Cathrine Fowler is the Professor for the Tresillian Chair in Child and Family Health at UTS. As a child and family health nurse, with qualifications in midwifery and adult education, she has gained extensive clinical and education experience working with families with children aged five and under.
Cathrine's research and clinical practice interests focus on parental learning; working with families who are experiencing complex and challenging parenting situations and who require additional support; and professional issues in child and family health nursing.
In 2009, Cathrine became the Child Advocate for the NSW Department of Corrective Services Mothers and Children’s program, and she has researched how to help incarcerated parents better care for their children. She has also investigated the feasibility of implementing a national approach to child and family health services.
Cathrine’s current research includes investigating parental sensitivity to infant cues related to infant feeding behaviour and weight. She is leading Tresillian’s participation in an international study exploring the promotion of person-centred practice within children’s hospital services through the use of key performance indicators.
- NSW Child and Family Health Nurses Association Member
- Maternal, Child and Family Health Nursing Australian Association Member
- Australian Association for Parenting and Child Health Inc Member
- Editorial panel member Child and Family Health Nursing Journal
- Member Advisory Group for the Children and Families Research Centre, Macquarie University
- Member Mothers and Children's Program Committee Corrective Services NSW
Can supervise: YES
- Parent-child relationships
- Nursing education and practice
- Child and family nursing
- Women’s, community and family health
- Parent education
- Family and Community Health Nursing - postgraduate
- Parent and Child Interaction Assessment (accredited NCAST Parent Child Interaction Assessment Instructor with NCAST University of Washington Seattle)
- Working with families who have complex histories and multiple vulnerabilities
- Child and family Health Nursing professional issues
- Relationship and strengths based approaches for working with families
Fowler, CM 2014, Hello Baby Parenting with Confidence: A Tresillian Guide, Tresillian Family Care Centres, Sydney.
A book for new parents
Fowler, CM, Barnett, B & Glossop, P 2004, Caring for the Family's Future: A practical workbook on recognising and manageing postnatal depression, 1, Surrey Beatty and Sons Ltd, Sydney Australia.
This monograph is extensively used by community health professionals to provide clinical practice guidance in the area of pernatal mental health. Many education programs on perinatal mental health use this publication as one of the supporting texts
Fowler, CM & gornall, P 2001, How to stay sane in your baby's first year, 1, Simon and Schuster, Sydney, Australia.
This publication is widely used within Australia by parents and health professionals. As a result of this text Professor Fowler is frequently requested to provide expert comment on parenting and child health issues within mainstream media
Appleton, J, Fowler, C, Laws, R, Russell, CG, Campbell, KJ & Denney-Wilson, E 2020, 'Professional and non-professional sources of formula feeding advice for parents in the first six months', MATERNAL AND CHILD NUTRITION.View/Download from: Publisher's site
Fowler, CM, Frazer, J, Flemington, T & Tran, Q 2020, 'Clinical response to child abuse presentations in the Vietnamese hospital emergency setting', Journal of Interpersonal Violence.
Ongoing fiscal stability has enabled the National Assembly in Vietnam to turn its attention to improving the health and well-being of women and children. Training pediatric health care professionals in the recognition and response to child abuse presentations in the emergency setting has the potential to improve outcomes for the disproportionate number of vulnerable children presenting to the emergency setting with nonaccidental injuries. This study explored the training needs and expectations of the staff preparing to undertake such a clinical training program. This qualitative study is based on semistructured interviews with 16 clinicians from the emergency setting of a leading pediatric hospital in Vietnam. Interview questions focused on current practice in recognizing and responding to child abuse and neglect presentations, the level of training and experience of participants, and subjective reports of confidence in recognizing abuse. Interviews were conducted in English and Vietnamese, with check-translation of transcripts performed by an independent translator. A culture of collegiality and innovative workplace practices was revealed. Analysis revealed two overarching themes that were related to the need for evidence, forensic analysis, respecting families, and consultation. Despite participant confidence in recognizing and reporting child abuse and neglect presentations, knowledge deficits were found. This article presents a critical analysis of the context within which the first evidence-based clinical training program of its kind in Vietnam was developed and implemented in a pediatric children’s hospital. Clinicians felt a strong moral obligation to protect children from further harm, however encountered a number of barriers inhibiting this process. Findings significantly shaped the Safe Children Vietnam training program and will also contribute to the development of protocols and improvement of community support services at the study site.
Rossiter, C, Power, T, Fowler, C, Elliott, K & Dawson, A 2020, 'Reflexivity in correctional research: researcher perspectiveson parenthood in a study with incarcerated parents', Qualitative Social Work: research and practice, vol. 19, no. 1.View/Download from: UTS OPUS or Publisher's site
Dahlen, HG, Thornton, C, Fowler, C, Mills, R, O'Loughlin, G, Smit, J & Schmied, V 2019, 'Characteristics and changes in characteristics of women and babies admitted to residential parenting services in New South Wales, Australia in the first year following birth: a population-based data linkage study 2000-2012.', BMJ open, vol. 9, no. 9.View/Download from: UTS OPUS or Publisher's site
OBJECTIVE:To examine the characteristics of women and babies admitted to the residential parenting services (RPS) of Tresillian and Karitane in the first year following birth. DESIGN:A linked population data cohort study was undertaken for the years 2000-2012. SETTING:New South Wales (NSW), Australia. PARTICIPANTS:All women giving birth and babies born in NSW were compared with those admitted to RPS. RESULTS:During the time period there were a total of 1 097 762 births (2000-2012) in NSW and 32 991 admissions to RPS. Women in cohort 1: (those admitted to RPS) were older at the time of birth, more likely to be admitted as a private patient at the time of birth, be born in Australia and be having their first baby compared with women in cohort 2 (those not admitted to an RPS). Women admitted to RPS experienced more birth intervention (induction, instrumental birth, caesarean section), had more multiple births and were more likely to have a male infant. Their babies were also more likely to be resuscitated and have experienced birth trauma to the scalp. Between 2000 and 2012 the average age of women in the RPS increased by nearly 2 years; their infants were older on admission and women were less likely to smoke. Over the time period there was a drop in the numbers of women admitted to RPS having a normal vaginal birth and an increase in women having an instrumental birth. CONCLUSION:Women who access RPS in the first year after birth are more socially advantaged and have higher birth intervention than those who do not, due in part to higher numbers birthing in the private sector where intervention rates are high. The rise in women admitted to RPS (2000-2012) who have had instrumental births is intriguing as overall rates did not increase.
Fowler, C, Dickinson, M, Daggar, L & Goodwin, G 2019, 'Mothers' experiences while admitted to a residential parenting unit: a qualitative study.', Contemporary nurse, vol. 55, no. 2-3, pp. 95-108.View/Download from: UTS OPUS or Publisher's site
Background: In Australia, most states have residential parenting units that provide parenting support to parents (usually mothers) who are experiencing significant parenting difficulties with their infants or toddlers. The three most common reasons for admission to a residential service are: sleep and settling issues, adjustment to parenting, and feeding issues. Aim: The overall study aim was to explore mothers' experience of a residential admission, as one tool to increase the "patient (mother) voice" within the residential parenting service and provide a mechanism for staff to understand the impact of their interactions with mothers on the care delivery process. Design: A qualitative descriptive approach and thematic analysis were used. One hundred mothers provided responses to a routinely collected questionnaire that asked about their experience while admitted to one of three residential parenting units. All mothers were eligible to participate. Results: Three major themes were identified: not knowing what to expect; working collaboratively with parents; and facilitating maternal learning. Mothers identified that they had increased parenting confidence levels, and gained new parenting knowledge and skills as an outcome of the residential stay. Conclusions: The value of a residential stay is clearly articulated by the mothers in the stories collected. These themes have affirmed that the residential units are parent-focused. Some mothers were surprised by the nurses' willingness to listen to their preferences about their child's care and to work with them adapting interventions to their cultural and home context.
Fowler, C, Green, J, Elliott, D, Petty, J & Whiting, L 2019, 'The forgotten mothers of extremely preterm babies: A qualitative study.', Journal of clinical nursing, vol. 28, no. 11-12, pp. 2124-2134.View/Download from: UTS OPUS or Publisher's site
AIMS AND OBJECTIVES:To explore the experiences of mothers of extremely premature babies during their Neonatal Intensive Care Unit stay and transition home. BACKGROUND:Mothers of extremely preterm infants (28 weeks' gestation or less) experience a continuum of regular and repeated stressful and traumatic events, during the perinatal period, during the Neonatal Intensive Care Unit stay, and during transition home. METHOD:An interpretive description method guided this study. Ten mothers of extremely premature infants who had been at home for less than six months were recruited via a Facebook invitation to participate in semi-structured telephone interviews exploring their experiences in the Neonatal Intensive Care Unit and the transition home. The data were examined using a six-phase thematic analysis approach. The COREQ checklist has been used. RESULTS:Two main themes emerged: (a) things got a bit dire; and (b) feeling a failure as a mother. Participants had a heightened risk of developing a mental disorder from exposure to multiple risk factors prior to and during birth, as well as during the postnatal period in the Neonatal Intensive Care Unit and their infant's transition to home. Mothers highlighted the minimal support for their mental health from healthcare professionals, despite their regular and repeated experience of traumatic events. CONCLUSION:The mothers were at high risk of developing post-traumatic stress symptoms and/or other mental health issues. Of note, study participants relived the trauma of witnessing their infant in the Neonatal Intensive Care Unit, demonstrated hypervigilance behaviour and identified lack of relevant support needed when their infant was at home. RELEVANCE TO CLINICAL PRACTICE:This study highlights the need for nurses to include a focus on the mothers' psychosocial needs. Supporting maternal mental health both improves maternal well-being and enables mothers to be emotionally available and responsive to their extremely preterm ...
Petty, J, Whiting, L, Mosenthal, A, Fowler, C, Elliott, D & Green, J 2019, 'The knowledge and learning needs of health professionals in providing support for parents of premature babies at home: A mixed-methods study', Journal of Neonatal Nursing, vol. 25, no. 6, pp. 277-284.View/Download from: UTS OPUS or Publisher's site
© 2019 The Authors Premature babies and their families often require on-going community-based care after discharge from the neonatal unit. Parents themselves have identified the need for health professionals to understand the specific needs of parents of premature babies in order to provide the optimal support they require. This study aimed to explore the existing knowledge base and learning needs of community health professionals, to further understand how they can adequately support parents in the community with premature babies. A mixed-methods approach was used comprising a questionnaire, semi-structured interviews and secondary data analysis. Participants included thirteen Health Visitor [HV] students, eight educators and seven parents from a previous study. Thematic analysis revealed important insights into the knowledge and learning needs necessary to support parents of premature babies in the community. Three main themes emerged: development of prior knowledge; the importance of practice-based learning; learning and training needs. Knowledge, confidence and skills in relation to caring for parents with premature babies varied between individuals depending on their placement during training and subsequent experiences. While transferable skills in supporting parents in the community were present, more education and training in the specific needs of premature babies and parents would be welcomed. Tailored resources for community-based health professionals on the specific needs of the premature baby would enhance provision of optimal support for parents.
