieux de l'activite de visites a domicile des puericultrices de PMI, a travers une enquete menee en 2017 en Haute-Garonne. Les resultats mettent en valeur l'impossibilite de realiser une prevention universelle a domicile et la necessite de cibler des facteurs de vulnerabilite. Le fait d'etre seule a domicile peut alors etre source de stress et les puericultrices expriment leur besoin de pouvoir travailler en lien avec les services sociaux et les equipes de psychiatrie. La supervision et les formations specifiques sur les problematiques de sante mentale apparaissent comme des outils interessants pour ameliorer les pratiques.
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22 Apr 2015
TL;DR: The norme d'activite et de moyens d'un service de PMI est d'une demi-journee de consultations par semaine for 200 enfants dans chaque departement as discussed by the authors.
Abstract: La norme d’activite et de moyens d’un service de PMI est d’une demi-journee de consultations par semaine pour 200 enfants dans chaque departement. Elle est atteinte dans 62 departements, et meme doublee dans 7 d’entre eux.
3 citations
14 Oct 2015
TL;DR: The Family Nurse Partnership (FNP) as discussed by the authors is a programme of prenatal and early childhood home visiting for vulnerable first-time mothers and their children, which aims to reduce health disparities in the UK.
Abstract: Giving children the best possible start in life is crucial to reduce health disparities. One of the UK Government’s efforts to support young children has been to adapt and assess the Family Nurse Partnership (FNP), a programme of prenatal and early childhood home visiting for vulnerable first-time mothers and their children. This article comments on a study published in the Lancet on Building Blocks, a multisite trial of the FNP in England.
2 citations
Dissertation•
20 Oct 2015
TL;DR: In this paper, a sociologique descriptive permettant de fournir un eclairage sur the reception in France of evidence-based interventions is presented. But, le reception reelle ne va cependant pas de soi and fait lobjet de nombreux debats.
Abstract: En France, un certain nombre de recommandations ont ete emises ces dernieres annees pour le developpement de programmes preventifs dits « evidence-based » dans le champ de la parentalite et de la petite enfance. Si leur diffusion est percue par les instances gouvernementales comme une opportunite de reduire un certain nombre de facteurs de risque sanitaires et sociaux et de promouvoir la sante et le bien-etre des populations, leur reception reelle ne va cependant pas de soi et fait lobjet de nombreux debats. La these consiste en une etude sociologique descriptive permettant de fournir un eclairage sur la reception en France de ces programmes. En effectuant des enquetes de terrain de type ethnographiques (observations participantes et entretiens) en France et aux Etats-Unis, cette these vise plus specifiquement a mettre en evidence la maniere dont ces programmes evidence-based sont concus dans leur pays d'origine et reappropries en France de leur elaboration institutionnelle a leur mise en oeuvre pratique sur le terrain. Le manuscrit, redige sous format narratif, est constitue de deux parties. La premiere partie s'interesse au processus de production des politiques de parentalite et de la petite enfance evidence-based au sein d'un centre de recherche economique americain et a leur reception dans le departement des affaires scientifiques d'un institut de sante publique francais. La deuxieme partie aborde la mise en oeuvre pratique de deux interventions evidence-based et apporte un eclairage sur la maniere dont elles vont impacter les pratiques professionnelles et les strategies educatives de familles faconnant et modelant une conception de la parentalite differente dans les deux pays. Les resultats de cette etude exploratoire font ressortir des specificites nationales propre a l'appropriation des programmes par ces deux pays et permettent de tirer un certain nombre d'enseignements pour l'expertise en sante publique dans le domaine de la parentalite.
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References
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TL;DR: The situations identified in this study can assist in developing the competencies needed by home visitors and can be conceptualized into an inventory for staff supervision, with workers completing the inventory to identify individual areas of training needs.
65 citations
"Les visites à domicile en périnatal..." refers background in this paper
...55 sondage mené auprès de 91 visiteurs a révélé que 86,7% avaient rencontré des mères souffrant de maladie mentale (y compris la dépression) au cours de la dernière année et que les problèmes liés à la maladie mentale figuraient parmi les situations rencontrées les plus difficiles (80)....
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TL;DR: Depression and trauma history may significantly influence the delivery and outcomes obtained from home visitation and these constructs were related to social support and sense of control, both of which are targets of home visitation.
Abstract: This article examines the prevalence and correlates of depression and trauma history in first-time mothers receiving home visitation. One hundred twenty-three mothers in a Healthy Families America (HFA) program completed measures of depression, trauma history, social support, sense of control, and child abuse risk. Number of completed home visits, number of uncompleted home visits, and total telephone contact time were documented for each participant over the first 6 months of enrollment. Nearly 30% of the mothers scored in the clinically significant range on the depression measure. Approximately 70% of the sample had experienced at least one violent trauma. Depression and violent trauma, but not nonviolent trauma, were related to greater child abuse risk and less maternal sense of control and social support. Violent traumas were related to greater interruptions in service delivery as reflected by more uncompleted home visits. After controlling for social support and sense of control, depression was associated with more telephone contact between mothers and home visitors. Mothers receiving home visitation exhibited a heightened incidence of depression and trauma history relative to the population at large. These constructs were related to social support and sense of control, both of which are targets of home visitation. Depression and trauma history may significantly influence the delivery and outcomes obtained from home visitation. © 2002 Wiley Periodicals, Inc.
63 citations
"Les visites à domicile en périnatal..." refers background in this paper
...Stevens, Ammerman, Putnam et Van Ginkel (85) ont mesuré les symptômes dépressifs chez les mères inscrites dans un programme Healthy Families America....
