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Hälsosamtal som metod att främja barns och ungdomars hälsa: en utmanande uppgift
Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. (CHILD)
2012 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to explore and describe health dialogues from pupils’ and nurses’ perspectives as well as the verbal interaction between them, in the context of a structured health and lifestyle tool.

Seventy-four pupils and 23 school nurses participated in focus group interviews, and further 14 nurses participated in individual interviews. To explore the verbal interaction, 24 health dialogues with pupils and school nurses were recorded using a video camera. The data from the interviews were subjected to qualitative content analysis and the verbal interactions were analysed using the paediatric version of the Roter Interaction Analysis System.

Health dialogues based on the pupil’s own situation were described as a process that provided them opportunities to influence their own health. Prerequisites for a pupil-centered health dialogue were that the pupils were prepared, felt respected and like active participants, and that their own experiences were in focus. How the nurses acted was crucial to the pupils’ experience of and possibility to benefit from of the health dialogue based on their own needs and wishes. A health and lifestyle tool could support the dialogue by constituting a structure, open up for discussion and contribute to an understanding of the individual’s situation. The tool could also facilitate the transmittal of health information on an individual as well as a group level. In terms of utterances in the dialogues, the school nurses were the ones who talked the most. The pupils most frequently gave information about their lifestyle and agreed with the nurses. The nurses asked questions and provided information about lifestyle, and checked that they had understood the pupils. Just over a third of the nurses’ verbal interaction approaches were aimed to make the pupil more active and participatory in the dialogues.

In conclusion, the health dialogues were described as an opportunity to gain knowledge about and insight into health and lifestyle, but a pupil-centered dialogue was considered crucial. The challenge is to adapt the health dialogue based on each pupil’s needs and wishes, and a health and lifestyle tool could contribute structure and support the dialogue.

 

Place, publisher, year, edition, pages
School of Health Sciences, Jönköping University , 2012. , 92 p.
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 26
Keyword [sv]
barnhälsovård, barn och ungdomar, elevcentrerade hälsosamtal, hälsofrämjande arbete, hälsosamtal, hälsoverktyg, sjuksköterska, skolhälsovård
National Category
Nursing
Identifiers
URN: urn:nbn:se:hj:diva-17654ISBN: 978-91-85835-25-6 (print)OAI: oai:DiVA.org:hj-17654DiVA: diva2:503596
Public defence
2012-03-09, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2012-02-17 Created: 2012-02-16 Last updated: 2012-11-26Bibliographically approved
List of papers
1. Health counselling: parental-oriented health dialogue - an innovation for child health nurses
Open this publication in new window or tab >>Health counselling: parental-oriented health dialogue - an innovation for child health nurses
2009 (English)In: Journal of Child Health Care, ISSN 1367-4935, E-ISSN 1741-2889, Vol. 13, no 1, 75-88 p.Article in journal (Refereed) Published
Abstract [en]

The Health Curve, used by nurses in community-based health care, is an educational tool for conducting goal-directed dialogues concerning lifestyle and health. The aim of this study was to investigate how child health nurses experienced the Health Curve as a tool for conducting dialogues with parents. Fourteen nurses were interviewed. The data were analysed according to qualitative analysis. The results showed that nurses working in child health care experienced the Health Curve as a useful tool for conducting health dialogues with parents. Through their work with the Health Curve, the nurses gained a greater insight into, and understanding of, the families' health and life situation. The results indicated that working with the Health Curve could increase the opportunity for nurses to provide parents with support early in the process, helping the family to lead a healthy lifestyle.

