Being a "Warrior" to Care for the New Family: A Meta-ethnography of Nurses' Perspectives on Municipal Postnatal Healthcare.

Care in the postnatal period is a goal for all families with a newborn baby, and support from nurses might prevent long-term health problems and contribute to a positive postnatal experience. This meta-ethnography aims to integrate and synthesize qualitative studies that illuminate and describe nurses' perspectives on municipal postnatal health care in high-income countries. Systematic literature searches for qualitative studies were conducted and 13 articles were included. The analysis followed the seven phases of Noblit and Hare. Being a "warrior" to care for the new family was identified as an overarching metaphor accompanied by three main themes: Stretching human boundaries, Stretching system boundaries, and Stretching knowledge boundaries. The overarching metaphor offers a deeper understanding of the nurses as "warriors" who despite tight timeframes and heavy workloads are stretching toward a caring relationship with the families. Being a warrior continuously pushing system boundaries puts the nurses in risk of being overstretched, balancing between their ideals and the reality. As more knowledge and clearer policies and procedures regarding the inclusion of fathers and LGBTQ parents in municipal postnatal healthcare are needed, more focus placed on the father or non-birthing parent, different cultural traditions and family constellations in practice and education is suggested.

Parents' experiences with public health nursing during the postnatal period: A reflective lifeworld research study.

AIM: To describe mothers' and fathers' experiences with public health nursing and child and family health centre services in the postnatal period, both as a couple and as individuals. METHOD: A phenomenological reflective lifeworld research approach with a descriptive design was chosen. A purposive sample of 10 mothers and 10 fathers were interviewed twice, 1-2 and 6-8 weeks postpartum, using joint and individual interviews. By focusing on being open and flexible, the data were analyzed to elucidate a meaningful structure of the phenomenon. RESULTS: The findings revealed that parents' experiences with public health nurse (PHN) and Child and Family Health Centre (CFHC) services in the postnatal period are characterised by a longing to be seen and confirmed both as unique individuals and as a family by the PHN. Although an increased need for both lay and professional care is prominent during the postnatal period, the parents drew a varied picture of their experiences demonstrating that the CFHC services are focussing almost exclusively on mother and child. CONCLUSION: A public health nurse can contribute to strengthen parenthood and promote the family's health when the focus is on the new baby. Being cared for while learning to care for the baby is pivotal in a phase that involves both joy and vulnerability. This study adds knowledge concerning the importance of both parents being seen and confirmed by the PHN as unique individuals and a family unit in the postnatal period.

Public health nurse education in the Nordic countries.

BACKGROUND: Higher education should promote critical reflection and guide students towards international activities. In the Nordic countries public health nurse educational programmes are mostly based on guidelines issued by national educational authorities, which describe students' learning outcomes. AIM: The aim of this paper is twofold: to give an overview of public health nurse education and service in the Nordic countries and thereby discuss opportunities for collaboration within the programmes. DATA SOURCES AND COMPILATION OF DATA: National legislations for public health nurse education and services are used as data. Since all sources are written in the language of each country, all the authors wrote the parts that describe each countries conditions in English and contributed to the compilation of data. RESULTS: We found both similarities and differences in public health nurse education and services. Opportunities for collaboration between the programmes are discussed. CONCLUSION: Critical reflection by the public health nurse students can be enhanced by arranging collaboration projects, an exchange of clinical placement, and joint master projects. Collaboration among academic staff within the educational programmes, in education and research, have the potential to enhance quality both within public health nurse education and in developing the profession of public health nursing.

Going blindly into the women's world: a reflective lifeworld research study of fathers' expectations of and experiences with municipal postnatal healthcare services.

Purpose: The aim of this study is to describe new fathers' expectations of and experiences with municipal postnatal healthcare services.Methods: A phenomenological reflective lifeworld research (RLR) approach has been used. Ten fathers were interviewed about their expectations of and experiences with municipal postnatal healthcare services, and the data were analysed to elucidate a meaning structure for the phenomenon.Results: The essential meaning of the phenomenon of fathers' expectations of and experiences with municipal postnatal health care described as going blindly into the women's world. The essential meaning is further explicated through its four constituents: not knowing what to ask for, feeling excluded, seeking safety for the family and longing for care.Conclusions: Entering the postnatal period with sparse knowledge about the child and family healthcare services available is difficult for the fathers who do not know what to ask for and what to expect. The fathers' feel excluded by the public health nurse, and the postnatal health care is seen as a mother-baby-public health nurse triad. The feeling of exclusion and inequality might be avoided if public health nurses focused both on mothers' and fathers' individual follow-up needs in the postnatal period and on seeing the newborn baby and the parents as a family unit.

