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Barns och föräldrars möte med sjuksköterskan i barnhälsovården
Linköping University, The Tema Institute, Department of Communications Studies. Linköping University, Faculty of Arts and Sciences.
2002 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Swedish child health care for children 0-7 years has a participation rate ofnearly one hundred per cent. Its work is preventive, and its ambition is toprevent health problems in preschool children and to promote good health in them and their families. The nurse is the key person and communication with parents and children is one of the important tools she uses in performing her tasks.

The overall purpose of this thesis is to describe and analyse the communication that takes place in encounters between the child health care nurse and families with children, during both visits to the child health care centre and visits in homes. The empirical material consisted of audio- and videotape recordings of five first visits to families with newborn children, of fortyfour visits of families to nurses at child health care centres, and of interviews with home visit participants. Data was primarily analysed qualitatively.

Most of what the families and the nurses discussed during the encountershad reference to the Swedish child health promotion programme, whetherthe encounters took place at the child health care centre or in participants' homes. This fact steered the interaction to a great extent. The nurses introduced the majority of topics in the conversations, but parents and children also brought up new topics. Advice, based to a great extent on the nurse's expertise, was given during almost every visit at the child health care centre. The nurse seldom encouraged parents to find their own solutions to various problems. Instead she offered standard solutions and answers to their questions. Non-verbal communication was a significant feature in the interaction. Video analysis contributes to a deeper understanding of the nurse's tasks, and also shows that the children were very active in the interaction.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet , 2002. , 82 p.
Series
Linköping Studies in Arts and Science, ISSN 0282-9800 ; 261
Keyword [en]
Child health care, Home visit, Children, Parents, Encounter, Social interaction, Verbal- and nonverbal communication, Advice, Empowerment, Video analysis
Keyword [sv]
Barnhälsovård, Sjuksköterske-patientrelation
National Category
Social Sciences Interdisciplinary
Identifiers
URN: urn:nbn:se:liu:diva-33961Local ID: 20119ISBN: 91-7373-428-4 (print)OAI: oai:DiVA.org:liu-33961DiVA: diva2:254809
Public defence
2002-10-11, Hörsalen, Hus Key, Universitetsområdet Valla, Linköping, 13:15 (Swedish)
Supervisors
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2014-08-29Bibliographically approved
List of papers
1. What they talk about: Conversations between child health centre nurses and parents
Open this publication in new window or tab >>What they talk about: Conversations between child health centre nurses and parents
2001 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 36, no 5, 659-667 p.Article in journal (Refereed) Published
Abstract [en]

Background. The voluntary child health promotion programme reaches virtually all children in Sweden and each child will visit the child health centre about 20 times until it has reached school age. The practical responsibility for the tasks at the child health centre resides mainly with the nurse. The nurse’s talk is the main instrument used to carry out health examinations, detect health problems and developmental deviations, pass on information and give individual advice and support to families.

Aim. The aim of the study is to explore the content of the conversations and analyse its relationship to both the child health promotion programme and the question of which party decides what is talked about in these encounters.

Methods. The empirical study, approved by the Committee for Ethics in Medical Investigation, was conducted at three child health centres in medium-sized towns in Sweden. Data collection consisted of audiotapes of 44 visits to these child health centres. The tape-recorded conversations were transcribed verbatim and constitute the material. The analysis was content-orientated and was performed in four steps: coding and generating topics, categorization of topics, identifying the initiator and searching for regularities.

Results/Conclusion. The results showed that the most common issues discussed concerned the child’s development (mainly physical aspects), situational matters and questions about procedures and routines. The nurses initiated most of the topics discussed and her dominance was established with the help of the official child health promotion programme. The findings evoke ideas about what possibilities the parents have of making their voices heard during the conversations. The conclusion is that the findings indicate a need for further research on nurse-parent/child communication during visits to the child health centre to acquire knowledge about the interactional consequences in the conversation when some topics are discussed but others are not.