Rossiter, C, Fowler, C, Hesson, A, Kruske, S, Homer, CSE & Schmied, V 2019, 'Australian parents' use of universal child and family health services: A consumer survey.', Health and Social Care in the Community, vol. 27, no. 2, pp. 472-482.View/Download from: UTS OPUS or Publisher's site
This study aimed to explore Australian parents' use of universally available well-child health services. It used an online survey of 719 parents of children aged from birth to 5 years in all states and territories to examine patterns of service use and consumer preferences. In Australia, several health professional groups provide advice to pregnant women, infants, children, and parents, offering health promotion, developmental screening, parenting support, and referral to specialist health services if required. The survey examined parents' use of different child and family health providers, and their preferences for support with several common parenting issues. The study indicated that families with young children obtain primary healthcare from a range of service providers, often more than one, depending on children's ages and needs. Parents frequently visit general practitioners for immunisation and medical concerns. They attend dedicated child and family health nurses for parenting advice and well-child checks and prefer them as an information source for many health issues. However, a substantial proportion of parents (44.1%) do not currently visit a child and family health nurse, often because they not only do not perceive a need but also sometimes because these services are unknown, inaccessible, or considered unsuitable. They may seek advice from less qualified sources. There is potential for increased collaboration between child and family health providers to ensure effective resource use and consistency of parenting information and advice. Nursing services may need to address accessibility and appropriateness of care.
Rossiter, C, Fowler, C, Hesson, A, Kruske, S, Homer, CSE, Kemp, L & Schmied, V 2019, 'Australian parents’ experiences with universal child and family health services', Collegian, vol. 26, pp. 321-328.View/Download from: UTS OPUS or Publisher's site
© 2018 Australian College of Nursing Ltd Background: Australian governments provide free services to promote maternal and child health, and to support parenting for families with children up to age five. Services are principally provided by dedicated child and family health nurses, but also by general practitioners, practice nurses, pharmacy nurses and midwives. Aim: This study aimed to examine the experiences of families with young children across Australia in accessing and receiving health care for well children, parenting support and advice from a range of providers. Methods: The study used quantitative and qualitative data from an online survey of 719 parents and carers with children aged up to five years. Findings: On quantitative scales, most respondents rated healthcare providers favourably for accessibility, credibility and their approach to families. However, qualitative responses revealed widely varying reactions to child and family health provision. Parents described both positive and negative experiences, highlighting elements of practice that are critical to consumer engagement. Discussion: Parents require health care and support that are accessible, consistent, affordable, encouraging, trustworthy, evidence-based and non-judgemental. Parents feel more confidence in the information and care provided by health professionals who are well-informed, resourceful and who respect their knowledge and beliefs. Conclusion: The findings demonstrate ways in which child and family health providers can engage and effectively support families with young children.
Hogan, R, Phillips, A, Green, J, Orr, F, Elliott, D & Fowler, C 2019, 'Premature birth and Indigenous Australians – a commentary', International Journal of Birth and Parent Education, vol. 6, no. 3, pp. 27-30.View/Download from: UTS OPUS
Appleton, J, Laws, R, Russell, CG, Fowler, CM, Campbell, K & Denney-Wilson, E 2018, 'Infant formula feeding practices and the role of advice and support: an exploratory qualitative study', BMC Pediatrics, vol. 18, pp. 1-11.View/Download from: UTS OPUS or Publisher's site
Background: Infant formula feeding practices are an important consideration for obesity prevention. An infant’s
diet is influential on their later risk of developing overweight or obesity, yet very little is known about infant
formula feeding practices. It is plausible that certain modifiable practices may put children at higher risk of
developing overweight or obesity, for example how much and how often a baby is fed. Understanding how
parents use infant formula and what factors may influence this practice is therefore important. Moreover,
parents who feed their infants formula have identified a lack of support and access to resources to guide them. Therefore
this study aimed to explore parents’ infant formula feeding practices to understand how parents use infant formula and
what factors may influence this practice.
Methods: Using an explorative qualitative design, data were collected using semi-structured telephone interviews and
analysed using a pragmatic inductive approach to thematic analysis.
Results: A total of 24 mothers from across Australia were interviewed. Mothers are influenced by a number of factors in
relation to their infant formula feeding practice. These factors include information on the formula tin and marketing from
formula manufacturers, particularly in relation to choosing the type of formula. Their formula feeding practices are
also influenced by their interpretation of infant cues, and the amount of formula in the bottle. Many mothers
would like more information to aid their practices but barriers exist to accessing health professional advice
and support, so mothers may rely on informal sources. Some women reported that the social environment
surrounding infant feeding wherein breastfeeding is promoted as the best option leads a feeling of stigma
when formula feeding.
Conclusions: Additional support for parents’ feeding their infants with formula is necessary. Health professionals and
policy around infant formula use should include how f...
Appleton, J, Russell, CG, Laws, R, Fowler, C, Campbell, K & Denney-Wilson, E 2018, 'Infant formula feeding practices associated with rapid weight gain: A systematic review', MATERNAL AND CHILD NUTRITION, vol. 14, no. 3.View/Download from: UTS OPUS or Publisher's site
Dahlen, HG, Foster, JP, Psaila, K, Spence, K, Badawi, N, Fowler, C, Schmied, V & Thornton, C 2018, 'Gastro-oesophageal reflux: a mixed methods study of infants admitted to hospital in the first 12 months following birth in NSW (2000-2011)', BMC PEDIATRICS, vol. 18.View/Download from: UTS OPUS or Publisher's site
Lam, W, Fowler, C & Dawson, A 2018, 'The role of culture in relation to the seasonal influenza prevention practices of Hong Kong Chinese parents with preschool children', International Journal of Health Promotion and Education, vol. 56, no. 1, pp. 3-16.View/Download from: UTS OPUS or Publisher's site
Aims and objectives: To explore the role of culture in the seasonal influenza prevention practices of Hong Kong Chinese parents with a healthy preschool child.
Background: Cultural values and norms significantly influence parents’ health preventive practices and related health promotion strategies. Most research is concerned with influenza prevention and focuses on the factors affecting vaccination uptake, the use of facemasks and effective hand hygiene. There is limited research exploring the influence of culture on the seasonal influenza prevention practices of parents with a young child in Hong Kong.
Design: Mixed methods using a multiple-case study approach.
Methods: Purposive intensity sampling was employed to recruit 20 parents with children under five years old. A thematic analysis was employed to examine the qualitative interview data and the quantitative data were analysed descriptively. The data were then integrated to provide a more rigorous comprehension of parents’ cultural seasonal influenza preventive practices. Comparisons were conducted across the 20 cases and patterns examined.
Results: Five themes were identified. They were sharing beds; boiling white vinegar to kill air-born germs; diet therapy to enhance health; self-prescribed Chinese medication to manage a child’s cold symptoms; and the co-use of Western and traditional Chinese medications to prevent seasonal influenza.
Conclusions: The findings indicate that a pluralistic approach to health promotion should be considered to ensure the likelihood that families accept, support and comply with health advice in seasonal influenza prevention. The delivery of culturally appropriate health promotion requires a close partnership between nurses and parents.
Priddis, H, Thornton, C, Fowler, C, Schmied, V, Tooher, J, Dickinson, M & Dahlen, HG 2018, 'Characteristics and service needs of women and babies admitted to residential parenting units in New South Wales: a mixed methods study', Journal of Clinical Nursing, vol. 27, no. 15-16, pp. 2963-2973.View/Download from: UTS OPUS or Publisher's site
Aims and Objectives: This study aims to examine the characteristics and service needs of women and babies admitted to Residential Parenting Services (RPS) in the first year following birth in New South Wales (NSW), Australia.
Background: In Australia there is a tiered system to support maternal, child and family health, which includes residential parenting services (RPS).
Design: Sequential explanatory mixed methods design.
Methods: Individual patient data were obtained from a random review of 10% of all medical records (n = 300 of 3011 admissions) of women with an infant of less than 12 months of age who were admitted to RPS in 2013. Following review of the medical records, qualitative data were collected via interviews with eight women who accessed RPS. Chi square analysis and student t-testing were used to analyse quantitative data. Qualitative data were analysed using a descriptive interpretive approach. An integrative approach was taken in reporting the findings
Results: Women admitted to the RPS were on average 32 years of age, were Australian born (72%), had a university qualification (40%) and most were employed. The majority of women were primiparous (60%), and had a vaginal birth (61%). Women with male infants were much more likely to be admitted to the RPS (58%) compared to the NSW male to female ratio (51.3% versus 48.7%). Over 50% of women reported mental health issues with 27% having an Edinburgh Postnatal Depression Scale score ≥13 on admission. The primary reason women sought parenting support were for sleep and settling (83%). During their stay, services used by women included social workers (44%), psychologists (52%) and psychiatrists (4.5%).
Conclusion: Women who access RPS report psychosocial and mental health issues. Services provided by RPS support women during this challenging early parenting period by providing multidisciplinary, holistic and peer support.
Relevance to clinical practice
A high prevalence of mental health issues identified...
Sims, DJ & Fowler, C 2018, 'Postnatal psychosocial assessment and clinical decision-making, a descriptive study.', Journal of clinical nursing, vol. 27, no. 19-20, pp. 3739-3749.View/Download from: UTS OPUS or Publisher's site
AIMS AND OBJECTIVES:To describe experienced child and family health nurses' clinical decision-making during a postnatal psychosocial assessment. BACKGROUND:Maternal emotional well-being in the postnatal year optimises parenting and promotes infant development. Psychosocial assessment potentially enables early intervention and reduces the risk of a mental disorder occurring during this time of change. Assessment accuracy and the interventions used are determined by the standard of nursing decision-making. DESIGN:A qualitative methodology was employed to explore decision-making behaviour when conducting a postnatal psychosocial assessment. METHODS:This study was conducted in an Australian early parenting organisation. Twelve experienced child and family health nurses were interviewed. A detailed description of a postnatal psychosocial assessment process was obtained using a critical incident technique. Template analysis was used to determine the information domains the nurses accessed, and content analysis was used to determine the nurses' thinking strategies, to make clinical decisions from this assessment. RESULTS:The nurses described 24 domains of information and used 17 thinking strategies, in a variety of combinations. The four information domains most commonly used were parenting, assessment tools, women-determined issues and sleep. The seven thinking strategies most commonly used were searching for information, forming relationships between the information, recognising a pattern, drawing a conclusion, setting priorities, providing explanations for the information and judging the value of the information. CONCLUSION:The variety and complexity of the clinical decision-making involved in postnatal psychosocial assessment confirm that the nurses use information appropriately and within their scope of nursing practice. The standard of clinical decision-making determines the results of the assessment and the optimal access to care. RELEVANCE TO CLINICAL PRACTICE:K...
