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

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.

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.

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).

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.

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.