Clients' perceptions of health visiting in the context of their identified health needs : An examination of process

Abstract

This study aimed to explore the process by which members of a client group identify and interpret their health needs, and develop perceptions of health visiting services. The study was carried out in two Phases. The first Phase used semistructured interviews and diaries to explore 41 parents' perceptions at one point in time. In Phase Two a series of three semistructured interviews were completed over a ten month period with 19 primiparous parents, commencing antenatally, and with 10 of their health visitors. Analysis was by the grounded theory method. Eight concept areas emerged from the interview data. These were: Health, health problems and other concerns The need for help - locating the problem Knowledge and experience Legitimation Advice, support and comparing notes Choosing a helper Relationship or problem centred Power and control A substantive theory is put forward which suggests that the nature of previous knowledge and the types of problems encountered influence the choice of helper and the degree of parental control desired at each stage. At stage one health is predominantly defined as socio-emotional, in line with social norms. At stage two, practical difficulties, especially with feeding, become important. At stage three, as other aspects assume less importance, the social norm appears to reassert itself. At stage one, independence is valued, but at stage two, parents assume a more dependent role. At stage three, parents feel more confidence in themselves. 'Comparing notes' offers a reciprocal helping relationship. The value attributed to the health visitor's involvement at each stage appears to reflect how far her views diverge from' those of the parent concerned. The recommendations identify changes of practice which will firstly improve communication between health visitors and clients, and secondly focus on the development by health visitors of appropriate knowledge and skills to meet the demands made by clients.

Date of Award	1 Jun 1988
Original language	English
Awarding Institution	Northumbria University
Supervisor	Jean Orr (Supervisor), Michael Clinton (Supervisor) & Robert Heyman (Supervisor)