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Team-based visits within Swedish child healthcare service: a national cross-sectional study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Public Health. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Disciplinary Domain of Medicine and Pharmacy, research centers etc., Centre for Clinical Research Sörmland.ORCID iD: 0000-0002-1438-8531
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Disciplinary Domain of Medicine and Pharmacy, research centers etc., Centre for Clinical Research Sörmland. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Paediatric Inflammation, Metabolism and Child Health Research.ORCID iD: 0000-0003-2648-4413
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.ORCID iD: 0000-0003-2857-4746
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Disciplinary Domain of Medicine and Pharmacy, research centers etc., Centre for Clinical Research Sörmland.
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2025 (English)In: Journal of Interprofessional Care, ISSN 1356-1820, E-ISSN 1469-9567, p. 957-974Article in journal (Refereed) Published
Abstract [en]

Complex healthcare needs can be met through effective interprofessional collaboration. Since 2014, Swedish Child Healthcare Services (CHS) include universal team-based visits with a nurse and a physician who perform such visits at the age of 4 weeks, 6 months, 12 months, and 2.5 to 3 years, as well as targeted team-based visits to address additional needs. The aim of this study was to describe the prevalence of team-based visits in the Swedish CHS and possible associations between team-based visits and contextual factors that may affect its implementation. A national cross-sectional survey was conducted using a web-based questionnaire distributed to all reachable nurses, physicians, and psychologists (n =3,552) engaged in the CHS. Data were analyzed using descriptive statistics and binary and multivariate logistic regressions. The response rate was 32%. Team-based visits were reported by 82% of the respondents. For nurses and physicians, the most frequent indication was specific ages, while for psychologists it was to provide parental support. Respondents working at Family Centers were more likely to perform team-based visits in general, at 2.5 to 3 years and in case of additional needs, compared to respondents working at Child Health Centers (CHC) and other workplaces. In conclusion, team-based visits are well implemented, but the pattern differs depending on the contextual factors. Targeted team-based visits and team-based visits at the age of 2.5 to 3 years are most unequally implemented.

Place, publisher, year, edition, pages
Taylor & Francis, 2025. p. 957-974
National Category
Nursing
Research subject
Caring Sciences
Identifiers
URN: urn:nbn:se:uu:diva-451939DOI: 10.1080/13561820.2021.1902960ISI: 000684129600001Scopus ID: 2-s2.0-85120906991OAI: oai:DiVA.org:uu-451939DiVA, id: diva2:1589931
Available from: 2021-09-01 Created: 2021-09-01 Last updated: 2026-01-23Bibliographically approved
In thesis
1. Interprofessionella teambesök i svensk barnhälsovård - en resurs att utveckla: En studie om teamarbete ur sjuksköterskors, läkares och psykologers perspektiv
Open this publication in new window or tab >>Interprofessionella teambesök i svensk barnhälsovård - en resurs att utveckla: En studie om teamarbete ur sjuksköterskors, läkares och psykologers perspektiv
2023 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Interprofessional teamwork has been described as a key method in promoting health and preventing illness in children. However, evidence-based knowledge about which form of teamwork in Child Healthcare Services (CHS) that enables a holistic view of the child in his or her family, considering medical, psychological and social circumstances, is required.

This thesis aimed to produce evidence-based knowledge about teams and interprofessional teamwork that could be used in the Swedish CHS, as well as an understanding of influencing factors at the individual, organisational and societal levels based on nurses’, physicians’ and psychologists’ perceptions.

The thesis includes four studies (I–IV) that used quantitative, qualitative and mixed method design to answer the overall purpose of the doctoral thesis. Together, these methods form an exploratory sequential mixed method design. For the quantitative studies (I and II) and the mixed study (III), a national cross-sectional study in the form of a web survey was answered by 1119 nurses, physicians and psychologists engaged in the Swedish CHS. In study IV, an explorative qualitative design was used, and data was obtained from seven digital focus group interviews with nurses, physicians, and psychologists engaged in CHS.

Interprofessional teamwork within the CHS, in the form of physical meetings such as team-based visits and parental groups held by a team, where professionals, the child, and the parents are present at the same time, was found to be important to achieve the goals of the team and meet the unique needs of the child and his/her family. Team-based visits contribute to a holistic view of the child in his/her family where medical, psychological and social circumstances are considered. Healthcare professionals require team-based visits delivered by interprofessional teams, in line with proportionate universalism. However, perceived needs for targeted team-based visits exceed its existence, especially in cases of psychosocial or complex indications.

Based on the findings, there are reasons to consider interprofessional team-based visits in the CHS as an important resource to be developed. For optimal team-based visits within CHS, factors at the individual, organisational and social level are required. These factors include: 1) placing the child at the centre, 2) physical meetings, 3) equality and equity, 4) continuity, 5) trust and confidence, 6) competence and learning, 7) communication, 8) goals and motivation, 9) responsibilities and roles, 10) flexibility, 11) safety and effectiveness and 12) well-being and meaningfulness.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2023. p. 140
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1964
Keywords
Child Healthcare Service, Interprofessional teamwork, Proportional universalism, Barnhälsovård, Teamarbete, Proportionerlig universalism, Team-based visits, Team competence, Mixed method
National Category
Nursing Public Health, Global Health and Social Medicine
Research subject
Caring Sciences
Identifiers
urn:nbn:se:uu:diva-508488 (URN)978-91-513-1861-5 (ISBN)
Public defence
2023-09-22, Sal IX, Universitetshuset, Biskopsgatan 3, Uppsala, 09:30 (Swedish)
Opponent
Supervisors
Funder
Gillbergska stiftelsen
Available from: 2023-09-01 Created: 2023-08-02 Last updated: 2025-02-20

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Nygren, Ulrika SveaTindberg, YlvaEriksson, LeifNordgren, Lena

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