Support of mothers and their infants by the child health nurse : expectations and experiences
Sammanfattning: The general aim of this thesis was to describe and analyse the CH nurse's support of mothers and their infants, given in order to form a good relationship md lead to favourable development of the child. In studies I, II and III, grounded theory and constant comparative method were used. The aim of study I was to identify how child health nurses view the mother-infant relationship, and how they can improve this relationship. The nurses (n=10) could, through observation of the interplay between mother and infant, view the relationship between the two of them. Such interplay depends on the mother's ability to interpret the infant's signals and the clarity of these signals. These attributes are influenced by mother and infant body language, vocal language, health status, expectations and life situation, which are also influenced mutually. The nurse could improve this relationship through promoting an understanding of the interplay between mother and infant.The aims of study II were to identify what the child health nurse believed was expected of her by women who had recently become mothers, primipara and multipara; and to investigate which problems the nurse found it most difficult to deal with and to analyse why they were difficult. The nurses (n=15) believed that mothers expected care of the infant and the family from the nurse, comprising support, advice, and child health assessments. The nurses found it most difficult to deal with obstacles to interaction with mothers, such as motherhood problems, hidden, social, and organisational problems.The aims of study III were to identify what first-time mothers expected of the child health nurse; and to investigate the help and support that new mothers receive from nurses, and whether first-time mothers felt that anything was lacking. The mothers (n=20) expected the nurse to be a supporter, characterized by accessibility, approachability, knowledge, advice and support. They had experienced most of these things, accessibility and approachability in particular. However, the nurses showed a lack of continuity in interest in the mothers' bodies and health. In addition, mothers who wished to discontinue breast-feeding felt that they lacked support from the nurse.The aim of study IV was to investigate mothers' experiences of their encounters with the child health nurse. A national random sample of mothers (n=140) reported, based on critical incident technique, support or lack of support from the nurse. Thematic content analysis, including 125 reports and demographic data, was accomplished. Symbolic interactionism was used as a frame of reference. The central factor was that they were able to share the realm of motherhood that the nurse is willing to share all kinds of emotions and experiences related to being a mother. The majority of the mothers had received valuable support during troublesome incidents. Nevertheless, there were several dissatisfied mothers who had expected support but thought that they had received insulting treatment instead.The aims of study V were to describe similarities and differences in expectations of the child health nurse, as they were expressed by recently delivered first-time mothers as compared to an expression of what child health nurses believed mothers of infants expected of them. Data from the intetviews with nurses in study II and mothers in study III (n=35) were analysed by thematic content analysis. The nurse could be someone to approach, who, through her knowledge, could assess the child's development and give immunizations and be a supporter, counsellor, safety provider and a parent group organizer. Similarities between mothers' and nurses' statements occurred more frequently than differences, which are suggested to depend on the Swedish tradition among new mothers of visiting the child health clinic. The mothers expected participation in parent groups to a higher degree than the nurses believed that they did.
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