Fowler, C, Rossiter, C, Dawson, A, Power, T, Jackson, D & Roche, M 2018, 'When parenting doesn’t 'come naturally’: providers’ perspectives on parenting education for incarcerated mothers and fathers', Studies in Continuing Education, vol. 40, no. 1, pp. 98-114.View/Download from: UTS OPUS or Publisher's site
Learning to parent sensitively and safely can be challenging for adults with childhood abuse and neglect experiences. Such childhood experiences are prevalent among incarcerated parents whose ability to parent their own children is also limited by separation from them. Several prisons have developed programs to foster pro-social parenting skills among incarcerated mothers and fathers to assist them on release. This paper reports a qualitative research study that explored the factors affecting the delivery and outcomes of parenting programs in correctional facilities in New South Wales Australia from the perspective of individuals involved in developing and implementing the programs. Thematic analysis of 19 interviews identified two main themes: supporting parents’ learning in correctional settings and providers’ learning about parent education in correctional settings. Respondents reported the benefits of providing creative learning opportunities enabling parents to build on their strengths and to develop relationships. These factors contributed to changing prisoners’ attitudes and supporting them to consider alternative parenting approaches. The co-productive approach to parent education supported enhanced parenting knowledge among parents and greater insights among educators. Parenting education can be successfully delivered in correctional settings and can assist incarcerated parents to build on existing knowledge and adapt it to their own needs.
Appleton, J, Fowler, C & Brown, N 2017, 'Parents' views on childhood obesity: qualitative analysis of discussion board postings.', Contemporary Nurse, vol. 53, no. 4, pp. 410-420.View/Download from: UTS OPUS or Publisher's site
Childhood obesity is an increasing concern for parents and health professionals alike. Parents' perception of obesity as a current health issue for their children is important for the everyday parenting and health choices parents make. As parents are frequently going online to seek and exchange information about parenting and child health, asynchronous online discussion forums provide an opportunity to investigate their perceptions and concerns. Understanding parents' perceptions, beliefs and attitudes is important in any childhood obesity prevention and intervention.To explore parents' perceptions, perspectives and concerns regarding childhood obesity expressed on asynchronous online discussion forums.A qualitative descriptive approach using template analysis to analyse a novel data collection strategy of 34 purposefully sampled threads from two Australian-based asynchronous online discussion forums.Parents on the discussion forum displayed an understanding of childhood obesity as a public health concern, the discussion incorporated issues such as providing a healthy diet and lifestyle for children. Parents shared their own opinions and experiences that challenged or conceded to the status quo of the discussion. Parents discussed the role of health professionals in obesity prevention. There were varied opinions on the relevance of health professionals, particularly nurses, monitoring of growth and risk of obesity.This exploratory study highlights that parents perceive childhood obesity as an important public health concern, and that they understand the key public health messages of prevention and intervention. Yet, for many it is difficult to successfully implement these messages into their everyday lives. Health professionals need to play a key role in providing non-judgemental, innovative support and advice to parents to successfully implement prevention and intervention strategies.
Clerke, T, Hopwood, N, Chavasse, F, Fowler, C, Lee, S & Rogers, J 2017, 'Using professional expertise in partnership with families: a new model of capacity- building', Journal of Child and Family Health, vol. 21, no. 1, pp. 74-84.View/Download from: UTS OPUS or Publisher's site
The first five years of parenting are critical to children’s development. Parents are known to respond best to interventions with a partnership-based approach, yet child and family health nurses (CFHNs) report some tension between employing their expertise and maintaining a partnership relationship. This article identifies ways in which CFHNs skilfully use their professional expertise, underpinned by helping qualities and interpersonal skills, to assist families build confidence and capacity, and thus buffer against threats to parent and child well-being. It reports on an Australian ethnographic study of services for families with young children. Fifty-two interactions were observed between CFHNs and families in day-stay and home visiting services in Sydney. A new model is presented, based on four partnership activities and the fluid movement between them, to show how CFHNs use their expertise to identify strengths and foster resilience in families in the longer term, without undermining the principles of partnership.
Fowler, C, Schmied, V, Dickinson, M & Dahlen, HG 2017, 'Working with complexity: experiences of caring for mothers seeking residential parenting services in New South Wales, Australia.', Journal of Clinical Nursing, vol. 26, no. 3-4, pp. 524-534.View/Download from: UTS OPUS or Publisher's site
To investigate staff perception of the changing complexity of mothers and infants admitted to two residential parenting services in New South Wales in the decade from 2005-to-2015.For many mothers with a young child parenting is difficult and stressful. If parenting occurs within the context of anxiety, mental illness or abuse it often becomes a high-risk situation for the primary caregiver. Residential parenting services provide early nursing intervention before parenting problems escalate and require physical or mental health focused care.A qualitative descriptive design using semi-structured interview questions was used as phase three of a larger study. Data were gathered from 35 child and family health nurses and ten physicians during eight focus groups.Three main themes emerged: 1) dealing with complexity; 2) changing practice; and 3) appropriate knowledge and skills to handle greater complexity.There was a mix of participant opinions about the increasing complexity of the mothers presenting at residential parenting services during the past decade. Some of the nurses and physicians confirmed an increase in complexity of the mothers while several participants proposed that it was linked to their increased psychosocial assessment knowledge and skill. All participants recognised their work had grown in complexity regardless of their perception about the increased complexity of the mothers. This article is protected by copyright. All rights reserved.
Hesson, A, Fowler, C, Rossiter, C & Schmied, V 2017, ''Lost and confused': Parent representative groups' perspectives on child and family health services in Australia', Australian Journal of Primary Health, vol. 23, no. 6, pp. 560-566.View/Download from: UTS OPUS or Publisher's site
© La Trobe University 2017. Consumer involvement in health care is widely accepted in policy and service delivery. Australia offers universal health services for families with children aged 0 to 5 years, provided by child and family health nurses and general practitioners. Services include, but are not limited to, monitoring and promoting child health and development, and supporting parents. This paper reports consumer representatives' perspectives on Australian parents' needs and experiences of child and family health services, identifying facilitators and barriers to service utilisation. Twenty-six representatives from consumer organisations explored families' experiences through focus groups. Qualitative data were analysed thematically. Consumer representatives identified several key implications for families using primary health services: feeling 'lost and confused' on the parenting journey; seeking continuity and partnership; feeling judged; and deciding to discontinue services. Participants highlighted accessible, timely, non-judgmental and appropriate interactions with healthcare professionals as vital to positive consumer experiences and optimal health and developmental outcomes. Representatives indicated that families value the fundamentals of well-designed health services: trust, accessibility, continuity, knowledge and approachability. However, both consumers and service providers face barriers to effective ongoing engagement in universally provided services.Journal compilation
Lam, W, Dawson, A & Fowler, C 2017, 'Approaches to better engage parent–child in health home-visiting programmes: A content analysis', Journal of Child Health Care, vol. 21, no. 1, pp. 94-102.View/Download from: UTS OPUS or Publisher's site
Home visiting is an evidence-based strategy used to enhance child and family health outcomes. Such primary healthcare endeavours demand the full participation of individual and families. We conducted a review to identify approaches to planning, executing and assessing home-visiting health promotion interventions to determine how parents and children can be best engaged. A structured search (2000–2015) was undertaken using a defined search protocol. The quality of the papers was assessed using standard appraisal tools. Sixteen studies were retrieved. A content analysis of the findings sections of the papers was undertaken and guided by the eight phases of the PRECEDE-PROCEED health promotion planning framework. The analysis found that while all the PRECEDE assessment areas were represented no studies included all phases. Parents and children did not appear to be actively involved in undertaking the assessments and evaluation of the home-visiting health promotion programmes. The findings suggest that there is a need to develop a consistent home-visiting approach that includes comprehensive assessments in the planning phases and parent and child involvement at each step of programme development, implementation and evaluation. This approach enables the development of tailored and sustainable health promotion intervention in order to achieve optimal child health outcomes.
Olley, H, Psaila, K, Fowler, C, Kruske, S, Homer, C & Schmied, V 2017, ''Being the bridge and the beacon': a qualitative study of the characteristics and functions of the liaison role in child and family health services in Australia.', Journal of Clinical Nursing, vol. 26, no. 1-2, pp. 91-102.View/Download from: UTS OPUS or Publisher's site
This article explores the characteristics and functions of the liaison role in child and family health services in Australia.Liaison roles are increasingly being used to improve communication between health services and professionals and to facilitate access to support for individuals and families in need. Nurses are commonly, although not always, the professionals who undertake these roles. Research on the role and outcomes of liaison positions in child and family health services is limited in Australia and internationally.A qualitative interpretive design informed this study. Interviews and focus groups were conducted with 40 liaison and other health professionals, primarily nurses, working with families with newborn and young children in two Australian States. Data were analysed thematically.Three major themes were identified reflecting the importance of defining the role and tasks which included building bridges between services and professionals, supporting families during transition between services and supporting clinicians. Several facilitators and barriers were identified, including concerns about sustainability of the roles.Professionals working in a liaison role in child and family health services emphasise that these positions have the potential to link services and professionals, thereby providing more effective care pathways for children and families especially for those with complex and multiple vulnerabilities. While a few children and family health services in Australia provide liaison services, the extent of liaison support and the outcomes for families in Australia is unknown.Nurses working with children and families are the most likely health professionals to undertake a liaison role. In many nursing contexts, liaison roles are relatively new and those in the role have the responsibility to define the key purpose of their role. Liaison roles are multifaceted requiring the nurse to have excellent communication and negotiation skills to effectiv...
Rossiter, C, Schmied, V, Kemp, L, Fowler, C, Kruske, S & Homer, CSE 2017, 'Responding to families with complex needs: A national survey of child and family health nurses.', Journal of Advanced Nursing, vol. 73, no. 2, pp. 386-398.View/Download from: UTS OPUS or Publisher's site
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.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.The descriptive study used cross-sectional data from the first national survey of child and family health nurses in Australia, conducted during 2011.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.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.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 organisation and delivery of services for families in Australia and internationally. This article is protected by copyright. All rights reserved.
