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Table 2 Interpretation of NPT applied to MCH nurse practice

From: Applying normalization process theory to understand implementation of a family violence screening and care model in maternal and child health nursing practice: a mixed method process evaluation of a randomised controlled trial

Proposition statements for FV work NPT constructs and sub components Interpretation in MCH context
Nurses and stakeholders have a shared understanding and value the FV work. Coherence (sense making work) Do MCH nurses think FV is a problem? What practices define FV screening? What is the meaning attributed to screening and FV work? Is there an understanding of the differences between case finding and routine screening? Is the MOVE model easy to describe and distinguish from routine practice?
FV work requires engagement with the model to manage FV in clinical practice. Cognitive participation (participation work) How do participants engage in the work? Is it valued? Is there evidence of commitment? Have stakeholders invested time, energy and work into MOVE?
All participants work to operationalize the model within the services. Who is doing the work and the interactions involved? Collective action (enacting work) IW - Do MCH nurses think screening at 3–4 months is acceptable? Is it preferred to 4 weeks? Are nurses using the clinical tools and are they worthwhile? How has the use of the clinical tools impacted on the nurse /client interaction?
 • Interactional workability (IW)
 • Relational integration (RI)
 • Skill set workability (SSW)
 • Contextual integration (CI)
RI - Is NM knowledge and expertise around FV trusted and understood by nurses? What is the functionality /relationship of the teams and FV services? Are they working, supportive and connected in relation to the work?
  SSW- Do NM feel their role is recognised? Do nurses feel adequately trained and competent to screen women? Do they have confidence in the FV liaison worker to perform secondary consultations?
CI - How is the FV work funded and supported by local and state government? Have teams successfully negotiated change to incorporate the work?
FV work requires ongoing monitoring of the work. Reflexive monitoring (appraisal work) What quality assurance measures are team leaders performing? How is FV work monitored by MCH team leaders? Is there allocated appraisal of the FV work in meetings and with FV services? How are nurses reflecting on their work? Is there evidence of modified practice to improve FV work?
  1. [21,27,32].