# 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.

## Key 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.