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Perceived needs for team-based visits in Swedish child healthcare services exceed its existence: A mixed-methods study targeting healthcare professionals
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 Public Health and Caring Sciences, Caring Sciences.ORCID iD: 0000-0002-1438-8531
School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna/Västerås, Sweden.
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, 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 Public Health and Caring Sciences, Family Medicine and Preventive Medicine. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.ORCID iD: 0000-0003-0667-7111
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2022 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 111, no 3, p. 653-666Article in journal (Refereed) Published
Abstract [en]

AIM: To investigate both quantitatively and qualitatively the differences between participation in team-based visits (TBVs) and perceived needs for TBVs from the perspectives of healthcare professionals, in the context of the Swedish three-tier national Child Healthcare program.

METHODS: A study-specific questionnaire, including multiple-choice questions with fixed and free-text response options, was developed, and used. To capture healthcare professionals' experiences and find explanations for the quantitative results in qualitative data, a convergent parallel mixed-methods study design was used. Descriptive statistics and McNemar's test were used to analyze the quantitative data, and content analysis was used to analyze the qualitative data.

RESULTS: Healthcare professionals perceived the need for TBVs in the Swedish Child Healthcare Services (CHS) to a high extent. The largest difference between the perceived need for TBVs and experienced TBVs was for indications associated with psychosocial problems. The quantitative findings were explored by the qualitative findings. Both individual and organizational factors influenced TBVs.

CONCLUSION: Perceived needs for TBVs in Swedish CHS exceed its existence. Healthcare professionals require TBVs delivered by interprofessional teams, in line with proportionate universalism. Accordingly, organizational structures (e.g., co-location and clear instructions on how to distribute TBVs) and human resources (e.g., psychologists and social worker) are needed.

Place, publisher, year, edition, pages
John Wiley & Sons, 2022. Vol. 111, no 3, p. 653-666
Keywords [en]
Child healthcare services, Interprofessional teamwork, Mixed method, Proportionate universalism, Team-based visits
National Category
Public Health, Global Health and Social Medicine
Identifiers
URN: urn:nbn:se:uu:diva-460937DOI: 10.1111/apa.16193ISI: 000728734500001PubMedID: 34813675OAI: oai:DiVA.org:uu-460937DiVA, id: diva2:1618514
Available from: 2021-12-09 Created: 2021-12-09 Last updated: 2025-02-20Bibliographically 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, YlvaNordgren, LenaEriksson, Leif

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