How public health nurses understand mothers of abused and neglected children: The perception of ‘Shindosa’ in mothers

Aim:  The purpose of this paper is to describe the practical knowledge that public health nurses use in identifying and providing assistance to the mothers of child abuse victims. Methods and Results:   A grounded theory qualitative research method was used to collect and analyse semistructured interviews of 22 public health nurses from health centers in Osaka, Japan. The data was systematically analysed by using a constant comparison process. The participants had an average age of 46.2 years with an average of 21.6 years of experience in their profession. The research examined the perspective of the public health nurses regarding the mothers of child abuse victims. The key factor ‘shindosa’, which is a sense of fatigue, defeat, or lack of energy, emerged from the data. In addition, public health nurses used a two-step process of perception. First, public health nurses began providing assistance to mothers by noticing the presence of shindosa in thems. Nurses became concerned by the state of the mothers and the way they interacted with their children. They perceived that the mother might be experiencing shindosa. Second, through continuous involvement with the mothers, public health nurses came to ascertain the essence of shindosa in mothers. Thus, their initial vague impression of the presence of shindosa became the catalyst to providing assistance to the mothers, and as a result, they gradually understood the fundamental nature of shindosa. Conclusion:  By focusing on mothers as well as children, public health nurses successfully achieved their goal to provide the appropriate and specific care to each mother with shindosa as a solution in the prevention of child abuse.