Fowler, C, Rossiter, C, Power, T, Dawson, A & Jackson, D 2017, 'Becoming a ‘better’ father: Supporting the needs of incarcerated fathers', The Prison Journal, vol. 97, no. 6, pp. 692-712.View/Download from: UTS OPUS or Publisher's site
Given the importance of fathering to the well-being and development of children, paternal incarceration has a major impact on children and families. Drawing on interviews with 64 incarcerated fathers in New South Wales, Australia, this article explores their experiences. The men’s childhood familial separation and disconnection is frequently repeated in adulthood, with limited contact with their own families even when not in custody. Despite barriers to connection, the interviewees express strong aspirations to be “good” fathers and to achieve a “better life” for their children. The absence of stable models of responsive fathering in early life is a common theme that has implications for the development of education and support programs for imprisoned fathers.
Rossiter, C, Power, T, Fowler, C, Jackson, D, Roche, M & Dawson, A 2017, '"Learning to become a better man": Insights from a fathering programme for incarcerated indigenous men', Australian Journal of Social Issues, vol. 52, no. 1, pp. 13-31.View/Download from: UTS OPUS or Publisher's site
Kassab, M, Fowler, C & Foureur, M 2016, 'Infant pain, beliefs and knowledge: discussion with Jordanian nurses', Australian Journal of Child and Family Health Nursing, vol. 13, no. 2, pp. 10-15.View/Download from: UTS OPUS
lam, Y, Fowler, C & Dawson, A 2016, 'The approaches Hong Kong Chinese mothers adopt to teach their preschool children to prevent influenza: a multiple case study at household level', BMC Nursing, vol. 15.View/Download from: UTS OPUS or Publisher's site
Wanda, D, Fowler, C & Wilson, V 2016, 'Using flash cards to engage Indonesian nursing students in reflection on their practice.', Nurse Education Today, vol. 38, pp. 132-137.View/Download from: UTS OPUS or Publisher's site
Reflective practice is now widely used as a critical learning tool in undergraduate and postgraduate nursing programs in most developed countries. However in developing countries, reflective practice is in its infancy.To introduce reflective practice to postgraduate students in an Indonesian nursing education institution. This paper presents the positive meanings of reflection and reflective practice experienced by the students and the way they used reflection within their practice.A descriptive qualitative study was conducted to explore the meaning of reflection or reflective practice using flashcards.A clinical reflective practice model taking into consideration Indonesian culture was developed and applied during students' clinical placement. A few weeks post clinical placement, 21 students participated in an evaluation session. The meaning of reflection or reflective practice was explored using flash cards containing images of people and environment with different situations and events. Students were asked to choose a card that represented their viewpoints about reflective practice and share it with the group. Data were digitally captured and analyzed using thematic analysis.Reflection provided a positive experience for the students. In their own words, they discussed their journey of using reflection during the clinical placement period. The use of reflection was identified as expanding their view of nursing practice, providing a safe place to explore their experiences and clarity when they encountered challenging situations during their clinical practice. Reflecting on practice experiences resulted in increased self-awareness, and enhanced their learning.The findings indicate that reflective practice can be implemented successfully in Indonesia and may have value for other Eastern countries that share similar cultural characteristics. The use of flash cards assisted the students describe through stories their experiences of participating in this reflective p...
Doab, A, Fowler, C & Dawson, A 2015, 'Factors that influence mother–child reunification for mothers with a history of substance use: A systematic review of the evidence to inform policy and practice in Australia', International Journal of Drug Policy, vol. 26, no. 9, pp. 820-831.View/Download from: UTS OPUS or Publisher's site
Fowler, C, Rossiter, C, Sherwood, J & Day, C 2015, 'New Understandings of Mothering: Mothers in an Abstinence-Based Drug Treatment Program', International Journal of Mental Health and Addiction, vol. 13, no. 2, pp. 173-184.View/Download from: UTS OPUS or Publisher's site
Fowler, C, Schmied, V, Psalia, K, Kruske, S & Rossiter, C 2015, 'Ready for Practice: What child and family health nurses say about education', Nurse Education Today, vol. 35, no. 2, pp. e67-e72.View/Download from: UTS OPUS or Publisher's site
Australia has a well-established universal child and family health service predominately staffed by specialist/qualified child and family health nurses. Two common and interrelated concerns are the need for nurses to be ready for practice after completing a nursing education program and the means to ensure ongoing nursing competence.
To investigate the readiness of CFH nurses to practise after qualification and their continuing engagement with learning.
The study used an interpretive descriptive approach.
This paper presents data from four questions from a larger survey of child and family health nurses across Australia.
1098 child and family health nurses responded to the survey.
Qualitative survey responses from the four education questions were analysed using inductive thematic content analysis.
Five significant themes were identified: hands-on experience (student clinical practice/placement); drawing on prior experience; learning on the job; learning (learning over time); and barriers to learning.
This paper provides insights into nurses' readiness for practice at the completion of a postgraduate child and family health nursing qualification and their maintenance of competence and specialist knowledge. It highlights: the need for clinical placement to be retained and enhanced; the significant contribution of more experienced child and family health nurses mentoring newly graduated child and family health nurses; the need for minimum education standards; the importance of reviewing education courses in relation to graduates' readiness for child and family health nursing practice; the importance of supporting ongoing professional development; and the removal of barriers to accessing education opportunities.
Johnston, R, Fowler, C, Wilson, V & Kelly, M 2015, 'Opportunities for Nurses to Increase Parental Health Literacy: A Discussion Paper', Issues in Comprehensive Pediatric Nursing, vol. 38, no. 4, pp. 266-281.View/Download from: Publisher's site
© 2015 Taylor & Francis Most families can access a range of health information and advice. Information and advice sources often include nurses, the Internet, social media, books, as well as family and friends. While the immediate aim may be to find information, it can also be to assist with parenting skills, solve parenting problems or as part of decision-making processes about their child’s health. These processes are strongly influenced by the parent’s level of health literacy. Health literacy describes a person’s capacity to obtain and utilize health related information. Although there are numerous health literacy definitions all have clearly defined steps. These steps are: obtaining relevant information; then understanding this information; and finally being able to use the information to achieve the expected outcome. Previous research has linked low levels of parental health literacy with poorer child health outcomes. Given this link, increasing health literacy levels would be advantageous for both families and health services. Nurses working with families are in a position to support the family to increase their health literacy through the use of a variety of strategies. This article outlines how health literacy can influence the way parents seek help when they are concerned about child health issues, the relevance of parental health literacy for nurses and suggests some tools that could be used to support the increase of health literacy.
Lam, W, Dawson, A & Fowler, C 2015, 'The Health Literacy of Hong Kong Chinese Parents with Preschool Children in Seasonal Influenza Prevention: A Multiple Case Study at Household Level', PLoS One, vol. 10, no. 12, pp. e0143844-e0143844.View/Download from: UTS OPUS or Publisher's site
Lam, Y, Dawson, A & Fowler, CM 2015, 'Health promotion interventions to prevent early childhood human influenza at the household level: a realist review to identify implications for programmes in Hong Kong', Journal of Clinical Nursing, vol. 24, no. 7-8, pp. 891-905.View/Download from: UTS OPUS or Publisher's site
Aims and objectives. To identify factors affecting the delivery of health promotion interventions to prevent early childhood human influenza at the household level.
Psaila, K, Schmied, V, Fowler, C & Kruske, S 2015, 'Interprofessional collaboration at transition of care: perspectives of child and family health nurses and midwives', Journal of Clinical Nursing, vol. 24, no. 1-2, pp. 160-172.View/Download from: Publisher's site
Schmied, V, Homer, CS, Fowler, CM, Psalia, K, Barclay, L, Wilson, I, Kemp, L, Fasher, M & Kruske, S 2015, 'Implementing a national approach to universal child and family health services in Australia: professionals' views of the challenges and opportunities', Health and Social Care in the Community, vol. 23, no. 2, pp. 159-170.View/Download from: Publisher's site
Australia has a well-accepted system of universal child and family health (CFH) services. However, government reports and research indicate that these services vary across states and territories, and many children and families do not receive these services. The aim of this paper was to explore professionals' perceptions of the challenges and opportunities in implementing a national approach to universal CFH services across Australia. Qualitative data were collected between July 2010 and April 2011 in the first phase of a three-phase study designed to investigate the feasibility of implementing a national approach to CFH services in Australia. In total, 161 professionals participated in phase 1 consultations conducted either as discussion groups, teleconferences or through email conversation. Participants came from all Australian states and territories and included 60 CFH nurses, 45 midwives, 15 general practitioners (GPs), 12 practice nurses, 14 allied health professionals, 7 early childhood education specialists, 6 staff from non-government organisations and 2 Australian government policy advisors. Data were analysed thematically. Participants supported the concept of a universal CFH service, but identified implementation barriers. Key challenges included the absence of a minimum data set and lack of aggregated national data to assist planning and determine outcomes; an inconsistent approach to transfer of information about mothers and newborns from maternity services to CFH nursing services or GPs; poor communication across disciplines and services; issues of access and equity of service delivery; workforce limitations and tensions around role boundaries. Directions for change were identified, including improved electronic data collection and communication systems, reporting of service delivery and outcomes between states and territories, professional collaboration, service co-location and interprofessional learning and development.
Rossiter, C, Power, T, Fowler, C, Jackson, D, Hyslop, D & Dawson, A 2015, 'Mothering at a Distance: What Incarcerated Mothers Value About a Parenting Program', Contemporary Nurse, vol. 50, no. 2-3, pp. 238-255.View/Download from: UTS OPUS or Publisher's site
Background: Children with incarcerated mothers experience adverse health, social and emotional circumstances, and are a particularly vulnerable group. Mothers in custody face significant challenges in parenting their children.
Aims: The study aimed to identify participants’ views on impact of a parenting support programme for incarcerated mothers in NSW Australia.
Methods: The mixed-methods study examined 134 responses to open and closed questions on a questionnaire for programme participants.
Results: Participants found the programme worthwhile, engaging and relevant. It enhanced their parenting knowledge and confidence. Open-ended responses highlighted program elements which participants valued, specifically support for their parenting role in complicated circumstances, greater understanding of child development and perspectives, and practical strategies for facilitating connections with their children during their incarceration.
Conclusions: The study informs nurses working with women who have experienced incarceration and their children, both in custodial and community settings.
