Public Health Nurses in an Internal Negotiation Process When There Is Concern About the Child’s Care

TL;DR

This study explores how public health nurses handle follow-ups when they are concerned about a child's care, highlighting challenges and negotiation processes.

Contribution

The study introduces a new model for public health nurses to guide follow-up processes in cases of child care concerns.

Findings

Public health nurses face challenges due to lack of routines and goals in follow-up processes.

Dilemmas and past responses influence nurses' approaches to child and family follow-up.

A model for follow-up was developed based on the nurses' internal negotiation processes.

Abstract

The aim of the study was to explore and describe how public health nurses at child health clinics experience and perceive the follow-up of children and families when there is concern about the child’s care. The goal was to contribute to knowledge development to guide health-promoting nursing care for children and their families. Theoretical perspectives included health promotion, child-centered and family-centered care, in addition to nursing care. An exploratory qualitative design informed by a hermeneutic approach was used. Data were collected in 3 focus groups with 16 public health nurses and analyzed using latent content analysis. The findings detail public health nurses’ internal negotiation processes in the follow-up of children and the family, and the ways these negotiation processes were influenced by various prerequisites, the approaches for follow-up, dilemmas that affected public health nurses’ approaches, and prolonged dwellings on past responses to children and families of concern. The lack of routines and goals for follow-up, a dominant parental perspective, and ambiguity related to health promotion and disease prevention, all created challenges for the public health nurses. Based on these findings, a model of public health nurse’s follow-up when there is concern about the child’s care was developed for future research.

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