Keyword
child health care, parents, children, nurse, encounter, interaction
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-21217 (URN)10.1046/j.1365-2648.2001.02023.x (DOI)
Available from: 2009-09-30 Created: 2009-09-30 Last updated: 2012-06-27Bibliographically approved
2. Nurses' Work with Empowerment during Encounters with Families in Health Care
Open this publication in new window or tab >>Nurses' Work with Empowerment during Encounters with Families in Health Care
2002 (English)In: Critical Public Health, ISSN 0958-1596, E-ISSN 1469-3682, Vol. 12, no 4, 351-363 p.Article in journal (Refereed) Published
Abstract [en]

One goal of Swedish child healthcare work is to empower parents, and thereby reinforce them in their parental roles. It may, however, be difficult to put this ideology into practice because the concept of empowerment is abstract, and because it is unclear what this concept means in practice. The overall aim of this article is to examine critically and discuss empowerment in nurses' work, in their everyday encounters with families in child healthcare. An empirical study was conducted at three child health centres in medium-sized towns in Sweden. Data collection consisted of audiotapes of 44 visits by families to nurses at these centres. The tape-recorded conversations were transcribed verbatim and have been used as data. Data were analysed qualitatively by examining the advice-giving sequences, to see the extent to which the nurse tried to involve and encourage parents to participate actively in problem solving, and how frequently the nurse enquired about the parents' opinions and ideas. It was revealed that the nurses dominated advice giving in these visits to the extent that they took the initiative in the majority of the advisory sequences that occurred, and that they decided both when advice should be given and the nature of the advice. Furthermore, there were remarkably few examples that could be called empowering or have an empowering function in the advice giving. The nurse instead gave standard solutions and answers in response to various questions from the parents, reinforcing her own role as an expert.

National Category
Social Sciences Interdisciplinary
Identifiers
urn:nbn:se:liu:diva-32812 (URN)10.1080/0958159021000029559 (DOI)18746 (Local ID)18746 (Archive number)18746 (OAI)
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2012-06-27Bibliographically approved
3. The institution enters the family home: Home visits in Sweden to new parents by the child health care nurse
Open this publication in new window or tab >>The institution enters the family home: Home visits in Sweden to new parents by the child health care nurse
2004 (English)In: Journal of Community Health Nursing, ISSN 0737-0016, E-ISSN 1532-7655, Vol. 21, no 1, 15-27 p.Article in journal (Refereed) Published
Abstract [en]

The purpose of this study is to investigate interactional patterns in the dialogue that occurs during home visits of the nurse to new parents, to find out whether there are similarities between home visits and visits to the child health care centers, and to discuss this in relation to what is emphasized as important in home visits. Audiotaped conversations of encounters during 5 home visits to new parents and interviews with parents and nurses were collected and analyzed qualitatively. Results show that the interactions were orchestrated by the nurse, and operated on an agenda that was task-oriented. The interaction was dominated by the nurse, and thus was asymmetrical. It seemed that the nurse was attentive to what the parents brought up in the discussions and responded to their worries very thoroughly, in accordance with the ideology. However, sometimes the parents were not even involved in the nurse's activities.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-23756 (URN)10.1207/s15327655jchn2101_2 (DOI)3268 (Local ID)3268 (Archive number)3268 (OAI)
Note

The original title of this article was: The institution enters the family home : Home visits to new parents by the child health care nurse.

Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2014-09-12Bibliographically approved
4. Joint working relationships: Children, parents and child healthcare nurses at work.
Open this publication in new window or tab >>Joint working relationships: Children, parents and child healthcare nurses at work.
2004 (English)In: Communication & Medicine, ISSN 1612-1783, Vol. 1, no 1, 71-83 p.Article in journal (Other (popular science, discussion, etc.)) Published
Abstract [en]

In child healthcare children's development is examined and assessed. The main aim of this article is to explore the different ways in which a child health nurse establishes joint working relationships with children and parents. Few studies in child healthcare include nonverbal interaction. It was found that a child often responds to the actions of the nurse and the parent by physical and bodily actions and by the direction of his/her gaze. The nurse has to be able to shift between several different interactional modes using various nonverbal communicative means. She uses her body to shift positions together with shifts in gaze in order to establish an interactional focus and a relationship with the child. The nurse also uses different artifacts in the room as well as the child's spontaneous activities during the assessment of the child's development. In addition, she uses the parents' relationships with their children in order to gain their support and to encourage their children in performing tasks. An important methodological consequence of this study is that it is necessary to use video-recorded data when interactions of this kind are analyzed.

Keyword
child healthcare, child-parent-nurse interaction, nonverbal interaction, joint working relationships, video analysis
National Category
Social Sciences Interdisciplinary
Identifiers
urn:nbn:se:liu:diva-22845 (URN)10.1515/come.2004.007 (DOI)16808690 (PubMedID)2185 (Local ID)2185 (Archive number)2185 (OAI)
Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2013-09-04Bibliographically approved

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