Appleton, J, Fowler, CM & Brown, N 2014, 'Friend or foe? An exploratory study of Australian parents' use of asynchronous discussion boards in childhood obesity', Collegian, vol. 21, no. 2, pp. 151-158.View/Download from: UTS OPUS or Publisher's site
Brown, N, Gallagher, R, Fowler, C & Wales, S 2014, 'Asthma management self-efficacy in parents of primary school-age children', Journal of Child Health Care, vol. 18, no. 2, pp. 133-144.View/Download from: UTS OPUS or Publisher's site
The aim of this study was to investigate asthma management self-efficacy in parents of primary school-age children with asthma and to explore possible associations between parent asthma management self-efficacy, parent and child characteristics, asthma task difficulty and asthma management responsibility. A cross-sectional descriptive survey of 113 parents was conducted to assess the level of parent asthma management self-efficacy, asthma task difficulty and confidence, asthma responsibility and socio-demographic characteristics. The findings indicate that parents had higher self-efficacy for attack prevention than attack management. Parents had higher self-efficacy for asthma management tasks that are simple, skills based and performed frequently such as medication administration and less confidence and greater difficulty with tasks associated with judgement and decision-making. Multivariate linear regression analysis identified English language, child asthma responsibility and parent education as predictors of higher asthma management self-efficacy, while an older child was associated with lower parent asthma management self-efficacy. The implications of these results for planning and targeting health education and self-management interventions for parents and children are discussed.
Fowler, CM, Reid, S, Minnis, J & Day, C 2014, 'Experiences of mothers with substance dependence: informing the development of parenting support', Journal Of Clinical Nursing, vol. 23, no. 19-20, pp. 2835-2843.View/Download from: Publisher's site
Aims and objectives. To understand the experiences of women with a history of substance dependence when they attempted to gain parenting support.
Background. Becoming a mother provides a window of opportunity to support women with a substance dependence make changes to their lives and the way they will parent their infants and young children. Yet there are many barriers and a constant fear of the removal of their children from their care.
Design. Focus groups were conducted using a qualitative interpretive descriptive approach to enable exploration of the women's experiences as mothers with infants and young children.
Method. A series of three focus groups were facilitated with three to six women per group. Thirteen women who were substance dependent participated in this study. Semi-structured interviews guided the collection of data. Thematic content analysis was used to work with the data.
Results. Four themes were identified: (1) feelings of guilt, (2) judged by others, (3) normalising and (4) support and learning to be a mother.
Conclusion. The mothers expressed alienation from mainstream health services. Providing parenting and child health services, which avoid mothers feeling judged by the staff and other mothers, is an important step to enabling these women to appropriately and sensitively care for their infants and young children.
Relevance to clinical practice. Midwives and nurses working with mothers and their infants and young children are well positioned to support women who are or have experienced substance dependence. Working with this group of mothers requires the development of a therapeutic relationship to provide optimum support, education and, if necessary, intervention.
Fowler, CM, Wu, C & Lam, W 2014, 'Participatory action research: Involving students in parent education', Nurse Education in Practice, vol. 14, no. 1, pp. 76-81.View/Download from: UTS OPUS or Publisher's site
A participatory action research project was used to provide a community nursing clinical experience of involvement in parent education. Nine Hong Kong nursing students self-selected to participate in the project to implement a parenting program called Parenting Young Children in a Digital World. Three project cycles were used: needs identification, skills development and program implementation. Students were fully involved in each cycle's planning, action and reflection phase. Qualitative and quantitative data were collected to inform the project. The overall outcome of the project was the provision of a rich and viable clinical placement experience that created significant learning opportunities for the students and researchers. This paper will explore the student's participation in this PAR project as an innovative clinical practice opportunity.
Lam, W, Wu, STC & Fowler, C 2014, 'Understanding parental participation in health promotion services for their children', Issues in Comprehensive Pediatric Nursing, vol. 37, no. 4, pp. 250-264.View/Download from: Publisher's site
McGarry, D, Cashin, A & Fowler, CM 2014, 'Is high fidelity human patient (Mannequin) simulation, simulation of learning?', Nurse Education Today, vol. 34, no. 8, pp. 1138-1142.View/Download from: Publisher's site
McGarry, D, Cashin, A & Fowler, CM 2014, 'Survey of Australian schools of nursing use of human patient (mannequin) simulation', Issues in Mental Health Nursing, vol. 35, no. 11, pp. 815-823.View/Download from: Publisher's site
Rapid adoption of high-fidelity human patient (mannequin) simulation has occurred in Australian Schools of Nursing in recent years, as it has internationally. This paper reports findings from a 2012 online survey of Australian Schools of Nursing and builds on findings of earlier studies. The survey design allowed direct comparison with a previous study from the USA but limited its scope to the pre-registration (pre-service Bachelor of Nursing) curriculum. It also included extra mental health specific questions. Australian patterns of adoption and application of high-fidelity human patient (mannequin) simulation in the pre-registration nursing curriculum share features with experiences reported in previous US and Australian surveys. A finding of interest in this survey was a small number of Schools of Nursing that reported no current use of high-fidelity human patient (mannequin) simulation and no plans to adopt it, in spite of a governmental capital funding support programme. In-line with prior surveys, mental health applications were meagre. There is an absence of clearly articulated learning theory underpinnings in the use of high-fidelity human patient (mannequin) simulation generally. It appears the first stage of implementation of high-fidelity human patient (mannequin) simulation into the pre-registration nursing curriculum has occurred and the adoption of this pedagogy is entering a new phase.
Ngaya-an, F & Fowler, CM 2014, 'The Role of Ayod Community Health Teams in Promoting Maternal and Infant Health in a Municipality in Ifugao, Philippines', Acta medica Philippina, vol. 48, no. 4, pp. 47-52.View/Download from: UTS OPUS
Objective. This study investigates the role of the Ifugao Community Health Teams, or the Ayods that function as frontline health workers, responsible for tracking pregnant women, bringing them to clinics for check-ups and encouraging planned facility-based birth. Specifically, this study examines their contribution to the Maternal and Child Health (MCH) Project, jointly initiated by the Philippines Department of Health (DOH) and Japan International Cooperation Agency (JICA). Commencing in 2006 and ending in 2010, the project aimed to improve the health and safety of mothers and newborns by ensuring the availability of quality health care, and increasing utilization of health facility and services.
Methods. A qualitative interpretive descriptive approach was used to guide the study. Three focus group discussions were conducted to collect data from a total of 21 participants, who were active members of the Community Health Teams in one municipality in Ifugao. To work with these data, an a priori template analysis was used to assist in identifying themes within the data.
Results. This study has highlighted three major themes: (1) Collaborative efforts of the Ayods play a role in the achievement of significant health outcomes for the community; (2) Equity, access and beliefs are key factors in the delivery of health care; and (3) Sustainability is secured through self-reliance and volunteerism.
Conclusion. The engagement of Ayods to trace and support pregnant women appears to have several successful health outcomes. The employment of existing community health workers and volunteers enabled the creation of sustainable model for isolated communities. It is anticipated that this vital service will continue to be provided. Nevertheless it will require ongoing and increasing support through the provision of allowances, education and community commitment to voluntary work.
Psaila, K, Fowler, C, Kruske, S & Schmied, V 2014, 'A qualitative study of innovations implemented to improve transition of care from maternity to child and family health (CFH) services in Australia', Women and Birth, vol. 27, no. 4, pp. e51-e60.View/Download from: Publisher's site
Psalia, K, Kruske, S, Fowler, CM, Homer, CS & Schmied, V 2014, 'Smoothing out the transition of care between maternity and child and family health services: perspectives of child and family health nurses and midwives?', BMC Pregnancy Childbirth, vol. 14, pp. 1-13.View/Download from: Publisher's site
Background: In Australia, women who give birth are transitioned from maternity services to child and health
services once their baby is born. This horizontal integration of services is known as Transition of Care (ToC). Little is
known of the scope and processes of ToC for new mothers and the most effective way to provide continuity of
services. The aim of this paper is to explore and describe the ToC between maternity services to CFH services from
the perspective of Australian midwives and child and family health (CFH) nurses.
Method: This paper reports findings from phase two of a three phase mixed methods study investigating the
feasibility of implementing a national approach to CFH services in Australia (the CHoRUS study). Data were
collected through a national survey of midwives (n = 655) and CFH nurses (n = 1098). Issues specifically related to
ToC between maternity services and CFH services were examined using descriptive statistics and content analysis of
Results: Respondents described the ToC between maternity services and CFH services as problematic. Key
problems identified included communication between professionals and services and transfer of client information.
Issues related to staff shortages, early maternity discharge, limited interface between private and public health
systems and tension around role boundaries were also reported. Midwives and CFH nurses emphasised that these
issues were more difficult for families with identified social and emotional health concerns. Strategies identified by
respondents to improve ToC included improving electronic transfer of information, regular meetings between
maternity and CFH services, and establishment of liaison roles.
Conclusion: Significant problems exist around the ToC for all families but particularly for families with identified
risks. Improved ToC will require substantial changes in information transfer processes and in the professional
relationships which currently exist be...
Psalia, K, Schmied, V, Fowler, CM & Kruske, S 2014, 'Discontinuities between maternity and child and family health services: health professional's perceptions', BMC Health Services Research, vol. 14, pp. 4-4.View/Download from: Publisher's site
Background: Continuity in the context of healthcare refers to the perception of the client that care has been connected and coherent over time. For over a decade professionals providing maternity and child and family health (CFH) services in Australia and internationally have emphasised the importance of continuity of care for women, families and children. However, continuity across maternity and CFH services remains elusive. Continuity is defined and implemented in different ways, resulting in fragmentation of care particularly at points of transition from one service or professional to another. This paper examines the concept of continuity across the maternity and CFH service continuum from the perspectives of midwifery, CFH nursing, general practitioner (GP) and practice nurse (PN) professional leaders. Methods: Data were collected as part of a three phase mixed methods study investigating the feasibility of implementing a national approach to CFH services in Australia (CHoRUS study). Representatives from the four participating professional groups were consulted via discussion groups, focus groups and e-conversations, which were recorded and transcribed. In total, 132 professionals participated, including 45 midwives, 60 CFH nurses, 15 general practitioners and 12 practice nurses. Transcripts were analysed using a thematic approach. Results: 'Continuity' was used and applied differently within and across groups. Aspects of care most valued by professionals included continuity preferably characterised by the development of a relationship with the family (relational continuity) and good communication (informational continuity). When considering managerial continuity we found professionals' were most concerned with co-ordination of care within their own service, rather than focusing on the co-ordination between services. Conclusion: These findings add new perspectives to understanding continuity within the maternity and CFH services continuum of care. All health ...
