The purpose of this paper was to develop a nursing-focused use of social exchange theory within the context of maternal-child home visiting. The nature of social exchange theory, its application to client-nurse interaction, and its fit with an existing data set from a field research investigation were examined. Resources exchanged between the nurse and clients were categorized and compared across the patterns of home visiting, nursing strategies based on exchange notions were identified, and variations in exchange were linked with client outcomes. The nurse provided resources within the categories of information, status, service, and goods. Clients provided time, access to the home, space within the home to conduct the visit, opportunities to observe maternal-child interaction, access to the infant, and information. The ease and breadth of resource exchange varied across the patterns of home visiting. The social exchange perspective was useful in categorizing resources, specifying and uncovering new resource categories, understanding nursing strategies to initiate and maintain the client-nurse relationship, and linking client-nurse interactive phenomena with client outcomes. Social exchange theory is potentially useful for understanding client-nurse interaction in the context of maternal-child home visits.
Throughout the history of community health nursing, home visiting has been and remains a central nursing intervention. Yet little conceptual clarification has dealt with this intuitively very valuable nursing intervention. Here, the concept of home visiting was investigated through a concept analysis. The nature of home visiting as it emerged over time was gleaned from historical and current literature. A working definition, capturing the essence of home visiting and implying new measurement possibilities, was formulated. Home visiting emerged as a specific nursing intervention, preceded by an antecedent event, unfolding as a process, with phases labeled as "contacting," "going to see," "gaining entry," "seeing," "terminating," and "telling." Nurse sub-outcomes, nursing strategies, contextual factors influencing the process, and potential consequences of home visiting were uncovered.
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