Health Resources and Strategies among Employed Women in Norway during Pregnancy and Early Motherhood.

The number of women in paid employment is increasing. However, when becoming a mother for the first time, many seem unprepared for the challenge of balancing motherhood and work as well as for the impact on their health. The aim of this study was to investigate the health resources and strategies of employed women in Norway during pregnancy and early motherhood by means of salutogenic theory. A hypothetical-deductive interpretive approach based on Antonovsky's salutogenic theory was applied in a secondary analysis. A total of six themes were identified; three were classified as health resources when experiencing tension and three as health strategies. Salutogenic theory seems to be a useful framework for illuminating the health resources and strategies adopted by employed women who become mothers. The identified health resources when experiencing tension and the health strategies applied may have implications for maternity care professionals and employers in promoting the health of such women and supporting them to combine work and family life.

Maternity care professionals' perceptions of supporting employed women in Norway.

The World Health Organization calls on health professionals to support women in combining maternity and work. The aim of this study was to explore midwives' and public health nurses' perceptions of supporting employed women to balance work and family life during pregnancy and early motherhood. An exploratory design, including multistage focus group interviews, was used. The focus group consisted of five midwives and one public health nurse who was working in maternity care. The data were analyzed by using qualitative content analysis. The comprehensive theme, "empowering the women when they are in 'another' state of normality", was based on two themes, "being in dialogue with the women" and "supporting the women to manage daily activities". The first theme was based on the subthemes, "perceiving the women to be in 'another' state of normality" and "providing an open atmosphere for dialogue", while the second subtheme was based on "confirming self-esteem" and "suggesting adjustments at work". The midwives and public health nurse empowered the women by enhancing their ability to carry out the self-care that was necessary in order to manage both their work and family life. Collaboration between maternity healthcare providers and employers should be developed in order to support employed women.

Readjusting one's life in the tension inherent in work and motherhood.

AIM: This paper is a report on a study undertaken to interpret employed first-time mothers' experiences of returning to work after maternity leave, in a Norwegian context. BACKGROUND: Despite the increasing rate of employed fertile women and increasing welfare benefits to support the work-life balance, the first years after giving birth are described as being the most demanding on mothers' health. However, little is known about mothers' experiences of returning to work after maternity leave. METHODS: The study included nine Norwegian employees who were individually interviewed during the first months after their return to work following maternity leave. The interviews were conducted during 2009 and interpreted using a method grounded in hermeneutics. FINDINGS: Overall, the meaning of returning to work was interpreted as 'Readjusting one's life in the tension inherent in work and motherhood'. This comprehensive theme was based on three sub-themes: (a) Striving to manage the workload and taking responsibility for the best interests of the child, (b) Struggling with feelings of not being a good enough mother, and (c) Maintaining a balance between sensitivity and self-confidence. CONCLUSION: Returning to work after maternity leave appears to be a transitional phase that can be critical to the well-being of first-time mothers. To support women during this phase, employers and public health nurses should monitor the work in relation to the women's capacity and value their competence both as employees and mothers.

Living on the edge of being overstretched--a Norwegian qualitative study of employed pregnant women.

In this study, our aim was to explore female employees' experiences of work during pregnancy and their expectations of becoming a mother for the first time. We conducted 10 interviews and analyzed the data using qualitative content analysis. The main finding, living on the edge of being overstretched, contained two themes: being exhausted by adapting to professional life and being prepared for becoming a mother. In order to increase the well-being of pregnant employees, women should be provided with information from their supervisors and health care services about pregnancy-related life changes.

Obtaining confirmation through social relationships: Norwegian first-time mothers' experiences while on maternity leave.

The social relationships of employed women on maternity leave undergo significant changes. The aim of the study was to illuminate first-time mothers' experiences of social relationships while on maternity leave. Nine mothers were interviewed at both 3-5 months and 11-14 months post-partum and the data were analyzed by means of interpretative analysis. The main theme of obtaining confirmation through social relationships was based on two themes (being confirmed by other mothers and balancing between being a mother and an employee) and on four subthemes (seeking company, sharing experiences, feeling ineffective and in a state of stagnation, and trying to handle contact with the workplace). In order to strengthen the social relationships of mothers, the mother-child health service should offer all mothers the opportunity to join a peer support group, while employers could keep in regular contact with staff members on maternity leave.