Appleton Jane V, Cowley Sarah
Centre for Research in Primary and Community Care, University of Hertfordshire, College Lane, Hatfield, Hertfordshire AL10 9AB, UK.
Int J Nurs Stud. 2008 Feb;45(2):232-45. doi: 10.1016/j.ijnurstu.2006.08.014. Epub 2006 Oct 16.
Assessment of family health need is a central feature of health visiting practice in which a range of skills, knowledge and judgements are used. These assessments are pivotal in uncovering need, safeguarding children and in determining levels of health intervention to be offered to children and their families by the health visiting service in the UK.
The central focus of this paper is to outline the critical attributes of the basic principles that underpin health visiting assessment practice that emerged as part of a case study enquiry.
A case study design informed by a constructivist methodology was used to examine health visitors' professional judgements and use of formal guidelines in identifying health needs and prioritising families requiring extra health visiting support.
The main study was conducted in three community Trust case sites in England, UK, with pilot work being undertaken in a fourth site.
Fifteen health visitors participated in the main study and data were collected during 56 observed home visits to families receiving extra health visiting support. Separate in-depth interviews were conducted with the health visitors, pre- and post-home contacts, while 53 client interviews also took place.
RESULTS/CONCLUSIONS: The analysis suggests that there are certain fundamental elements associated with the majority of health visitor assessments and these have been termed assessment principles. These characteristics are integral to, and provide the basis upon which health visitors' assessments are conducted and professional judgement is formed. They reflect the basic principles of health visiting assessment practice, which exist despite the constraints and realities of the practice context and can be differentiated from the activity centred methods of assessment processes.
家庭健康需求评估是健康访视实践的核心内容，在此过程中会运用一系列技能、知识和判断。这些评估对于发现需求、保护儿童以及确定英国健康访视服务向儿童及其家庭提供的健康干预水平至关重要。
本文的核心重点是概述作为案例研究调查一部分而出现的、支撑健康访视评估实践的基本原则的关键属性。
采用建构主义方法论指导的案例研究设计，以考察健康访视员在识别健康需求以及对需要额外健康访视支持的家庭进行优先排序时的专业判断和对正式指南的运用。
主要研究在英国英格兰的三个社区信托案例点进行，在第四个点开展了试点工作。
15名健康访视员参与了主要研究，在对接受额外健康访视支持的家庭进行的56次观察家访期间收集了数据。在家访前后分别与健康访视员进行了深入访谈，同时还进行了53次客户访谈。
结果/结论：分析表明，大多数健康访视员评估存在某些基本要素，这些要素被称为评估原则。这些特征是健康访视员进行评估和形成专业判断不可或缺的，并为其提供了基础。它们反映了健康访视评估实践的基本原则，尽管存在实践背景的限制和现实情况，但这些原则依然存在，并且可以与以活动为中心的评估过程方法区分开来。
