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Let’s Talk About Stress: Community Child Health Nurses Experiences of Stress in Whānau Engagements

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Thesis(1.75 MB)

Date

2025

Authors

Hodren, Anne

Supervisor

Nicholson, Ellen
Blamires, Julie

Item type

Thesis

Degree name

Doctor of Health Science

Journal Title

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Volume Title

Publisher

Auckland University of Technology

Abstract

Background While stress is considered a normal part of daily life community child health nurses are often experiencing multiple complex stressors as part of their care of whānau. While community child health nursing is undoubtedly valued and highly skilled work, the very nature of this work inevitably exposes community child health nurses to multiple psychologically demanding challenges and stressors that could significantly impact on the nurse’s wellbeing, and their capacity to engage with, and be attuned to, whānau. While there is some evidence that explores and describes the impact of stress in general and in nursing, little is known about how community child health nurses in Aotearoa New Zealand experience stress when engaging with whānau and how this affects their capacity to be attuned to the whānau they are supporting. Objective This study aimed to explore community child health nurses’ experiences of, and perspectives on, self-regulation and attunement in times of stress when working with whānau. Two research questions were posed; firstly, how do Aotearoa New Zealand Community Child Health nurses describe the relationship between stress and the capacity to self-regulate their stress response when engaging with whānau? and secondly, how do Aotearoa New Zealand Community Child Health nurses describe the influence of stress on attunement, the capacity to build trust, and their ability to reflect on whānau relationships? Using interpretive descriptive methodology, this qualitative study was undertaken in two phases, with phase one being a vignette-based survey with 26 community child health nurse participants, and phase two being a semi-structured interview with 10 community child health nurse participants. Findings Unique to this study was the rich description of the experience and impact of stress by Aotearoa New Zealand community child health nurse participants when engaging with whānau; a relatively unexplored area of nursing practice in the literature, especially as the study focused solely on exploring the impact of stress within engagement with whānau and describing what the experience is genuinely like for the nurses. The findings provide a unique picture of the complexity the nurse participants faced in navigating whānau relationships, while simultaneously being in a state of stress, which, at times, made it difficult for the nurses to recognise their own stress, and hindered their capacity to make sound decisions, while also remaining attuned and professional. The findings revealed the individual nurse’s experience of stress to be unique, complex, and unpredictable, and shaped by context, as the nurse participants strived to establish and maintain therapeutic relationships with whānau, while managing their own stress responses. The resulting impact on nurses and whānau relationships requires urgent attention to reduce the negative impact of stress on community child health nurses, and improve knowledge, resourcing, and supports to ensure safe and quality care. Conclusions The significance of the study findings lies in the ‘laying bare’ of the nurse participants’ experiences of the pervasive nature of stress, and its profound impact on both the nurses themselves, and their care of whānau. Attention needs to be drawn urgently to the consequences of stress on community child health nurses, so that the quality and continuity of care in community child health nursing is not compromised. The normalisation and acceptance of stress within the nursing profession has served to further entrench stress as an inevitable part of nursing practice, thereby limiting opportunities for personal, professional and systemic change. As a key outcome of the study, a multipronged approach is proposed that buffers and ameliorates the negative impacts of stress, lifting the sole responsibility for managing stress off the shoulders of nurses and redistributing it across employers, government, education, and other institutions within the Aotearoa New Zealand context. When managing stress is everyone’s responsibility, there is a greater chance of change.

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http://hdl.handle.net/10292/20186

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Doctoral Theses