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Table 4 Influences on normalisation of FV screening using NPT constructs

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

NPT construct

Influencing factors

Coherence or ‘sense making work’

Enablers:

 

 • Previous FV work

 

 • Increased discussion of the FV work in team meetings

 

Barriers:

 

 • Time of significant change with introduction of KAS framework

 

 • Some participants misunderstood their role and in several areas, frequent staff changes impacted on implementation

Cognitive participation or ‘participation work’

Enablers:

 

 • Favourable responses of women and the perceived client consciousness raising (primary prevention)

 

 • Continual team discussions on FV work

 

Barriers:

 

 • Lack of privacy to screen in consultations

 

 • Heavy workloads and competing client demands

 

 • Limited FV service support

Collective action or ‘enacting work’

 
 

Enablers:

 

 • Use of the maternal health and wellbeing checklist at 3–4 months enhanced client-nurse interaction and was a ‘good fit’ into the government guidelines

 

 • Planting a seed by multiple asking points

 

 • FV liaison worker

 

 • Adequate knowledge and skill set

 

Barriers:

 

 • Poor organisational structure - limited ability to link with other team members or services

 

 • Low funding and disproportionate allocation of FV liaison worker support to some teams

Reflexive monitoring or ‘appraisal work’

Enablers:

 

 • Clinical supervision allowed for individual reflection

 

Barriers:

 

 • Lack of awareness that evaluation and monitoring was required

 

 • Absence of formal reporting systems in both MCH and FV service

  1. [21,32,42].