Schmied, V, Fowler, CM, Rossiter, C, Homer, CS, Kruske, S & CHoRUS team 2014, 'Nature and frequency of services provided by child and family health nurses in Australia: results of a national survey', Australian Health Review, vol. 38, no. 2, pp. 177-185.View/Download from: UTS OPUS or Publisher's site
Objective. Australia has a system of universal child and family health (CFH) nursing services providing primary health services from birth to school entry. Herein, we report on the findings of the first national survey of CFH nurses, including the ages and circumstances of children and families seen by CFH nurses and the nature and frequency of the services provided by these nurses across Australia.
Wu, CS, Fowler, CM, Lam, WY, Wong, HT, Wong, CH & Loke, AY 2014, 'Parenting approaches and digital technology use of preschool age children in a Chinese community', The Italian Journal of Pediatrics, vol. 40, pp. 1-8.View/Download from: UTS OPUS or Publisher's site
Young children are using digital technology (DT) devices anytime and anywhere, especially with the invention of smart phones and the replacement of desktop computers with digital tablets. Although research has shown that parents play an important role in fostering and supporting preschoolers developing maturity and decisions about DT use, and in protecting them from potential risk due to excessive DT exposure, there have been limited studies conducted in Hong Kong focusing on parent-child DT use. This study had three objectives: 1) to explore parental use of DTs with their preschool children; 2) to identify the DT content that associated with child behavioral problems; and 3) to investigate the relationships between approaches adopted by parents to control childrens DT use and related preschooler behavioral problems.
Hopwood, N, Fowler, CM, Lee, A, Rossiter, C & Bigsby, M 2013, 'Understanding partnership practice in child and family nursing through the concept of practice architectures', Nursing Inquiry, vol. 20, no. 3, pp. 199-210.View/Download from: UTS OPUS or Publisher's site
A significant international development agenda in the practice of nurses supporting families with young children focuses on establishing partnerships between professionals and service users. Qualitative data were generated through interviews and focus groups with 22 nurses from three child and family health service organisations, two in Australia and one in New Zealand. The aim was to explore what is needed in order to sustain partnership in practice, and to investigate how the concept of practice architectures can help understand attempts to enhance partnerships between nurses and families.
Fowler, CM, Rossiter, C, Day, C & Lee, A 2012, 'Partners in Hope: an innovative program to support mothers affected by alcohol and drug dependence and their children', Australian Journal of Child and Family Health Nursing, vol. 9, no. 2, pp. 18-21.View/Download from: UTS OPUS
Fowler, CM, Rossiter, C, Maddox, J, Dignam, DM, Briggs, CJ, DeGuio, A & Kookarkin, JL 2012, 'Parent satisfaction with early parenting residential services: a telephone interview study', Contemporary Nurse, vol. 43, no. 1, pp. 64-72.View/Download from: UTS OPUS or Publisher's site
Early parenting residential units provide a child and family health support and education service for parents experiencing parenting difficulties. An ongoing concern of nursing staff and management is whether the parenting knowledge and skills gained are translated into sustainable parenting practices after discharge. This paper explores the response to a post discharge telephone interview about parents' experience of nursing care during their residential stay and their parenting experience since discharge. A descriptive qualitative approach identified four themes in the parents' responses: greater confidence, greater knowledge about their babies, changing expectations of parenting and their infants, and sustainability of parenting skills.
Risks associated with maternal-infant bed-sharing are widely documented and promoted. This study aims to examine sleep patterns and strategies including bed-sharing. Women aged over 18 who have infants aged up to 24 months were eligible to participate in an anonymous online questionnaire in March 2010. A representative sample of 1,000 respondents was randomly selected from a total sample of 2000. The challenge of facilitating infant sleeping was highlighted, with 92% of respondents having difficulties at some point. Almost all (97%) felt sleep-deprived at some time, with almost half reporting that they were always or regularly deprived of sleep. Sleep deprivation exacerbated exhaustion or feeling run down (75%), irritability (70%), made mothers less patient with their infants (63%) and put additional strain on their relationship with their partner (37%). Strategies to facilitate infant sleeping included rocking and patting (50%), giving a dummy/comforter (46%) and allowing the baby to fall asleep in their arms (47%) or after feeding (45%). Just under half (41%) utilised bed-sharing as a sleep strategy at night. Bed-sharing was more likely to be used if babies experienced frequent waking at night and unstable sleep patterns. Maternal-infant bed-sharing continues to be an infant sleep strategy used by mothers, despite the risks involved. This study highlights that mothers still continue to bed-share despite preventative health campaigns and the known risks. Thus, health promotion should be modified to include a stronger emphasis on risk minimisation strategies.
Kassab, M, Foster, JP, Foureur, M & Fowler, CM 2012, 'Sweet-tasting solutions for needle-related procedural pain in infants one month to one year of age', Cochrane Database of Systematic Reviews, no. 12.View/Download from: UTS OPUS or Publisher's site
To determine the effectiveness of sweet-tasting solutions for needle-related procedural pain in infants one month to one year of age compared to no treatment, placebo, other sweet-tasting solutions, or pharmacological or other non-pharmacological pain-relieving methods.
Kassab, M, Roydhouse, J, Fowler, CM & Foureur, M 2012, 'The Effectiveness of Glucose in Reducing Needle-Related Procedural Pain in Infants', Journal of Pediatric Nursing, vol. 27, no. 1, pp. 3-17.View/Download from: UTS OPUS or Publisher's site
This systematic review examined the effectiveness of glucose in relieving needle-associated pain in infants. Meta-analysis was not undertaken, and there was variation in dose, administration method, concentration, and outcome measurement. Glucose was more effective than placebo in relieving infant pain as measured by behavioral outcomes, but there were mixed findings for physiological outcomes. Based on these findings, 25%-50% glucose appears effective for infant pain management.
Kassab, M, Sheehy, AD, King, MT, Fowler, CM & Foureur, M 2012, 'A double-blind randomised controlled trial of 25% oral glucose for pain relief in 2-month old infants undergoing immunisation', International Journal of Nursing Studies, vol. 49, no. 3, pp. 249-256.View/Download from: UTS OPUS or Publisher's site
This article reports a double-blind RCT to determine the effectiveness of 25% oral glucose solution in reducing immunisation pain in 2-month old infants.
McGarry, DE, Cashin, A & Fowler, C 2012, 'Child and adolescent psychiatric nursing and the 'plastic man': Reflections on the implementation of change drawing insights from Lewin's Theory of Planned Change', Contemporary Nurse, vol. 39, no. 2.
Child and adolescent psychiatric nursing (CAPN) as a discipline has been remarkably slow in the uptake of high fidelity human patient simulation (HFHPS) as an education tool. Assuming HFHPS has potential use, and the issue is one of change management, this paper speculates about how Lewin's paradigm for Planned Change might provide guidance to the specialty discipline of CAPN in development of strategies to promote adoption of HFHPS to education of pre-registration nurses. Kurt Lewin (1890-1947) was a seminal theorist of change, whose pioneering work has had significant impact across many disciplines. His theory of Planned Change has four components - Field Theory, Group Dynamics, Action Research and the 3-Step Model of Change. Each component is considered briefly and then combined within an example of application. © 1992-2011 eContent Management.
McGarry, DE, Cashin, AJ & Fowler, CM 2012, 'Child and adolescent psychiatric nursing and the 'plastic man': Reflections on the implementation of change drawing insights from Lewin's theory of planned change', Contemporary Nurse, vol. 41, no. 2, pp. 263-270.View/Download from: UTS OPUS or Publisher's site
Child and adolescent psychiatric nursing (CAPN) as a discipline has been remarkably slow in the uptake of high fidelity human patient simulation (HFHPS) as an education tool.
Rossiter, C, Fowler, CM, McMahon, C & Kowalenko, N 2012, 'Supporting depressed mothers at home: their views on an innovative relationship-based intervention', Contemporary Nurse, vol. 41, no. 1, pp. 90-100.View/Download from: UTS OPUS or Publisher's site
This study explored the responses of a group of 111 mothers who experienced distress and/or depression and who received an innovative home visiting service until their child's first birthday. The article reports a thematic content analysis of the qualitative questionnaire responses returned by mothers after completing the intervention. The mothers valued the home visiting program for its capacity to increase their parenting confidence and to enhance their bond with their infants. They attributed this to the reassurance provided by the program and the skills and qualities of the home visitors. Their responses complement the benefits identified in the quantitative analysis of the program and demonstrate its impact from participants' viewpoints.
Filipinos have been an important part of the global workforce since the first half of the twentieth century. The initial migration of primarily men has shifted to an increasing numbers of women in recent decades. These changes are primarily attributed to a high demand for domestic workers, nurses and occupations that are female dominated. In 2005, about 70% of the international labour migrants are women from the Philippines. Living in a foreign land, these women face challenges that affect their physical, emotional and social well being. Especially on their first year living abroad, these women experience significant stress which affects their health as they adjust to a new work environment, culture, social norms, diet, and weather. The emotional strain can be greater for those who have left their families behind in the Philippines and aggravated by the financial need to send money to them. Striking examples, such as the homicide rate of Filipino women married to Australian men being 5.6 times higher than that of Australian-born women, underscores the importance of supportive health care environments and appreciating socio-cultural factors. In the delivery of healthcare services to migrant women, it is critical to consider the unique socio-cultural background of women as well as health beliefs and practices.
Fowler, CM, Dunston, R, Lee, A, Rossiter, C & McKenzie, JA 2012, 'Reciprocal learning in partnership practice: an exploratory study of a home visiting program for mothers with depression', Studies in Continuing Education, vol. 34, no. 2, pp. 99-112.View/Download from: UTS OPUS or Publisher's site
This paper reports on a small exploratory study that investigates the place and role of reciprocal learning within a partnership-based home visiting program for mothers experiencing depression. The study is one important example of an increased focus on reciprocal learning within practice that has significant implications for the development of professional education and, more generally, for workplace learning and ongoing professional development. The study addresses two major gaps in the research literature: a lack of detailed accounts of how partnership based approaches are taken up and developed in Australian health care; and a lack of attention to learning as a focus and outcome of artnership- based practice. Using information from in-depth interviews with nurses and mothers we describe and analyse the experience of participants, their learning and knowledge development, the techniques used to facilitate learning, and the development of a relationship between mother and nurse, and mother and child.
Fowler, CM, Lee, A, Dunston, R, Chiarella, M & Rossiter, C 2012, 'Co-producing parenting practice: learning how to do child and family health nursing differently', Australian Journal of Child and Family Heath Nursing, vol. 9, no. 1, pp. 7-11.
