Poster Presentation Women's Health Forum 2021

Understanding primary health care nurses’ attitudes and practice relating to preconception care.  (#54)

Edwina Dorney 1 , Jo Millard 2 , Karin Hammarberg 3 , Adrienne Gordon 1 , Kevin McGeechan 4 , Kirsten Black 1
  1. The University of Sydney, Sydney, NSW, Australia
  2. Australian Primary Health Care Nurses Association , Melbourne, Victoria, Australia
  3. Public Health & Preventative Medicine , Monash University , Melbourne , Victoria , Australia
  4. School of Public Health , The University of Sydney , Sydney, NSW , Australia

Background: Preconception care (PCC) entails a comprehensive set of interventions to optimise the health of women and their partners prior to pregnancy. This improves pregnancy outcomes, childhood health and the health of future generations. Access to health care professionals, and time constraints once with a health professional, are two identified barriers to delivering PCC. In Australia, Primary Health Care Nurses (PHCNs) are the largest body of clinicians working in primary care and they are uniquely placed to deliver PCC.

Method:

We surveyed PHCNs, with AHPRA registration who see clients of reproductive age in Australia. Recruitment was via the Australian Primary Health Care Nurses Association (APNA) online newsletter and private Facebook Page.

The 18-item, online, anonymous survey included questions about demographics, and PCC knowledge and practices. Data were analysed using SPSSv.24.

Results: We received 152 completed surveys. 97% of participants were female and 73% worked in the general practice setting. 74% reported discussing PCC with clients, although only 13% did so routinely.  Respondents were three times more likely to discuss PCC with women than men.

94% of respondents identified at least one barrier to the delivery of PCC with time and lack of knowledge the most frequently cited barriers.

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87% of respondents indicated that more education would increase their confidence in delivering PCC. Despite this only 12.4% of respondents had completed an online, freely available APNA e-learning module on PCC.

Discussion: This study details current attitudes and practices of Australian PHCNs relating to PCC. The findings can inform the design of targeted strategies at the individual, organisational and health system levels to improve PHCNs capacity to deliver PCC. Such strategies include education programs, and resources to support PHCNs, as well as consideration of revised incentives.

  1. 1. World Health Organization. Preconception care: Maximizing the gains for maternal and child health. A Policy Brief. Geneva 2013.
  2. 2. Dorney E, Black KI. Preconception care. Australian Journal of general practice. 2018;47(7):424-9.
  3. 3. Australian Institute of Health and Welfare. A profile of primary health care nurses Australian Government 2020 [Available from: https://www.aihw.gov.au/reports/primary-health-care/a-profile-of-primary-care-nurses/contents/primary-health-care-nurses
  4. 4. Mazza D, Chapman A, Michie S. Barriers to the implementation of preconception care guidelines as perceived by general practitioners: a qualitative study. BMC Health Serv Res. 2013;13:36.
  5. 5. Hurst HM, Linton DM. Preconception Care: Planning for the Future. The Journal for Nurse Practitioners. 2015;11(3):335-40