Uncovering psychosocial needs: Perspectives of Australian child and family health nurses in a sustained home visiting trial
Katina Kardamanidis
NSW Department of Health, North Sydney NSW
Lynn Kemp
Associate Professor and Director, Centre for Health Equity Training Research and Evaluation (CHETRE), Liverpool Hospital; University of New South Wales, Sydney NSW
Virginia Schmied
School of Nursing and Midwifery, University of Western Sydney, Sydney NSW
PP: 50 - 58
Abstract
The first Australian trial of sustained nurse home visiting provided an opportunity to explore nurses' understanding of the situations that support mothers of infants to disclose personal and sensitive psychosocial information.
Using a qualitative descriptive design, semi-structured interviews were conducted and transcripts were analysed drawing upon aspects of Smith's interpretative phenomenological analysis. Five themes pertaining to the experience of relationship building to foster disclosure of sensitive information emerged:
- Building trust is an ongoing process of giving and giving in return
- Being 'actively passive' to develop trust
- The client is in control of the trust-relationship
- The association between disclosure of sensitive issues and a trust-relationship, and
- Empowerment over disclosure.
This study provides a deeper understanding of how child and family health nurses develop relationships that lead women to entrust the nurse with personal, sensitive information, and may inform the practice of psychosocial needs assessment in other contexts.
Keywords
home visits, empowerment, psychosocial risk assessment, nurse-patient relationship, child and family health nurse, interviews, phenomenology
References
Australian Minister for Health and Ageing (2008) Media release: Helping close the gap through innovative home visit program. Retrieved 5 November 2008 from http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr08-nr-nr015.htm.
Briggs C (2006) Nursing practice in community child health: Developing the nurse-client relationship. Contemporary Nurse 23(2): 303-311.
Chalmers KI (1992) Giving and receiving: An empirically derived theory on health visiting practice. Journal of Advanced Nursing 17(11): 1317-1325.
Cowley S and Houston AM (2003) A structured health needs assessment tool: Acceptability and effectiveness for health visiting. Journal of Advanced Nursing 43(1): 82-92.
Cowley S, Mitcheson J and Houston AM (2004) Structuring health needs assessments: The medicalisation of health visiting. Sociology of Health & Illness 26(5): 503-526.
Davis H, Day C and Bidmead C (2002) Working in partnership with parents: The parent adviser model. London: Harcourt Assessment.
Government of South Australia Children Youth and Women's Health Service (2005) Family home visiting service outline. Retrieved 5 November 2008 from http://www.cyh.com/library/CYWHS_FHV_Service_Outline.pdf.
Gunn J, Hegarty K, Nagle C, Forster D, Brown S and Lumley J (2006) Putting woman- centered care into practice: A new (ANEW) approach to psychosocial risk assessment during pregnancy. Birth-Issues in Perinatal Care 33(1): 46-55.
Hegarty K, Brown S, Gunn J, Forster D, Nagle C, Grant B et al (2007) Women's views and outcomes of an educational intervention designed to enhance psychosocial support for women during pregnancy. Birth-Issues in Perinatal Care 34(2): 155-163.
Houston AM and Cowley S (2002) An empowerment approach to needs assessment in health visiting practice. Journal of Clinical Nursing 11(5): 640-650.
Jack SM, DiCenso A and Lohfeld L (2005) A theory of maternal engagement with public health nurses and family visitors. Journal of Advanced Nursing 49(2): 182-190.
Jansson A, Petersson K and Uden G (2001) Nurses' fi rst encounters with parents of newborn children: Public health nurses' views of a good meeting. Journal of Clinical Nursing 10(1): 140-151.
Keatinge D, Fowler C and Briggs C (2007) Evaluating the family partnership model (FPM) program and implementation in practice in New South Wales, Australia. Australian Journal of Advanced Nursing 25(2): 28-35.
Kemp L, Eisbacher L, McIntyre L, O'Sullivan K, Taylor J, Clark T et al (2006) Working in partnership in the antenatal period: What do child and family health nurses do? Contemporary Nurse 23(2): 312-320.
Kemp L, Harris E, McMahon C, Matthey S, Vimpani G, Anderson T et al (2008) Miller early childhood sustained home-visiting (MECSH) trial: Design, method and sample description. BMC Public Health 8: 424.
McNaughton DB (2000) A synthesis of qualitative home visiting research. Public Health Nursing 17(6): 405-414.
McNaughton DB (2005) A naturalistic test of Peplau's theory in home visiting. Public Health Nursing 22(5): 429-438.
Meadows LM and Morse JM (2001) Constructing evidence within the qualitative project. In Morse JM, Swanson JM and Kuzel AJ (Eds) The nature of qualitative evidence, pp.187-200. Thousand Oaks CA: Sage.
Mitcheson J and Cowley S (2003) Empowerment or control? An analysis of the extent to which client participation is enabled during health visitor/ client interactions using a structured health needs assessment tool. International Journal of Nursing Studies 40(4): 413-426.
Olds DL and Kitzman H (1990) Can home visitation improve the health of women and children at environmental risk? Pediatrics 86(1): 108-116.
Paavilainen E and Astedt-Kurki P (1997) The client-nurse relationship as experienced by public health nurses: Toward better collaboration. Public Health Nursing 14(3): 137-142.
Sandelowski M (2000) Whatever happened to qualitative description? Research in Nursing & Health 23(4): 334-340.
Smith JA (1995) Semi-structured interviewing and qualitative analysis. In Smith JA, Harre R and van Langenhove L (Eds) Rethinking methods in psychology, pp.9-26. London: Sage.
Smith JA (1996) Beyond the divide between cognition and discourse: Using interpretative phenomenological analysis in health psychology. Psychology & Health 11(2): 261-271.
Smith JA, Jarman M and Osborn M (1999) Doing interpretative phenomenological analysis. In Murray M and Chamberlain K (Eds) Qualitative health psychology: Theories and methods, pp.218-240. London: Sage.
Smith JA and Osborn M (2003) Interpretative phenomenological analysis. In Smith JA (Ed) Qualitative psychology: A practical guide to research methods, pp.51-80. London: Sage.
Zerwekh JV (1991) A family caregiving model for public health nursing. Nursing Outlook 39(5): 213-217.

eContent Home