Child and family health nurses are increasingly required to examine the way in which they work with parents, in order to achieve more effective parenting outcomes and more sustainable health services. New approaches to working successfully with parents require acknowledgement that parents are competent, knowledgeable, resourceful and uniquely experienced with their child/ren. This calls for an approach to practice that enables ongoing parental learning and capability development, in contrast to more traditional practices. This article discusses the implications of these new approaches with reference to the idea of co-production, a concept that sits at the heart of recent initiatives in public sector and health service reform. Co-production extends previous thining about the nature and scope of parent participation, locating parents as equal partners and producers alongside health professionals.
Fowler, CM, Rossiter, C, Bigsby, M, Hopwood, N, Lee, A & Dunston, R 2012, 'Working in partnership with parents: the experience and challenge of practice innovation in child and family health nursing', Journal of Clinical Nursing, vol. 21, no. 21-22, pp. 3306-3314.View/Download from: UTS OPUS or Publisher's site
Aims and objectives. This study investigated what Family Partnership Model practice means in the day-to-day practice of child and family health nurses working with parents. Background. The Family Partnership Model has been widely implemented in child and family health services in Australia and New Zealand, with limited understanding of the implications for nursing practice. Design. A qualitative interpretive study design was used. Method. Semi-structured interviews were conducted with 22 nurse participants, who had completed the Family Partnership Model training programme. Subsequent focus groups enabled these participants to validate the themes identified in the initial analysis and to confirm that the nurses concurred with the issues raised. Thematic content analysis produced rich descriptions and explanation of nurses' experiences and perspectives. Results. Four themes emerged from the analysis: experience of changing practices, exploring with parents, challenging unhelpful constructions and a commitment to examining practice. Conclusion. Overall, the participants embraced the use of the Family Partnership Model, providing examples of change and increasing confidence in their approach to working with parents. Relevance to clinical practice. This study demonstrates that the effective utilisation of the Family Partnership Model in nursing practice is a more complex and dynamic process than simply embracing the model. There are significant challenges to be negotiated when implementing new ways of working with parents, particularly questioning existing dominant forms of practice for nurses, managers and wider health organisations, and their clients. This paper also raises issues about sustaining practice innovation, which extends beyond the best intent of individual nurses, requiring receptive organisational conditions and leadership.
There exists an ethical imperative to ensure the wellbeing of infants undergoing painful procedures, even procedures of short duration. The use of suitable, non-pharmacological pain-relieving measures such as sweet-tasting solutions (for example, sucrose of glucose) should be considered.
McGarry, DE, Cashin, A & Fowler, C 2011, 'Child and adolescent psychiatric nursing and the 'plastic man': Reflections on the implementation of change drawing insights from Lewin's Theory of Planned Change', Contemporary Nurse, vol. 39, no. 2.
Child and adolescent psychiatric nursing (CAPN) as a discipline has been remarkably slow in the uptake of high fidelity human patient simulation (HFHPS) as an education tool. Assuming HFHPS has potential use, and the issue is one of change management, this paper speculates about how Lewin's paradigm for Planned Change might provide guidance to the specialty discipline of CAPN in development of strategies to promote adoption of HFHPS to education of pre-registration nurses. Kurt Lewin (1890-1947) was a seminal theorist of change, whose pioneering work has had significant impact across many disciplines. His theory of Planned Change has four components - Field Theory, Group Dynamics, Action Research and the 3-Step Model of Change. Each component is considered briefly and then combined within an example of application. © 1992-2011 eContent Management.
McGarry, DE, Cashin, AJ & Fowler, CM 2011, ''Coming ready or not' high fidelity human patient simulation in child and adolescent psychiatric nursing education: Diffusion of Innovation', Nurse Education Today, vol. 31, no. 7, pp. 655-659.View/Download from: UTS OPUS or Publisher's site
This paper is the first to address high fidelity human patient simulation (HFHPS) as a technique to prepare pre-registration nursing students for practice in child and adolescent psychiatric nursing (CAPN). By examining the published literature in a systematic review, no evidence was located that discussed the application of this innovative mannequin-based educational technique for this population. Indeed, mental health nursing preparation generally had minimal literature addressing the adoption of HFHPS. Rogers' (2003) model of the Diffusion of Innovation was applied as a lens to explain this observation. His model fitted this observed pattern well and provided a range of explanatory paradigms. It was limited, however, in its predictive ability to suggest when and under what conditions HFHPS might be expected to be adopted by nursing preparation programmes for CAPN. At the conclusion to this examination, the absence of a conversation evident in the mental health or CAPN literature on the preparation of pre-registration nursing students using this educational technique is striking. The potential of this approach to be combined in new ways to better prepare nursing students for the challenges of practice in mental health or CAPN needs extensive examination.
Newman, C, Fowler, CM & Cashin, AJ 2011, 'The development of a parenting program for incarcerated mothers in Australia: A review of prison-based parenting programs', Contemporary Nurse, vol. 39, no. 1, pp. 2-11.View/Download from: UTS OPUS or Publisher's site
The increasing population of children with an incarcerated parent is a significant public health issue. A literature search highlighted that children of incarcerated parents experience psychological stressors that may potentially impact on health and behavioural outcomes. Parenting programs for prisoners may be of benefit as early parenting experiences during childhood have a significant impact on a child's future experiences as an adolescent and adult. A review of identified evaluation-based studies of parenting programs for prisoners (n=11), although varied in program delivery approaches and evaluation methods, suggest that such programs have the potential to improve the parenting skills, knowledge and confidence of incarcerated parents. Finally, this paper provides an outline of the development of an Australian based parenting program for incarcerated mothers and their young children.
Perry, V, Fowler, CM, Heggie, K & Barbara, K 2011, 'The impact of a correctional-based parenting program in strengthening parenting skills of incarcerated mothers', Current Issues in Criminal Justice, vol. 22, no. 3, pp. 457-472.View/Download from: UTS OPUS
Despite a relative paucity of information on the impact that incarceration of a parent has on a child, most literature agrees that the effects are real and profound. Corrective Services NSW (CSNSW) in conjunction with Tresillian Family Care Centres introduced a parenting program, Mothering at a Distance (MAAD), across correctional facilities for female prisoners in New South Wales (NSW), Australia. The central aim of the Program was to provide early parenting education and support intervention to mothers in custody, with the aim of guarding against the intergenerational cycle of crime. The Program intended to enhance a prisoner's ability to provide appropriate and sensitive parenting and reduce the emotional and social impact of separation on their children. An evaluation of the Program's development, implementation, effectiveness, and sustainability was conducted on all groups run between October 2006 and December 2008. This article provides a summary of the evaluation findings.
Schmied, V, Donovan, J, Kruske, S, Kemp, L, Homer, CS & Fowler, CM 2011, 'Commonalities and challenges: A review of Australian state and territory maternity and child health policies', Contemporary Nurse, vol. 40, no. 1, pp. 106-117.View/Download from: UTS OPUS or Publisher's site
Nurses and midwives play a key role in providing universal maternal, child and family health services in Australia. However, the Australian federation of states and territories has resulted in policy frameworks that differ across jurisdictions and services that are fragmented across disciplines and sectors. This paper reports the findings of a study that reviewed and synthesised current Australian service policy or frameworks for maternity and child health services in order to identify the degree of commonality across jurisdictions and the compatibility with international research on child development. Key maternity and child health service policy documents in each jurisdiction were sourced. The fi ndings indicate that current policies were in line with international research and policy directions, emphasising prevention and early intervention, continuity of care, collaboration and integrated services. The congruence of policies suggests the time is right to consider the introduction of a national approach to universal maternal, child health services.
Rossiter, C, Fowler, CM, Hopwood, N, Lee, A & Dunston, R 2011, 'Working in partnership with vulnerable families: the experience of child and family health practitioners', Australian Journal of Primary Health, vol. 17, no. 4, pp. 378-383.View/Download from: UTS OPUS or Publisher's site
Abstract.Family circumstances in infancy are persistent and powerful determinants of childrenâs physical and mental health, influencing inequalities that trace from childhood through to adulthood. While the social factors that perpetuate patterns of inequality are more complex than can be addressed through single interventions, child and family health (CFH) services represent crucial sites where trajectories of inequality can be disrupted. In particular, approaches that foster opportunities for practitionerâparent engagement that challenge traditional hierarchical health care practice, such as the Family Partnership Model (FPM), are recommended as ways of addressing disadvantage. Little is known about how practitioners implement models of working in partnership with families and, consequently, there is a gap in understanding how best to develop and sustain these new CFH practices. This paper reports a research project that investigated the experiences of 25 health professionals working within a FPM framework with vulnerable families. Through discussion of four key themes â redefining expertise, changing practices, establishing new relationships with parents and the complexities of partnership practice â the paper offers first-hand accounts of reframing practices that recognise the needs, skills and expertise of parents and thus contribute to empowerment of families.
Brown, N, Gallagher, RD, Fowler, CM & Wales, S 2010, 'The role of parents in managing asthma in middle childhood: An important consideration in chronic care', Collegian, vol. 17, no. 2, pp. 71-76.View/Download from: UTS OPUS or Publisher's site
Asthma is a significant illness for Australian children and their families. In childhood, parents have the primary responsibility for managing asthma on a day-to-day basis, and therefore understanding the management of asthma by parents is important to nursing practice. Middle childhood (5-12 years) is an important time in the lives of children and families with asthma, as children commence school and spend increasing amounts of time away from direct parental care. In order to manage asthma during middle childhood, parents need to understand asthma as an illness, understand the treatment of asthma, be able to monitor and respond to changes in condition, manage other carers, manage asthma in the context of family life and guide the development of self-management responsibility in their child with asthma. While the scope of parent management in terms of asthma knowledge and treatment has been well explored in the literature, less is known about the process by which parents support the development of self-management responsibility in children with asthma.
Schmied, V, Mills, A, Kruske, S, Kemp, L, Fowler, CM & Homer, CS 2010, 'The nature and impact of collaboration and integrated service delivery for pregnant women, children and families', Journal Of Clinical Nursing, vol. 19, no. 23-24, pp. 3516-3526.View/Download from: UTS OPUS or Publisher's site
Aim. This paper explores the impact of models of integrated services for pregnant women, children and families and the nature of collaboration between midwives, child and family health nurses and general practitioners. Background. Increasingly, maternity and child health services are establishing integrated service models to meet the needs of pregnant women, children and families particularly those vulnerable to poor outcomes. Little is known about the nature of collaboration between professionals or the impact of service integration across universal health services. Design. Discursive paper. Methods. A literature search was conducted using a range of databases and combinations of relevant keywords to identify papers reporting the process, and/or outcomes of collaboration and integrated models of care. Results. There is limited literature describing models of collaboration or reporting outcomes. Several whole-of-government and community-based integrated service models have been trialled with varying success. Effective communication mechanisms and professional relationships and boundaries are key concerns. Liaison positions, multidisciplinary teams and service co-location have been adopted to communicate information, facilitate transition of care from one service or professional to another and to build working relationships. Conclusions. Currently, collaboration between universal health services predominantly reflects initiatives to move services from the level of coexistence to models of cooperation and coordination.
