What they talk about: conversations between child health centre nurses and parents

Background. The voluntary child health promotion programme reaches virtually all children in Sweden and each child will visit the child health centre about 20 times until it has reached school age. The practical responsibility for the tasks at the child health centre resides mainly with the nurse. The nurse's talk is the main instrument used to carry out health examinations, detect health problems and developmental deviations, pass on information and give individual advice and support to families. Aim. The aim of the study is to explore the content of the conversations and analyse its relationship to both the child health promotion programme and the question of which party decides what is talked about in these encounters. Methods. The empirical study, approved by the Committee for Ethics in Medical Investigation, was conducted at three child health centres in medium-sized towns in Sweden. Data collection consisted of audiotapes of 44 visits to these child health centres. The tape-recorded conversations were transcribed verbatim and constitute the material. The analysis was content-orientated and was performed in four steps: coding and generating topics, categorization of topics, identifying the initiator and searching for regularities. Results/Conclusion. The results showed that the most common issues discussed concerned the child's development (mainly physical aspects), situational matters and questions about procedures and routines. The nurses initiated most of the topics discussed and her dominance was established with the help of the official child health promotion programme. The findings evoke ideas about what possibilities the parents have of making their voices heard during the conversations. The conclusion is that the findings indicate a need for further research on nurse-parent/child communication during visits to the child health centre to acquire knowledge about the interactional consequences in the conversation when some topics are discussed but others are not.