Using group concept mapping to explore the complexities of managing children's care

Background - Children whose assessed health needs cannot be met by statutory and universal services may require bespoke packages of continuing care. A project management group was set up to design a study that would explore the complexities for a children’s community nurse (CCN) of managing such packages.

Methodology - Group concept mapping (GCM), a mixed quantitative/qualitative participant-centred methodology, was used to obtain consensus from 20 CCNs about the complexities
inherent in managing such packages and to develop a concept map that illustrated the emerging conceptual framework.

Discussion - The participants’ ideas were written as statements and analysed. Core analysis of a square symmetrical matrix through multidimensional scaling and hierarchical cluster
analysis was undertaken to produce a set of maps and reports. The final concept map was interpreted. It contained 99 statements organised into five conceptual clusters: ‘education and training’ (17 statements), ‘risk and safety’ (15 statements), ‘continuing care process’ (17 statements), ‘relationships and boundaries’ (22 statements) and ‘working with families’ (28 statements).

Conclusion - CCNs used GCM to explore their roles and responsibilities when managing children’s continuing care. Their resulting ideas were developed into a five-cluster conceptual framework that illustrated their views about the complexities of
managing such care.

Implications for practice - The emergent conceptual framework enables CCNs to explore their practice in relation to managing packages of care. Additionally, the framework will be used
to design a CCN workforce planning instrument that will be useful to measure complexity in CCN caseloads. The GCM methodology could be used by other nursing teams who wish to develop their practice.