Sorensen, R, Fowler, CM, Nash, CJ & Bacon, W 2010, 'Addressing the gap in Indigenous health: government Intervention or community governance? A literature review', Health Sociology Review, vol. 19, no. 1, pp. 20-33.View/Download from: UTS OPUS
The high incidence of sexual abuse of Indigenous children in remote Australia prompted the Australian Government to implement an emergency response of health and welfare measures (the Intervention) in 2007 to protect children and communities from harm. In this article we seek to assess the measures employed in the Intervention against the body of evidence of strategies likely to be effective in reducing Indigenous health disadvantage. Our view is that the emergency response may not have long-term benefit because of the dearth of basic primary health services in remote Aboriginal communities to continue the effort that the Intervention has begun. We conclude that Intervention measures are not sufficiently well aligned with evidence-based health improvement strategies to bring about long-term health gain in Indigenous communities. Governments must reassess the benefit of externally-imposed approaches to reducing health disparity and move to actively build capacity in Aboriginal communities to deliver culturally-relevant health and social services that meet community need.
Halle, C, Dowd, T, Fowler, C, Rissel, K, Hennessy, K, MacNevin, R & Nelson, MA 2008, 'Supporting fathers in the transition to parenthood', CONTEMPORARY NURSE, vol. 31, no. 1, pp. 57-70.View/Download from: Publisher's site
Halle, C, Dowd, T, Fowler, CM, Rissel, K, Hennessy, K, MacNevin, R & Nelson, M 2008, 'Supporting fathers in the transition to parenthood', Contemporary Nurse, vol. 31, no. 1-2, pp. 57-70.View/Download from: UTS OPUS or Publisher's site
This paper focuses on the exploration of 22 men's feelings and beliefs about fatherhood; and their expectations and views about parenting. The paper will also investigate how fathers' antenatal expectations matched the reality of early family life including emotional well-being, attitudes to parenting, adjustment to family life and sources of support.
Fowler, CM & Lee, A 2007, 'Knowing How to Know: questioning 'knowledge transfer' as a metaphor for knowing and learning in health', Studies in Continuing Education, vol. 29, no. 2, pp. 181-193.View/Download from: UTS OPUS
Many healthy human experiences and practices have become medicalized and professionalized within health during the past century. In the example used in this article, the legitimation of formal, evidence-based scientific knowledge about parenting within nursing and midwifery can have the effect of replacing and discrediting embodied, informal and culturally located ways of knowing and learning. At the same time, recent developments within health policy increasingly focus on the need for active engagement by members of the community in the production and maintenance of their own health. This is often promoted in terms of partnership between consumers of health services and providers. The dominant metaphor of knowledge transfer, however, produces a prescriptive text that assumes a unidirectional movement from expert professional knowledge providers towards the consumers of that knowledge. This article addresses this problematic by discussing a case study of one woman learning to breastfeed her first baby. It examines, through discursive analysis, the complex and contradictory dynamics of her knowing and learning, situated in relation to formal knowledge about breastfeeding, in order to explore and elaborate an argument for more complex cultural and relational understandings of knowing and learning than that offered by the knowledge transfer metaphor.
Keatinge, D, Fowler, CM & Briggs, CJ 2007, 'Evaluating the Family Partnership Model (FPM) program and implementation in practice in New South Wales,Australia.', Australian Journal of Advanced Nursing, vol. 25, no. 2, pp. 28-35.View/Download from: UTS OPUS
Objective This study investigates participants experiences of implementing and educating colleagues in the Family Partnership Model (FPM). Design Qualitative research approaches using content analysis.
Lee, A, Dunston, R & Fowler, CM 2012, 'Seeing is Believing: An Embodied Pedagogy of 'Doing Partnership' in Child and Family Health' in Hager, P, Lee, A & Reich, A (eds), Practice, Learning and Change: Practice-Theory Perspectives on Professinal Learning, Springer, Dordrecht, pp. 267-276.View/Download from: UTS OPUS or Publisher's site
This chapter examines practices of 'doing partnership' between health professionals and users or clients of a health service. The move from expert-client modes of practice to partnership modes raises an important set of questions concerning the changing nature of professional practice to more specifically include the 'other' in the defining of the key activities and enactments of practices. Partnership practice is an example of a broad set of moves within the human service sector to shift the balance of power, capacity and responsibility from a provider-consumer relationship to one of co-production (Dunston et al. 2009; Brodie et al. 2009). These moves are complex mixes of neoliberal cost-cutting efficiency measures and redesigning of relationships between citizens and government in terms of active citizenship, civic participation and entitlement in relation to services. They are widespread across the human services, from health to social care, education, housing and local govemment and are increasingly finding their way into business and management: human resource management, marketing and so on.
Fowler, CM & McGarry, DE 2011, 'Praxis: The Essential Nursing Construct' in Cashin, A & Cook, R (eds), Evidence-Based Practice in Nursing Informatics: Concepts and Applications, IGI Global, Hershey, New York, pp. 40-50.View/Download from: Publisher's site
Praxis is grounded as an essential underpinning construct of nursing. Praxis is advocated to be the route to allow nurses to be emancipated from 'regimes of truth' and reified bureaucratic structures. Praxis is also described as the vehicle to take nurses on the journey of continued professional and profession growth.
Dahlen, H, Schmied, V, Fowler, C & Thornton, C 2015, 'Characteristics, trends, co-admissions and service needs of women admitted to residential parenting services in the year following birth in NSW', WOMEN AND BIRTH, ELSEVIER SCIENCE BV, pp. S44-S44.View/Download from: Publisher's site
Hurt, D, Fowler, C & Foureur, M 2015, 'Midwives' understanding of perinatal depression and the scope of midwifery practice', WOMEN AND BIRTH, ELSEVIER SCIENCE BV, pp. S18-S19.View/Download from: Publisher's site
Doab, A, Fowler, C & Dawson, A 2014, 'Factors that influence mother-child reunification for mothers with a history of substance use:A systematic review of the evidence to inform policy and practice in Australia.', Australasian Professional Society on Alcohol and Drugs, Adelaide.
Issues: Child abuse and neglect are of national concern in Australia and increasing reports to authorities are placing statutory child protection services under pressure Given the current increases in the number of Australian children in out of home care (OOHC) care, and that a large proportion of children in OOHC are have a parent with a substance use disorder (SUD), it is worthwhile examining the literature to provide evidence to inform the development of preventative and remedial interventions.
Approach: Using a narrative synthesis design, this review explores programs and maternal characteristics that either facilitate or act as a barrier to mother-child reunification in mothers with SUD
Key Findings: Outcomes regarding treatment modality and reunification were mixed. Factors such as presence of a mental health disorder and using opiates and were among several barriers to reunification.
Implications: This has implications for health care planning and delivery for women who use opiates and a have a mental health issue.
Conclusion: Women with SUDs who have a child in out of home care have multiple unmet needs. More comprehensive and integrated care services as well as greater access to primary health care must be considered if we are to improve outcomes and address issues for these women, as well as their children and potential future generations.
Implications for Practice or Policy: Practice and policies that better support mothers with a SUD including reduction of stigma, removal of barriers for treatment access, and increased treatment retention are required. Furthermore, treatment for mental health issues must be better integrated into SUD treatment settings.
McGarry, D, Cashin, A & Fowler, C 2014, 'Practice Theory and Situated Learning: How could future educational approaches to mental health nursing preparation be informed?', INTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, WILEY-BLACKWELL, pp. 24-24.
McGarry, D, Fowler, C & Cashin, A 2013, 'We need to talk about clinical placements: Are the collaboration and partnerships required for gold standards of clinical placements delivering? (apologies to lionel shriver) (poster)', INTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, WILEY-BLACKWELL, pp. 20-20.
McGarry, D, Cashin, A & Fowler, C 2011, 'Marketing mental health nursing on Australian schools of nursing websites - Is mental health nursing positioned 'between the flags?'', INTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, WILEY-BLACKWELL, pp. 12-12.
Fowler, C, Kowalenko, N & McMahon, C 2010, 'Learning together about the infant: Coproduction of maternal knowledge', INFANT MENTAL HEALTH JOURNAL, WILEY-BLACKWELL, pp. 132-132.
McGarry, D, Cashin, A & Fowler, C 2009, 'Can caring be simulated? An examination of the literature related to application of high fidelity simulation to mental health nursing preparation', INTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, WILEY-BLACKWELL PUBLISHING, INC, pp. A16-A16.
Rossiter, C, Fowler, CM, Dunston, R, Sherwood, J & Day, C Centre for Research in Learning & Change UTS 2013, Integrating parenting support in alcohol and drug treatment program for mothers and their children: a study of practice innovation, pp. 1-45, Sydney.View/Download from: UTS OPUS
Rossiter, C, Hopwood, N, Dunston, R, Fowler, CM, Bigsby, M & Lee, A Centre for Research in Learning and Change, FASS, UTS 2011, Sustaining Practice Innovation in Child and Family Health: report to partners, pp. 1-38, Sydney.View/Download from: UTS OPUS
The publication reports on the findings of a UTS Partnership Grant-funded project, a collaboration between the Centre for Learning & Change FASS and FNMH, Tresillian Family Care Centres, Kaleidoscope Hunter Children's Health Network and the Royal New Zealand Plunket Society. The study explored the implementation of the Family Partnership Model (FPM, Davis, Day and Bidmead 2002) in three child and family health nursing services in Australia and New Zealand. The FPM is an internationally-recognised exemplar of co-productive partnership practice, and has been adopted by all Australian states as the preferred model for providing universal child health services. Unlike previous studies of the FPM that assess its impact on individuals and families, this case study used in-depth qualitative methods to investigate the complex process in which nurses learn about a new way of working with families and how they incorporate new insights into their practice. They study also considers how innovative models of service delivery are implemented within health systems and how they are sustained over time.
Perry, V, Fowler, CM & Heggie, K NSW Department of Corrective Services 2009, Evaluation of the mothering at a distance program, pp. 1-100, Sydney, Australia.