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.

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.

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: Expecting a child and becoming a parent is one of life’s major events, during which the parents’ perspective on life and their couple relationship changes. For some parents, childbearing entails a decrease in parental couple relationship quality. The way in which parents are able to cope with childbearing may be connected with their Sense of Coherence; which is a person’s ability to perceive life as comprehensible, manageable and meaningful. For parents’ positive childbearing experiences, professional and social support have been proven to be valuable. However, far from all parents have access to social support; furthermore, professional support does not always meet the needs of expectant parents. Hence, more research is needed to increase knowledge about expectant parents’ experiences of professiona land social support. In addition, more research is needed to explore factors associated with quality of couple relationship among parents during childbearing.

Aims: The overall aim of the thesis was to explore professional and social support for first-time mothers and partners during childbearing in relation toquality of couple relationship and Sense of Coherence.

Methods: The study’s designs were explorative, prospective and longitudinal; both qualitative and quantitative methods were used. Specifically, explorative designs, qualitative methods and phenomenographic analysis were used to explore expectant first-time mothers’ (I) and partners’ perceptions of professional support (II). Furthermore, an explorative design, qualitative method and qualitative content analysis were used to explore expectant first-time mothers’ experiences of social support (III). Within Study IV, a prospective longitudinal design, descriptive statistics, non-parametric tests and multiple linear regression analysis were used to evaluate factors associated with quality of couple relationship among first-time mothers and partners, during pregnancy and the first six months of parenthood.

Results: The overall results of the thesis revealed both similarities and differences between expectant first-time mothers’ and partners’ perceptions of professional support, effects from social support and associated factors with perceived quality of couple relationship. The similarities were; both mothers and partners perceived that professional support could facilitate partner involvement, influence their couple relationship and facilitate contacts with other expectant parents. According to first-time mothers’ experiences, their couple relationship with their partner was also strengthened by social support during pregnancy. Further, the results showed that both first-time mothers’ and partners’ higher perceived couple relationship quality six months after birth, was associated with their higher perceived social support. The results showed also that both mothers and partners perceived their quality of couple relationship to decrease and Sense of Coherence to increase six months after childbirth, compared to the pregnancy. Differences revealed were such as: higher Sense of Coherence was only associated with mothers’ higher perceived quality of couple relationship, and first-time mothers reported perceiving more social support compared to the partners both during pregnancy, first week and six months after childbirth.

Conclusions: Professional and social support can strengthen first-time mothers and partners both individually and as a couple, in their abilities to cope with childbearing. On the individual basis, the expectant parents could be strengthened through professional and social support that contributed to their understanding and feeling of being prepared for childbirth and parenting, for instance. As a couple, the parents were strengthened by professional support that included the partner’s role, as well as higher perceived social support overall. In contrast, lack of support could have a negative influence on the expectant parents’ feeling of being prepared for childbirth and parenting. Besides this, the results indicates that childbearing has a positive effect on parents’ abilities to cope with life even though their quality of couple relationship decrease. Professionals can use these results in their further understanding about how to offer satisfactory support to first-time mothers and partners during childbearing.