'Sticking to carpets' - assessment and judgement in health visiting practice in an era of risk: a qualitative study

Caroline King

Research output: Contribution to journalArticle

Abstract

Aim and objective

This paper aims to explore health visitors’ accounts of assessment and judgement in health visiting in the context of policy change and an increased focus on risk, which is reshaping practice.
Background

Assessment and judgement underpin the targeting of support in health visiting practice. Existing literature suggests that needs assessment in health visiting is a complex process which draws on different types of knowledge.
Methods

The study, upon which this paper draws, was a qualitative exploration which aimed to explore the impact of policy change on health visiting practice and on families. The accounts of sixteen health visitors, who took part in semi-structured interviews, are reported. The interview data were analysed using thematic and narrative techniques.
Results

Health visitors’ accounts of their observations of families’ homes, relationships and practices, such as their references to ‘dirt’, harmful practices and appropriateness, illustrate ways in which assessment and judgement in health visiting practice are shaped by a discourse of risk and notions of ideal parenting. Health visitors problematise this discourse in relation to the potential stigmatising impacts for families. Although health visitors indicate ambivalence towards the use of assessment tools, the findings indicate that they feel the tools provide them with a safety-net at a time when their practice is being reshaped by a discourse of risk.
Conclusion

This paper identifies that assessment and judgement in contemporary health visiting are shaped by a discourse of risk. A discussion of the role of ‘emotion in use’ and collective emotions provides an appropriate theoretical lens to consider the impact that risk discourse has on health visiting practice and on families.
Relevance to clinical practice

This study highlights the need for assessment and judgement in health visiting practice to be highly reflexive, to support families in an era of risk.
Original languageEnglish
Pages (from-to)1901-1911
Number of pages11
JournalJournal of Clinical Nursing
Volume25
Issue number13-14
Early online date14 Apr 2016
DOIs
Publication statusPublished - Jul 2016

Fingerprint

Community Health Nurses
Health
Needs Assessment
Family Practice
Emotions
Interviews
Parenting
Lenses
Safety

Keywords

  • collective emotion
  • community nursing
  • health visiting
  • health policy
  • needs assessment
  • qualititive methods
  • risk discourse

Cite this

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title = "'Sticking to carpets' - assessment and judgement in health visiting practice in an era of risk: a qualitative study",
abstract = "Aim and objectiveThis paper aims to explore health visitors’ accounts of assessment and judgement in health visiting in the context of policy change and an increased focus on risk, which is reshaping practice.BackgroundAssessment and judgement underpin the targeting of support in health visiting practice. Existing literature suggests that needs assessment in health visiting is a complex process which draws on different types of knowledge.MethodsThe study, upon which this paper draws, was a qualitative exploration which aimed to explore the impact of policy change on health visiting practice and on families. The accounts of sixteen health visitors, who took part in semi-structured interviews, are reported. The interview data were analysed using thematic and narrative techniques.ResultsHealth visitors’ accounts of their observations of families’ homes, relationships and practices, such as their references to ‘dirt’, harmful practices and appropriateness, illustrate ways in which assessment and judgement in health visiting practice are shaped by a discourse of risk and notions of ideal parenting. Health visitors problematise this discourse in relation to the potential stigmatising impacts for families. Although health visitors indicate ambivalence towards the use of assessment tools, the findings indicate that they feel the tools provide them with a safety-net at a time when their practice is being reshaped by a discourse of risk.ConclusionThis paper identifies that assessment and judgement in contemporary health visiting are shaped by a discourse of risk. A discussion of the role of ‘emotion in use’ and collective emotions provides an appropriate theoretical lens to consider the impact that risk discourse has on health visiting practice and on families.Relevance to clinical practiceThis study highlights the need for assessment and judgement in health visiting practice to be highly reflexive, to support families in an era of risk.",
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'Sticking to carpets' - assessment and judgement in health visiting practice in an era of risk : a qualitative study. / King, Caroline.

In: Journal of Clinical Nursing, Vol. 25, No. 13-14, 07.2016, p. 1901-1911.

Research output: Contribution to journalArticle

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KW - community nursing

KW - health visiting

KW - health policy

KW - needs assessment

KW - qualititive methods

KW - risk discourse

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