Donetto Sara, Maben Jill
National Nursing Research Unit, King's College London, London, UK.
Health Expect. 2015 Dec;18(6):2559-69. doi: 10.1111/hex.12226. Epub 2014 Jun 30.
In 2011-2012, we carried out a programme of research to inform the Department of Health's strategy for strengthening health visiting services in England. Our research included a study of parents' views of their experiences with health visiting services in two geographical areas in England. Here, we draw upon data from this work to illustrate valuable aspects of family support outside the home reported in parents' accounts of their experiences of health visiting. We also explore the usefulness of relational autonomy as a theoretical lens for understanding the mechanisms through which this support operates.
We draw upon data from semi-structured interviews with 44 parents across two 'Early Implementer Sites' of the 'new service vision' in England. Our thematic analysis of the data was informed by grounded theory principles.
Parents valued being able to attend child health clinics and group activities outside the home; this helped them to avoid social isolation and to identify, choose and use the forms of advice and support that best suited them. We suggest that health visiting outside the home and children's centres services may also foster parental autonomy, especially when this is understood in relational terms.
Health visiting outside the home and children's centres services are an important complement to health visiting in the home; both dimensions of family support should be available in the community. Relational readings of autonomy can help illuminate the ways in which these services can foster (or undermine) parents' autonomy.
2011年至2012年期间,我们开展了一项研究项目,为英国卫生部加强健康访视服务的战略提供信息支持。我们的研究包括对英格兰两个地理区域内家长关于健康访视服务体验的看法进行研究。在此,我们借鉴这项工作的数据,以阐述家长在描述其健康访视经历时所报告的家庭外支持的重要方面。我们还探讨了关系自主性作为一种理论视角,对于理解这种支持发挥作用机制的有用性。
我们借鉴了对英格兰“新服务愿景”的两个“早期实施点”的44位家长进行半结构化访谈的数据。我们对数据的主题分析以扎根理论原则为依据。
家长重视能够参加儿童健康诊所及家庭外的团体活动;这有助于他们避免社会孤立,并识别、选择和使用最适合自己的建议和支持形式。我们认为,家庭外的健康访视和儿童中心服务也可能促进家长的自主性,尤其是从关系角度理解时。
家庭外的健康访视和儿童中心服务是家庭内健康访视的重要补充;社区应同时提供这两个层面的家庭支持。自主性的关系性解读有助于阐明这些服务促进(或损害)家长自主性的方式。