National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-13883 (URN)10.1177/1367493508098382 (DOI)19240192 (PubMedID)
Available from: 2010-12-07 Created: 2010-12-07 Last updated: 2017-12-11Bibliographically approved
2. Pupils' perspectives on preventive health dialogues
Open this publication in new window or tab >>Pupils' perspectives on preventive health dialogues
2010 (English)In: British Journal of School Nursing, ISSN 1752-2803, E-ISSN 2052-2827, Vol. 5, no 1, 26-33 p.Article in journal (Refereed) Published
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-13138 (URN)10.12968/bjsn.2010.5.1.46596 (DOI)
Available from: 2010-09-15 Created: 2010-09-15 Last updated: 2017-12-12Bibliographically approved
3. Adolescents' and school nurses' perceptions of using a health and lifestyle tool in health dialogues
Open this publication in new window or tab >>Adolescents' and school nurses' perceptions of using a health and lifestyle tool in health dialogues
2011 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 20, no 17-18, 2573-2583 p.Article in journal (Refereed) Published
Abstract [en]

Aim and objective. To describe and explore adolescents’ and nurses’ perceptions of using a health and lifestyle tool in healthdialogues in the School Health Service.

Background. In Sweden, dialogues concerning health and lifestyle are offered to adolescents aged 14 years with the purpose of encouraging an interest in a healthy lifestyle. A health and lifestyle tool including a health questionnaire and a health profile has recently been developed, with the aim of facilitating the communication about health and lifestyle in these dialogues.

Design.Qualitative descriptive design.

Method. Twenty-nine adolescents and 23 nurses participated in focus group interviews, which were subjected to qualitative content analysis.

Results. The health and lifestyle tool was perceived as constituting a structure for the dialogues and as a clear and applicable starting point, focusing on individual aspects. The tool contributed to an understanding of the health situation and to the transmittal of health information on an individual as well as a group level.

Conclusion.The tool was perceived as constituting a useful structure for the dialogues about health and lifestyle. When it was used the individual’s health and lifestyle were concretised, which opened up for a dialogue and different aspects of health and lifestyle were detected. However, in some cases the outcome of the tool could be conceived as a stringent assessment and thereby complicate the dialogues.

Relevance to clinical practice.The use of a tool, such as the one used in this study, is one way to improve the dialogues in the School Health Service, allowing them to be more focused on the individual’s needs and to detect aspects that would otherwise not be so easily detected. The implications of this study include using the findings to guide counselling sessions in the schools and other health care settings.

Keyword
adolescent, health dialogues, health and lifestyle tool, nurses, nursing, School Health Service
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-15941 (URN)10.1111/j.1365-2702.2011.03816.x (DOI)
Available from: 2011-08-31 Created: 2011-08-31 Last updated: 2017-12-08Bibliographically approved
4. Health dialogues between pupils and school nurses: a description of the verbal interaction
Open this publication in new window or tab >>Health dialogues between pupils and school nurses: a description of the verbal interaction
2012 (English)In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 89, no 2, 260-266 p.Article in journal (Refereed) Published
Abstract [en]

Objective:The purpose of this study was to explore and describe the content and the verbal interaction in health dialogues between pupils and school nurses.

Method: Twenty-four health dialogues were recorded using a video camera and the conversations were analysed using the paediatric version of the Roter Interaction analysis system.

Results:The results showed that the age appropriate topics suggested by national recommendations were brought up in most of the health dialogues. The nurses were the ones who talked most, in terms of utterances. The pupils most frequently gave information about their lifestyle and agreed with the nurses’ statements. The nurses summarized and checked that they had understood the pupils, asked closed-ended questions about lifestyle and gave information about lifestyle. Strategies aimed to make the pupil more active and participatory in the dialogues were the most widely used verbal interaction approaches by the nurses.

Conclusion:The nurses’ use of verbal interaction approaches to promote pupils’ activity and participation, trying to build a partnership in the dialogue, could indicate an attempt to build patient-centred health dialogues. 

Clinical implications: The nurses’ great use of questions and being the ones leading the dialogues in terms of utterances point at the necessity for a nurses to have an openness to the pupils own narratives and an attentiveness to what he or she wants to talk about.

National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-17653 (URN)10.1016/j.pec.2012.07.012 (DOI)
Available from: 2012-02-16 Created: 2012-02-16 Last updated: 2017-12-07Bibliographically approved

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