The next day, I spoke further with Mary Griffiths about the challenges in transferring a US program to a UK setting. The first and most obvious change was the name of the program – in the US it is the Nurse Family Partnership, and in the UK, it is the Family Nurse Partnership. This was a purposeful reframing of the relationship, putting the family first.
Mary described some of the other small changes to the program, such as changing the language of the materials used, but in essence the program has transferred well. Both programs speak in terms of fidelity goals, i.e. integrity to the model, such as enrolling the woman in the program by mid-pregnancy, retaining the clients until the child is two years of age and achieving prescribed “doseage”or the number of visits.
As she explained, the Family Nurse Partnership Program is based on the theories of human ecology, attachment and self-efficacy.
Human ecology theory
- Bronfenbrenner’s theory of human ecology emphasises the importance of the social context as an influence on human development. Use of this theory means that nurses help their clients to consider the impact of their social context on their growing child, and to develop strong relationships with those who can play a supportive role.
- Attachment theoryBowlby’s attachment theory emphasises the importance of the security and safety that a primary relationship with a caregiver gives for a child’s healthy emotional development. Nurses use this theory to guide their work with FNP clients on sensitive and responsive care-giving.
- Self-efficacy theorySelf-efficacy is seen by Bandura, in his social cognitive theory, as an individual’s belief in their ability to achieve their goals and that realising these will lead to a desired outcome. Nurses use this concept to guide their efforts in supporting positive change, enabling clients to understand why particular actions are important and to develop the confidence necessary to achieve these.