Högskolan i Skövde

Child-centered care is based on the fact that children are individuals with their own rights. Since January 2020, The United Nations Convention on the Rights of the Child (CRC) is law in Sweden. Children's meeting with professionals is important because it becomes the children's impression of healthcare that may reflect the children's future image of and feelings about the whole healthcare system. This prospective cross-sectional study aimed to explore child healthcare competence among nurses within primary healthcare. Data were collected through a web-based questionnaire among 101 primary healthcare district nurses, specialist nurses, and registered nurses. The study was compliant with the STROBE checklist. The results showed that the nurses have a good ability to apply child-centered care during children's visits to primary healthcare. To further implement a child-centered approach in primary healthcare, nurses need to have access to workplace educational opportunities continually, to enhance their child competence throughout their nursing careers.

Aim: The aim of this study was to explore healthcare professionals’ experiences of working with extended home visits for parents.

Background: It is essential to identify parents, both expectant and with a newborn child, who need support in their parenting abilities at an early stage because children’s health and well-being are affected by their home environment as well as by their parents’ health and social relationships. Home visits represent a cost-effective way of identifying and supporting families with a newborn. Further research is needed to explore healthcare professionals’ experiences working with extended home visits for parents.

Methods: This was a qualitative interview study focusing on an intervention introduced in the Enhanced Parenting—Extended Home Visits project in Sweden. Data were collected via 13 semi-structured interviews with healthcare professionals who provide the intervention in antenatal care (midwives) and child health care (CHC nurses and family supporters), and a qualitative content analysis was performed.

Findings: Data analysis resulted in one theme and four categories. The theme – to provide multidimensional adapted professional support, – and the four categories – strengthened collaboration between professionals enriches their work. Home visits provide time for conversation, which promotes continuity of care and relationships with parents; being humble guests in parents’ homes provides insight; and home visits provide the opportunity to strengthen parenting and participation in the family centre. The goals of the Enhanced Parenting—Extended Home Visits project were to strengthen parents’ confidence in their parenting abilities and to build trusting relationships with healthcare professionals. The conclusion of this study, from the participants’ perspective, is that these goals can be achieved with the intervention.

Implications for Practice: Extended home visits seem to help healthcare professionals provide collaborative, multi-professional support for parents, both expectant and with a newborn child, with unique support needs.

Background: Globally, the digital sources developed and available in antenatal care differ, and infrastructure challenges may impede the further development of such sources. Challenges accompanying digital developments can include the commonly occurring high workload, which affects healthcare professionals' ability to acquire professional knowledge about how to best support parents in using digital sources. Including healthcare professionals in the development process of digital sources may increase the likelihood that such sources will be adopted and employed by these professionals in their future care work. Therefore, the present research explored healthcare professionals' perceptions of the digital support intervention Childbirth Journey, which was constructed as a serious game for expectant parents.

Methods: Data were collected through semi-structured focus-group interviews with 11 midwives at antenatal, labour and postnatal clinics as well as with child healthcare nurses. Prior to the interviews, all participants were provided the intervention, Childbirth Journey, which is a serious game in a mobile application format consisting of two distinct parts: (1) a story-driven game and (2) a Knowledge Portal. The data were analysed using phenomenographic methods.

Results: The perceptions of Childbirth Journey by healthcare professionals, midwives and child healthcare nurses are presented in four descriptive categories: extended professional support, trustworthy contents, diversity or individuality, and both appealing and in need of development.

Conclusions: Current study revealed that Childbirth Journey may be utilised as a digital support for parents, allowing healthcare professionals to offer a digital solution as a complementary support to standard, face-to-face meetings with caregivers. However, the research results also revealed that some elements of Childbirth Journey must be improved, thereby representing a main contribution of this study: insights into how to better develop digital tools under the umbrella of health care. Thus, we conclude that in order to create sustainable and safe digital care solutions that function as trustworthy professional supports instead of technical products that risk harming users, the perspectives of both patients and healthcare professionals should be considered in the exploration and development of these solutions.

Objective: The aim of this study was to explore expecting parents’ perceptions of the Childbirth Journey as an intervention that includes medical information for parental support, constructed as a serious game.

Methods: In this qualitative study, semi-structured interviews were held with expecting parents in Sweden who were able to talk about specific parts of the Childbirth Journey they appreciated or found difficult to understand. A phenomenographic methodology was employed for data analysis.

Results: Participants perceived the Childbirth Journey to be easily accessible and customized with reliable information. The design and features of the intervention were perceived by the expecting parents to enhance the intervention’s usability, appeal, and trustworthiness. When parental couples used the Childbirth Journey together, it gave them an opportunity to discuss and better understand each other’s situation. The participants proposed several changes to the existing version of the game, mostly related to extending practical information and illustrated scenarios but also to the further development of the game’s design and animations. The participants found the Knowledge portal to be the most appealing part of the Childbirth Journey.

Conclusions: The Childbirth Journey intervention was concluded to be a valuable digital complement to in-person profes- sional support, especially given the current COVID-19 pandemic restrictions in place in Sweden, which do not allow antenatal visits by partners. However, in its current form, the Childbirth Journey has some deficiencies and would therefore benefit from further development and exploration.

Background

In today's society, people are experiencing the rapid development of digitalisation. Expecting parents may have difficulties evaluating the information online; they are not always sure which sources of information are trustworthy, and this exacerbates their feelings of anxiety. More research is needed to broaden the knowledge about how their use of digital sources may influence their health.

