Logo: to the web site of Uppsala University

uu.sePublications from Uppsala University
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Interprofessionella teambesök i svensk barnhälsovård - en resurs att utveckla: En studie om teamarbete ur sjuksköterskors, läkares och psykologers perspektiv
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
2023 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Description
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 [en]
Child Healthcare Service, Interprofessional teamwork, Proportional universalism
Keywords [sv]
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: urn:nbn:se:uu:diva-508488ISBN: 978-91-513-1861-5 (print)OAI: oai:DiVA.org:uu-508488DiVA, id: diva2:1785481
Public defence
2023-09-22, Sal IX, Universitetshuset, Biskopsgatan 3, Uppsala, 09:30 (Swedish)
Opponent
Supervisors
Funder
Gillbergska stiftelsenAvailable from: 2023-09-01 Created: 2023-08-02 Last updated: 2025-02-20
List of papers
1. Healthcare professionals' perceptions about interprofessional teamwork: a national survey within Swedish child healthcare services
Open this publication in new window or tab >>Healthcare professionals' perceptions about interprofessional teamwork: a national survey within Swedish child healthcare services
Show others...
2021 (English)In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 21, no 1, article id 265Article in journal (Refereed) Published
Abstract [en]

Background: Globally, interprofessional teamwork is described as a key method to promote health and prevent illness in children, namely, to achieve the goals of Child Healthcare Services (CHS). However, how teamwork should be designed within CHS to achieve the goals is unclear. This study aimed to investigate healthcare professionals' perceptions about 1) taking part in interprofessional teamwork, 2) team characteristics, and 3) whether the perceptions were related to professional affiliation or workplace.

Methods: A national cross-sectional survey was conducted using a web-based study-specific questionnaire sent to all accessible nurses, physicians, and psychologists in Swedish CHS (n = 3552). The response rate was 31.5%. To identify possible associations, logistic regressions were conducted.

Results: Almost all respondents, 1096/1119 (97.9%), reported taking part in some type of interprofessional teamwork within the Swedish CHS. Among those, the most common was team-based visits (82.2%). It was perceived that performing team-based visits resulted in fulfilled goals, expertise exceeding individual team members' competences, provision of high-quality care, and meeting children's and families' needs, to a greater extent, than if not performing team-based visits. Correspondingly, working as a team in parental groups was perceived as resulting in fulfilled goals, meeting the needs of children and their families, and continuity within the team to a greater extent than if not working together in a team. Professional affiliation was associated with different perceptions and types of teamwork. Family Centers were positively associated with all types of teamwork as well as continuity within the team.

Conclusions: Healthcare professionals' perceptions about team characteristics were associated with professional affiliation, workplace, and type of teamwork (defined as team activities) within the CHS. Professionals within Swedish CHS, taking part in team-based visits and in interprofessional teamwork in parental groups, perceived that the team fulfilled its goals and met the needs of children and families to a greater extent than professionals not taking part in these types of teamwork. Professionals at Family Centers were more likely to work in teams in different ways. Knowledge about interprofessional teamwork for individuals and groups in Swedish CHS might also be valuable in other healthcare settings, dealing with complex needs.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2021
Keywords
Child healthcare services, Cross-sectional survey, Family center, Interprofessional teamwork, Parental groups, Team-based visit
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-440118 (URN)10.1186/s12913-021-06139-3 (DOI)000632811500002 ()33752664 (PubMedID)
Funder
Gillbergska stiftelsen
Available from: 2021-04-14 Created: 2021-04-14 Last updated: 2026-03-27Bibliographically approved
2. Team-based visits within Swedish child healthcare service: a national cross-sectional study
Open this publication in new window or tab >>Team-based visits within Swedish child healthcare service: a national cross-sectional study
Show others...
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
National Category
Nursing
Research subject
Caring Sciences
Identifiers
urn:nbn:se:uu:diva-451939 (URN)10.1080/13561820.2021.1902960 (DOI)000684129600001 ()2-s2.0-85120906991 (Scopus ID)
Available from: 2021-09-01 Created: 2021-09-01 Last updated: 2026-01-23Bibliographically approved
3. Perceived needs for team-based visits in Swedish child healthcare services exceed its existence: A mixed-methods study targeting healthcare professionals
Open this publication in new window or tab >>Perceived needs for team-based visits in Swedish child healthcare services exceed its existence: A mixed-methods study targeting healthcare professionals
Show others...
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
Keywords
Child healthcare services, Interprofessional teamwork, Mixed method, Proportionate universalism, Team-based visits
National Category
Public Health, Global Health and Social Medicine
Identifiers
urn:nbn:se:uu:diva-460937 (URN)10.1111/apa.16193 (DOI)000728734500001 ()34813675 (PubMedID)
Available from: 2021-12-09 Created: 2021-12-09 Last updated: 2025-02-20Bibliographically approved
4. Opportunities and difficulties with providing child healthcare through team-based visits in child healthcare services: a focus group study
Open this publication in new window or tab >>Opportunities and difficulties with providing child healthcare through team-based visits in child healthcare services: a focus group study
Show others...
2025 (English)In: BMC Primary Care, E-ISSN 2731-4553, Vol. 26, no 1, article id 280Article in journal (Refereed) Published
Abstract [en]

Background

The Swedish Child Healthcare services (CHS) includes team-based visits. Team-based visits are defined as physical meetings where different professionals, including the child and his or her parents, participate at the same time at the same place. This study aimed to explore healthcare professionals’ experiences of these visits to better understand the opportunities and difficulties in meeting the unique needs of children and their families through team-based visits.

Methods

An explorative qualitative design. Data were obtained through seven digital focus group interviews (FGDs) with 34 professionals within CHS, following the guidelines provided by Krueger and Casey.

Results

All professional groups perceived great opportunities with team-based visits. Optimal team-based visits meant accessible and safe family support, based on children’s and families’ needs. Trustful relationships with someone in the team, can promote families’ trust in the team, the assessment process, and healthcare organizations. For optimal team-based visits in CHS, professional competence, as well as organizational structures, are required. However, without enabling factors, here can be opposite effects on all those involved.

Conclusions

Optimal team-based visits in CHS delivered in the right way, at the right time, by the right individuals can be an efficient and comprehensive way to meet the unique needs of children and families.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2025
Keywords
Child healthcare services, Focus group discussion, Interprofessional teamwork, Team-based visits, Team competence
National Category
Nursing Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:uu:diva-508489 (URN)10.1186/s12875-025-02981-0 (DOI)001568449900001 ()40922033 (PubMedID)2-s2.0-105015164514 (Scopus ID)
Available from: 2023-08-02 Created: 2023-08-02 Last updated: 2025-10-08Bibliographically approved

Open Access in DiVA

UUThesis_Nygren,U-2023(1914 kB)1050 downloads
File information
File name FULLTEXT01.pdfFile size 1914 kBChecksum SHA-512
99c49873903a2f19d1ee3854d087ee2d64de98f0c8c103e2366fd6f0ebb39224a90933c150307a9d6e15cc1dca12b7c1c56ba38c4584f0d428042d34f2bb5093
Type fulltextMimetype application/pdf

Authority records

Nygren, Ulrika Svea

Search in DiVA

By author/editor
Nygren, Ulrika Svea
By organisation
Centre for Clinical Research SörmlandCaring Sciences
NursingPublic Health, Global Health and Social Medicine

Search outside of DiVA

GoogleGoogle Scholar
Total: 1054 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

isbn
urn-nbn

Altmetric score

isbn
urn-nbn
Total: 2815 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf