Hälsovägledning i barnhälsovården: syntetisering av två uppdrag

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Hälsovägledning i barnhälsovården: syntetisering av två uppdrag

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Publication Doctoral Thesis
Title Hälsovägledning i barnhälsovården: syntetisering av två uppdrag
Author(s) Olander, Ewy
Date 2003
English abstract
Child Health Services (CHS) form a strategic arena for Swedish health promotion, from a societal as well as individual perspective. The present study focuses on district nurses health counselling in CHS. The aim is to improve understanding of what is important in shaping and accomplishing health promotion, and to generate theory useful in a CHS context. Data were collected at CHS in primary health care. Data sources consist of video-observations with recalled interviews of seven district nurses? meetings with parents and children during open consultations, field notes, notes from group discussions and individual interviews. Data from findings in my earlier study of health counselling in CHS were also used. Data analysis followed the classic Grounded Theory (GT) method. In accordance with GT, concepts and categories were integral parts of a constant comparative analysis. Empirical data indicated that health promotion in CHS has two approaches, a population approach and an individual approach. District nurses thus have two missions: a public health mission (a government demand based on families as parts of the population), and a family health mission (a request from individual families). District nurses' main concern in CHS is to synthesise these two opposing missions and approaches in their practical work at the CHC (Child Health Centres). The category Population-individualisation evolved as the core category. Subcategories are Two-facedness, Individualisation efforts, Normality focus, Case record concern, Communication staging and Action scope promoting. Four dynamic fields between public and family health missions evolved. One is the Population-individualisation field in which general concerns for public health are combined with considering the needs of the specific family. The other fields were labelled Individual support, Population inspection and Routine check-up. Four patterns for synthesis evolved. One is a Hypothetical ideal proceeding. This is a synthesis where both approaches are equally strong. Three patterns with oscillatory movements were evident in praxis: a Sig-sagging pattern with small oscillating movements, a Pendulating pattern with longer movements and a Compensating pattern with different movements compensating each other. Through the generating analysis a substantive theory could be formulated. The generated theory grounded in empirical data within the context of CHS provides us with knowledge that can help district nurses understand and manage their main concern for synthesising these two missions. This theory may also contribute to increased awareness among administrators, decision makers and nurse- and health promotion educators with regard to the double mission in health promotion and the strategies for coping with it. In this way, generated theory should be able to contribute to improve health promotion and health counselling in CHS.
Swedish abstract
Denna studie fokuserar på distriktssköterskors hälsovägledning i barnhälsovården. Syftet med studien är att öka förståelsen för hur hälsovägledning utformas och genomförs, samt att generera teori, användbar för praktisk barnhälso-vårdsverksamhet. Data samlades in genom videoobservationer med efterföljande intervjuer, fältanteckningar, anteckningar från gruppdiskussioner och enskilda intervjuer samt genom data från tidigare studier av hälsovägledning i barnhälsovården. Analysen följde den klassiska Grounded Theory metoden för teorigenerering. Studien visar att barnhälsovårdens distriktssköterskor är mycket angelägna om att syntetisera verksamhetens folkhälsouppdrag och familjehälsouppdrag med dess motstående inriktningar, dvs. befolkningsinriktning och individinriktning. Det sammansatta begreppet befolkningsindividualisering är ett teoretiskt begrepp för denna syntetisering. I möten med barn och föräldrar hanterar barnhälsovårdens distriktssköterskor dubbelsidigheten genom oscillerande mönster för att bibehålla en syntetisering. Teorin som genererades kan vara användbar både i den praktiska verksamheten och i utbildningar för att öka förståelsen för hur det komplexa hälsoarbetet i barnhälsovården kan hanteras och syntetiseras. Genom att den belyser hantering av motstående uppdrag, kan den troligen också vara användbar inom andra verksamheter med dubbelsidighet i uppdraget.
Buy print http://webshop.holmbergs.com/...7940 (print-on-demand service)
Publisher Lärarutbildningen, Malmö högskola
Series/Issue Malmö Studies in Educational Sciences;8
ISSN 1651-4513
ISBN 91-85042-05-6
Pages 162
Language swe (iso)
Subject(s) Child Health Promotion
Synthesising
Population-individualisation
Grounded Theory
Health Education
Health Counselling
Child Health Services
Humanities/Social Sciences
Research Subject Categories::SOCIAL SCIENCES::Social sciences::Pedgogical work
Research Subject Categories::MEDICINE::Social medicine::Public health medicine research areas::Family medicine
Handle http://hdl.handle.net/2043/7940 (link to this page)

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