Original Research

Developing the health visitor concept of family resilience in Wales using Group Concept Mapping


Carolyn Wallace1 PhD, Reader *

Fran Dale2 MA Childhood Studies, Retired health visitor

Georgina Jones3 MSc, Health Visitor/Practice Teacher

Jane O'Kane4 MSc, Head of Nursing CYP and CAMHS Cwm Taf Health Board

Michelle Thomas5 MSc, Senior Lecturer, Health Visitor

Liz Wilson6 MSc, Flying Start Health and Social Care Manager,

David Pontin7 PhD, Aneurin Bevan Chair of Community Health


1 PRIME Centre Wales/Faculty of Life Sciences and Education, University of South Wales, Lower Glyntaf Campus, Pontypridd, CF371DL, Wales, UK

2 n/a

3 Abertawe BroMorgannwg University Health Board, Flying Start, Port Talbot Resource Centre, Moor Road, Port Talbot, SA12 7BJ, Wales, UK

4 Abertawe Bro Morgannwg University Health Board, Orchard Street, Central Clinic , Swansea, SA1 5AT, Wales, UK

5, 7 Faculty of Life Sciences and Education, University of South Wales, Lower Glyntaf Campus, Pontypridd, CF371DL, Wales, UK

6 Hywel Dda University Health Board, Flying Start Offices, Former Morfa Infants School, New Street, Morfa, Llanelli, SA15 2DQ, Wales, UK

ACCEPTED: 25 July 2018

early abstract:

Introduction: A health visitor’s ability to assess and analyse aspects of family resilience in daily practice is essential to enable practitioners to support families and facilitate positive lifestyle choices and improve child health and  developmental outcomes.  The purpose of this research was to undertake an in-depth exploration of the concept of family resilience as understood by health visitors in Wales and to develop a concept map. This knowledge has been used to develop the FRAITTM (Family Resilience Assessment Instrument Tool) . This is a standardised form of assessment, measuring instrument, guidance, training package and community of practice for use in health visitor daily practice. This paper presents the first stage of the FRAITTM research study, that of identifying the clusters within the concept map of what health visitors perceive as ‘family resilience’.

Methods: A structured Group Concept Mapping (GCM) methodology using Concept Systems Global MaxTM online software was used to gain a consensus of the understanding of the concept of family resilience from 62 invited health visitors practicing across Wales.  This is an integrated qualitative and quantitative approach to brainstorming, idea synthesis, idea sorting, idea rating and group analysis. GCM has six clear steps with four steps described in the method.  They are preparing for concept mapping, generating ideas, structuring the statements, and concept mapping analysis. Steps five and six, interpreting the maps and utilization are considered in the results section. 

Results: Use of multi-dimensional scaling and hierarchical cluster analysis enabled point, cluster, rating and pattern matching maps to be presented to the study group. These were then interpreted, understood and consensus gained on how the concept of family resilience was constructed from both the study group and the health visitor participants.  Family resilience understood by health visitors in Wales comprises of five clusters, ‘family health’, ‘responsive parenting’, ‘engagement’, ‘family support’ and ‘socioeconomic factors’. Each of the clusters has an identified number of underpinning statements from a total number of 117 statements.

Conclusion: Family Resilience as understood by health visitors is a multidimensional concept. Using online software such as Concept Systems Global MaxTM enabled health visitors working across Wales to achieve a consensus and generate the data in preparation for building a Family Resilience assessment tool and instrument for use in their daily practice as required by Welsh Government Policy.