Two sides of the same well-child visit: Analysis of nurses’ and families’ perspectives on empowerment in health counselling

Aims: To explore the degree of empowering health counselling in well-child visits, considering nurse and family perspectives and to examine its associated factors. Background: Empowerment has gained high priority in the world health strategy, being claimed for its benefits for people’s health and well-being. Design: The design includes an exploratory cross-sectional, correlational study. Methods: We collected data between January 2018-October 2019 from a convenience sample of 82 families attending a 5-year-old well-child visit and 25 nurses at Portuguese health centres. Families and nurses assessed the same counselling session using parallel statements of the Portuguese Empowering Speech Practice Scale, grouped in two subscales (nurses’ action and families’ action). Questionnaires also included the Parent’s Longitudinal Continuity in Primary Care scale, the Family Nutrition and Physical Activity tool and anthropometric and sociodemographic questions. We employed descriptive statistics, paired-samples t-test, analysis of variance and regression analysis. Results: Both nurses and families reported that empowerment had been practiced in high degree. The most practiced elements were those from nurses’ action subscale (e.g. constructing a positive atmosphere) and the least practiced were from families’ action (e.g. disclosure). A discrepancy between nurses’ and families’ ratings were found for individualized information and advice, disclosure and asking questions, with families reporting higher scores. Nurses’ formal training in empowerment and obesity was associated with higher scores on the nurses’ action subscale. The families’ limited experience with a regular health centre and nurse and families having children with overweight were both associated with lower scores on the two subscales. Conclusions: Although the positive experience by nurses and families is an important finding, the reasons for the differences in perceptions of empowerment require further research. Impact: The Portuguese Empowering Speech Practice Scale can be a useful tool to evaluate services, both from professionals’ and families’ perspectives and to identify areas of improvement.