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TL;DR: The adaptation for paraprofessional visitors of a home visitation model originally developed for nurses is described, with several hypothesized benefits, including power as role models and increased empathy with clients.
Abstract: The adaptation for paraprofessional visitors of a home visitation model originally developed for nurses is described. There are several hypothesized benefits of using paraprofessional home visitors, including power as role models and increased empathy with clients. Challenges inherent in employing paraprofessionals include limited formal education and resulting lack of credibility among professional care providers, difficulties in acculturation to the workplace, and learning how to effectively focus their commitment to and identification with the community. These challenges result in the need for unique training and sensitive and consistent supervision. Implementation data from the randomized trial of home visitation in Denver indicate that paraprofessional visitors conducted the program according to the prescribed visitation schedule and covered the material appropriately. Differences that emerged between nurse and paraprofessional visitors regarding content covered are discussed and suggestions are made for future programmatic considerations. © 1997 John Wiley & Sons, Inc.
61 citations
"Les visites à domicile en périnatal..." refers background in this paper
...Dans le cadre de NFP, des auteurs mettent en évidence que les résultats décevants de l’intervention de non-professionnels sur l’essai de Memphis pourraient être partiellement expliqués par l'accent mis sur les questions environnementales plutôt que sur le programme d'éducation parental, qui avait été perçu comme « étranger et inutile » (109)....
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01 Jan 2005
TL;DR: Early childhood intervention programs are designed to mitigate the factors that place children at risk of poor outcomes as mentioned in this paper, such as resource disparities in early childhood, and the consequences of those threats for educational outcomes and beyond.
Abstract: WORKFORCE AND WORKPLACE Proven Benefi ts of Early Childhood Interventions There is increasing recognition that the fi rst few years of a child’s life are a particularly sensitive period in the process of development, laying a foundation in childhood and beyond for cognitive functioning; behavioral, social, and self-regulatory capacities; and physical health. Yet many children face various stressors during these years that can impair their healthy development. Early childhood intervention programs are designed to mitigate the factors that place children at risk of poor outcomes. Such programs provide supports for the parents, the children, or the family as a whole. Th ese supports may be in the form of learning activities or other structured experiences that aff ect a child directly or that have indirect eff ects through training parents or otherwise enhancing the caregiving environment. As part of a recent study, RAND researchers synthesized what is known from the scientifi cally sound research literature about the shortand long-term benefi ts from early intervention programs, the features that are associated with moreeff ective programs, and the economic gains that accrue from investing additional resources in early childhood. We summarize those fi ndings here. A companion research brief focuses on the characteristics and number of children who may need help to overcome threats to healthy development, such as resource disparities in early childhood. It also addresses the consequences of those threats for educational outcomes and beyond.
57 citations
"Les visites à domicile en périnatal..." refers background in this paper
...Ils retrouvent un rendement net de 2,88 $ US pour chaque dollar investi, celui-ci doublant pratiquement avec 5,70 $ US de rendement pour les familles avec le risque le plus élevé (34)....
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TL;DR: In this paper, the authors examined the impact of investment between utero to 18 months of age on a range of parental and child outcomes and found that the program impact was concentrated on parental behaviors and the home environment, with little impact on child development.
Abstract: The literature on skill formation and human capital development clearly demonstrates that early investment in children is an equitable and efficient policy with large returns in adulthood. Yet little is known about the mechanisms involved in producing these long-term effects. This paper presents early evidence on the nature of skill formation based on an experimentally designed, five-year home visiting program in Ireland targeting disadvantaged families - Preparing for Life (PFL). We examine the impact of investment between utero to 18 months of age on a range of parental and child outcomes. Using the methodology of Heckman et al. (2010a), permutation testing methods and a stepdown procedure are applied to account for the small sample size and the increased likelihood of false discoveries when examining multiple outcomes. The results show that the program impact is concentrated on parental behaviors and the home environment, with little impact on child development at this early stage. This indicates that home visiting programs can be effective at offsetting deficits in parenting skills within a relatively short timeframe, yet continued investment may be required to observe direct effects on child development. While correcting for attrition bias leads to some changes in the precision of estimates, overall the results are quite similar.
56 citations
"Les visites à domicile en périnatal..." refers background in this paper
...Par rapport à l’enfant Eléments d’inquiétudes sur la qualité des soins (16) Surveillance pondérale suite à une prématurité ou un faible poids de naissance (8) Problème somatique de l’enfant (7) VAD anténatale pour préparer l’arrivée de l’enfant (1) « inquiétudes que je peux avoir sur la prise en charge des enfants au domicile » « nécessité d’une surveillance du développement de l’enfant et des soins apportés par les parents » » difficulté de repérage des besoins du bébé par la mère » « risque de maltraitance »...
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...Les échanges concernant ces situations se font essentiellement par liens téléphoniques (48), puis par des réunions sur les lieux de soins (20) et sur la PMI (16) et enfin par courriers électroniques (8)....
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...Cette notion renvoyant aux compétences, capacités et expériences permettant aux personnes d’être économiquement productives et de contribuer à la société (16)....
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...Les divers professionnels auxquels elles pensent pour assurer ces supervisions sont d’abord des psychologues (25), puis les équipes de psychiatrie (5) avec les psychiatres (13), pédopsychiatres (16) et les équipes de périnatalité (6)....
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...54 informations aux parents plutôt que les programmes n’apportant qu’un soutien (promotion de comportements positifs dès la grossesse, établissement de réseaux de soutien social ou dépistage du retard de développement), les programmes ciblant les enfants maltraités plutôt que des familles à risque, avec une longueur modérée (6-12 Mois) ou un nombre modéré de séances (16-30)....
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