Enabling choice, public health nurses' perceptions of their work with children and their families: a thesis presented in partial fulfilment of the requirements for the degree of Masters of Arts in Nursing at Massey University

Abstract

The purpose of this study was to provide understanding of the personal practice of public health nurses with their clients, in particular with children within the context of their family. A grounded theory approach was used for the analysis of the data and the generation of a theoretical description and explanation of the way public health nurses perceive their practice world. Data were gathered through in depth interviews with public health nurses and were analysed through the method of constant comparative analysis. Enabling choice as a theoretical framework was formulated to describe and assist others to understand the possibilities that public health nurses aim for in their encounters or relationships with their clients. A number of concepts were identified from the data which contribute to the way public health nurses work to enable choice for their clients. These include the way nurses become accessible to their clients through a process of becoming known and accepted. The way public health nurses frame their practice, assess their clients, and use interaction with their clients within an encounter or a relationship is also described within the framework of enabling choice for clients. Metaphors used by the nurses to describe their practice highlighted contradictions related to the influence of the social context. The consequences of the constraints implicit in the social context of community health nursing practice were discussed as they impacted on the ability of the public health nurses to enable choice for their clients. Public health nursing has not been well documented or understood. The findings of this study go some way towards creating a framework within which to understand and explain aspects of community health nursing practice.