Knowledge of and Attitudes Toward Perinatal Home Visiting in Women with High-Risk Pregnancies

Factors Related to Burnout Among Perinatal Home Visiting Nurses

PURPOSE

Risks for burnout among nurses have been understudied in public and community health settings. This qualitative descriptive study aimed to describe the experiences of nurses working in a perinatal community health program for high-risk families with a focus on challenges and risks for burnout.

METHODS

We conducted field observation and semistructured individual interviews in 2019 with nurses at 2 sites implementing Prenatal Care Coordination (PNCC), a Medicaid benefit for high-risk pregnant people and infants in Wisconsin. A larger parent study assessed the implementation of PNCC overall through a thematic analysis process. Initial deductive coding was guided by the Consolidated Framework for Implementation Research.

FINDINGS

Emergent themes demonstrated that PNCC nurses face several significant barriers and known risks for burnout, including role strain related to scope of practice and training, discordant racial and socioeconomic identities leading to role conflict, and low control combined with high psychological demand.

CONCLUSIONS

Given that the COVID-19 pandemic has exacerbated burnout risk among nurses in hospital settings, and that nurses addressing social determinants of health may be at increased risk for burnout, these findings represent a critical perspective on the experiences and needs of perinatal nurses in public and community health settings.

Solicitude em visita domiciliar de enfermeiras no cuidado pré-natal de alto risco: relato de experiência

Resumo Objetivos relatar a experiência de produção de cuidado no pré-natal de alto risco, por meio de visitas domiciliares estruturadas na solicitude. Método estudo descritivo, na modalidade relato de experiência, pautado na vivência de enfermeiras em desenvolver visitas domiciliares, sob o referencial da solicitude para 17 mulheres com gravidez de alto risco. Resultados as visitas domiciliares possibilitaram às enfermeiras a valoração dos aspectos subjetivos do cuidado, com apreensão de necessidades das mulheres e compreensão da gravidez na vida de cada uma delas, aspectos determinantes à atenção pré-natal integral. Promoveu cuidado singular e contraposição às insuficiências e negativas experienciadas na atenção pré-natal recebida, ancorada no modelo biomédico. Conclusão e implicações para a prática a visita domiciliar por enfermeiras, sob os auspícios da solicitude, revelou-se como tecnologia de atenção pré-natal de alto risco que produz acolhimento de necessidades singulares, assim como conduz a reconstrução do cuidado no contexto da gravidez de alto risco.