Question

The focus of this study was to explore expecting parents’ use of digital sources and how this influences their health during pregnancy.

Methods

A systematic review covered the thematic analysis of 39 articles.

Findings

The analysis resulted in the following theme: The digitalised society involves both opportunities and challenges, and expecting parents express a need for a variety of digital sources to improve their health, and sub-themes: Digital sources could promote parents’ health and well-being in a digitalised society; Consuming digital health information facilitates understanding, different feelings and social connections; and A variety of digital sources may facilitate parental identification and adaption to parenthood.

Conclusion

Different digital sources in our digitalised society mean access to information and opportunities to extend social connections for expecting parents. This can promote their ability to understand and adapt to parenthood, as well as to improve their health and well-being and make the parental transition. However, professional support during face-to-face consultations cannot always be exchanged to digital sources. It is important to base digital sources devoted to expecting parents and digitalisation overall on multi-sectorial collaborations and coordination between different organisations and the digital sources they provide.

Objective: To explore parents’ experiences using digital tools in relation to pregnancy, labor and birth, and the child’s first 18 months. Background: Parents find relevant information using digital healthcare tools, material obtained from professionals, as well as personal opinions and experiences that vary in quality. Method: Fifteen parents were interviewed and data were analyzed beginning with content analysis and followed by thematic analysis. Results: The main theme was insecurity and responsibility for own choices and knowledge. Parents use digital tools to take responsibility for their insecurity and need for knowledge when entering parenthood. Conclusion: The parents’ experiences highlighted that (1) insecurity can be both eased and enhanced using digital tools, (2) they took responsibility for feelings of insecurity and the search for knowledge, and (3) they needed knowledge to make the right choices and feel secure that these choices are made in the best interest of their new family. 

Background: Professional support in childbearing has beneficial effects on childbirth experience, interactions within the family, breastfeeding and medical outcomes. However, more knowledge is needed about prerequisites for professional support to be valuable and satisfactory during childbearing. Aim: The aim of this discourse paper is to describe and explore prerequisites for professional support that are of value for women and their families during childbearing as well as how healthcare organizations can be formed to facilitate these prerequisites. Design: Discourse paper. Methods: This discourse paper is based on our own experiences and is supported by literature and theory. Results: Well-functioning structures and processes facilitate professional support that leads to safe, secure, calm and prepared parents with the ability to handle the challenges of childbearing and parenting. When organizing care in childbearing, prerequisites for support needs must also be considered. 

Background: During the COVID-19 pandemic, the workload on the intensive care unit (ICU) increased nationally in Sweden as well as globally. Certified registered nurse anaesthetics (CRNAs) in Sweden were transferred at short notice to work with seriously ill patients with COVID-19 in the ICU, which is not part of the CRNAs’ specialist area. However, limited research has shed light on healthcare professionals’ experiences of the pandemic.

Objectives: This study illuminates CRNAs’ experiences of working in the ICU during the COVID-19 pandemic.

Methods: This study used a qualitative method with an inductive approach to interview nurse anaesthetists’ who worked in the ICU during the COVID-19 pandemic.

Findings: The participants experienced ambivalent feelings towards their work in the ICU. They also lacked information, which created feelings of uncertainty and resulted in expectations that did not correspond to the reality. They described that due to an inadequate introduction, they could only provide “sufficient” care, which in many cases caused ethical stress. Not being able to get to know their new colleagues well enough to create effective cooperation created frustration. Even though the participants experienced the work in the ICU as demanding and challenging, overall, they enjoyed their time in the ICU and were treated well by their colleagues.

Conclusions: While CRNAs cannot replace intensive care nurses (ICNs), they are a useful resource in the ICU in the care of patients with COVID-19. Healthcare workers who are allocated from their ordinary units to the ICU need adequate information and support from their work managers to be able to provide the best possible care and to stay healthy themselves.

Background: The access to digital tools for parents is increasing, and further exploration is needed to gain knowledge about parents' experiences in using such tools, for example, when preparing for childbirth and parenthood. This study protocol describes a prospective study that will explore serious games as digital tools for parental support, and both parents' and healthcare professionals' views will be included. The objectives of the prospective study are to explore two different serious games: (1) Childbirth Journey (Swedish: Förlossningsresan), relating to pregnancy, childbirth and parenthood; and (2) Interplay (Swedish: Samspel), relating to parental couple relationships and parenthood.

Methods: An intervention study will be conducted. The study will include four different sub-studies (A–D) with both qualitative and quantitative methods and a longitudinal design. Both parents (A, B and D) and healthcare professionals (C) will be included, and data will be collected through interviews (A–C) and repeated web-based questionnaires (D). Data will be analysed using phenomenography and qualitative content analysis (A–C), and descriptive and analytical analyses will be performed for comparisons and associations (D).

Discussion: The value of monitoring and reporting on developments and trends in digital innovation for public health has been stipulated by the World Health Organization. The prospective study will contribute further knowledge about multidisciplinary development of digital tools as professional support for parents, as well as knowledge about parents' and healthcare professionals' experiences using digital tools concerning pregnancy, labour, parenthood and parental couple relationships.

Trial Registration: This study was retrospectively registered (02/10/2020) within the ISRCTN with ID: ISRCTN18017741. http://www.isrctn.com/ISRCTN18017741.