Vacillating between "strange" and "familiar" - representations of children in migrant families and their health in Swedish school health services.

ABSTRACT

Representations of migrants influence how they are perceived by others. Hence, how children who have migrated or whose parents have migrated (Children in Migrant Families CMFs) are represented in clinical practice guidelines (CPGs) for Swedish school health services (SHS) may influence how they are perceived by school nurses. Thus, this study aimed to explore representations of CMFs in school nurses' CPGs. Data consisted of 130 CPGs from municipalities in Sweden. Documents were analyzed using the "What is the Problem Represented to be" (WPR) approach - an analytic strategy for investigating embedded assumptions of "problems". In the analysis, Sarah Ahmed's work on "strangers" and "strangeness" was applied. In the CPGs, the CMFs and their health were repeatedly mentioned in conjunction with the need for particular or additional actions, efforts, or routines when assessing or discussing their health, to a degree beyond what is "usually" provided. This need was motivated by representing the CMFs and their health as being the same, yet different in relation to "Swedish" children in general. Thus, the children were not only represented as different, but they were "foreignized". These representations of difference and foreignness placed the children on a continuum in relation to what is recognized as "familiar" in their health, and constructed elastic boundaries between the strange and the familiar. By illustrating how these boundaries were used for difference-making between "familiar" and "strange", this study showed how CMFs are alternately represented as similar and different, and foreignized while provided with SHS aiming to make them "familiar".