Visual methods in health dialogue and public health work. An action research approach to improve school nurses’ work with adolescents

Abstract

School nursing involves relationships and understandings based on young people’s needs. Visual technologies have become a central part of young people’s life and context: they use their phones to communicate and shape their relationships and they turn to social media when inquiring about health issues. Visual methods in health communication thus draw on existing practices, and are well documented as research methods to elicit experiences of illness, health behaviour, emotions and other unarticulated and fuzzy aspects of life. Our aim was to explore whether visual methods could improve the health dialogue and work of public health nurses (PHNs) in schools. We were particularly interested in examining how PHNs could relate to adolescents in terms of the challenges of using visual technologies and social media in a school nursing context. We used a qualitative action research approach with a critical design involving focus groups in combination with participant observations and workshops on the use of visual methods. Forty of approximately sixty PHNs in Tromsø participated in the study. We collected the data from January to October 2016. Systematic text condensation was used for analysis of the texts and field notes, and visual meaning making for analysis of drawings made by the PHNs. We found that visual methods could improve the school health dialogue and school nurses’ public health work because visualization draws on a preferred form of communication for young people. PHNs’ ethical practice included being aware of new ethical issues that arose from adolescents’ use of visual technologies and social media. When uncertainty or indecision remained, the PHNs resolved ethical challenges through discussion and collaboration with fellow nurses and other professionals. The provision of training in visual methods would enhance PHNs’ professional toolbox and improve their efforts to promote adolescent health in a school nursing context.