Date of Award


Degree Name

Doctor of Nursing Science

Dissertation Committee

Mary Jo Clark, PhD, RN, Chairperson; Patricia A. Roth, EdD, RN, Member; Nancy M. Sweeney, DNSc, RN, Member


high-risk infants, home visits, nurse-patient relationship, nursing, patients, Public Health Nurses


Although there is considerable research on the relationship between client expectations and outcomes of care in acute care settings, less is known about clients' expectations for public health nurses' home visits. The aim of this study was to understand clients' expectations of public health nurses' home visits as a first step in making explicit how expectations affect client responses to, and ultimately, outcomes of public health nurses' care. Interviews were conducted with a convenience sample of 19 primary caretakers of high-risk infants admitted to a Neonatal Intensive Care Unit (NICU) and voluntarily enrolled in a High-Risk Infant (HRI) Program in Southern California. All but one of the participants were the mothers of the high-risk infants. The findings of this study elucidated a process of forming expectations , which consisted of two stages, expectation formation and expectation reformation. Contrary to psychological theories of expectations, participants had not formed expectations of public health nurses' home visits. Most had no knowledge of public health nurses work or their infant's referral to the program. However, with prompts from the researcher, participants used guesswork to predict what the nurse might do or say or to state their ideal expectations. The interaction with the public health nurse was a pivotal influence in confirming positive expectations and disconfirming negative expectations. Participants were surprised when the nurse addressed other health care issues of the family.

Document Type

Dissertation: Open Access



Included in

Nursing Commons