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Title: From reassurance to parental self-efficacy : lay and professional perceptions of the purpose and value of health visitor-led child health clinics : a grounded theory study
Author: Webb, Joanne
ISNI:       0000 0004 7431 7668
Awarding Body: University of the West of England
Current Institution: University of the West of England, Bristol
Date of Award: 2018
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Despite the widespread presence of Health Visitor led baby clinics across the UK for over a century, there is little published research about this model of support, its purpose or effectiveness. No national guidance exists about how or indeed, if, baby clinics should be conducted; local services are therefore left to consult their own professional instincts and experience for guidance on the delivery of this long-standing service offer. This research follows a systematic review of the effectiveness of universal Health Visitor led Child Health Clinics, which suggested that professional reflection and research into the focus, structure and function of clinic models and the theoretical process of community-based family support within the health visiting service is now needed in order to progress this element of universal service provision to an evidence base. The aim of this research was to take a preliminary look at both lay and professional perspectives of the purpose and value of baby clinics, in order to illuminate the experiences of mothers and professionals attending clinics and the process of support that they may be engaged in. Informal semi structured interviews were conducted with 24 participants; 9 Health Visitors, 3 Community Nursery Nurses, 8 Mothers, 2 Infant Feeding Specialists, A senior lecturer delivering a Public Health Nursing Course and an NCT Postnatal leader and Tutor. A constructivist Grounded theory methodology was used to analyse the data. A substantive theory was constructed from the analysis which suggests that the experience of support at baby clinics can be conceptualised in two constructed social psychological processes, which represent two disparate models of clinic provision: A surveillance model, focussing on weighing and monitoring which appears to engender a cycle of ‘serial reassurance’ and a primary prevention model focussing on reflection and compassion, facilitating the promotion of parental self-efficacy. The two iterative, cyclical support processes, each have four conceptual categories which were developed from the narratives: The first reflecting a didactic approach, where weighing, monitoring and advising form the basis of the interaction between health visitor and mother. The second reflecting an heuristic approach where the exchange of support between mothers and between health visitors and mothers is relational, experiential and socially orientated. The grounded theory outlined in this study provides conceptual insight into the social process of providing support for mothers and infants at health visitor led baby clinics. Implications for practice are considered and it is suggested that organisations providing health visiting services who seek to align their model of clinic provision with a primary prevention agenda should consider restructuring clinics to deliver a psychologically informed heuristic model which encourages social interaction between parents. Such a model should focus on facilitating self-compassion, resilience and self-efficacy within parents as they make the psycho-social adjustment into their new or renewed parenting role and should encourage a sensitive and responsive approach to parenting.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Health Psych.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: Baby Clinics ; Child Health Clinics ; Health Visiting ; Health Visitors ; Public Health Nursing