Umeå University's logo

umu.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • 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
Barnhälsovårdens förändrade roller och behov av digital utveckling
Umeå University, Faculty of Medicine, Department of Nursing.ORCID iD: 0009-0000-9580-2310
2023 (Swedish)Doctoral thesis, comprehensive summary (Other academic)Alternative title
Child health care - changed roles and needs of digital development (English)
Abstract [sv]

Bakgrund: Den svenska barnhälsovården är frivillig och kostnadsfri, och de flesta svenska familjer följer programmet. Den är dock inte jämlikt fördelad över landet och kan därför behöva utvecklas med fler digitala element och bli mer familjefokuserad. Många, särskilt kvinnor, beskrivs behöva mycket stöd under övergången till föräldraskap och uppskattar professionell hjälp för att hantera känslomässig och psykosocial stress. Familjefokuserad omvårdnad ligger till grund för omvårdnadspraktiker inom barnhälsovården, vilket innebär att specialistsjuksköterskan skapar vård tillsammans med familjen och tar vara på alla kompetenser på bästa sätt. Att involvera föräldrarna i utvecklingen av barnhälsovården är därmed av yttersta vikt.

Syfte: Det övergripande syftet var att utröna hur föräldrar och Barnavårdscentralensspecialistsjuksköterskor (BVC-sjuksköterskor) uppfattar och använder Internet som en källa för hälsokompetens, samt att utvärdera effekten av en digital pilotinterventionutvecklad i samarbete med föräldrar med målet att minska föräldrastress, öka hälsolitteracitet och tillfredsställelse med barnavårdscentralen (BVC).

Metoder: Kvalitativa (I, III), mixade (II) och kvantitativa (IV) metoder baserade på intervjudata, gruppdiskussioner och frågeformulär användes i de fyra studierna som syftade till att; I) beskriva BVC-sjuksköterskors erfarenheter och åsikter om föräldrars internetanvändning, II) beskriva hälso- och barnutvecklingsrelaterade sökmönster på internet hos föräldrar till friska barn och hur informationen användes i kontakter med barnhälsovården (BHV), III) beskriva föräldrars behov och förväntningar på digitalt stöd i samband med barnhälsovård, och slutligen IV) utvärdera effekten av en digital pilotintervention riktad till föräldrar, avseende föräldrars stress och eHälsolitteracitet. Kvalitativa data analyserades med hjälp av kvalitativ innehållsanalys och kvantitativa data med beskrivande och jämförande statistiska metoder.

Resultat: Studie I visade att föräldrars internetanvändning påverkade BVC-sjuksköterskors arbete på olika sätt. Internet ansågs underlätta vård, tillgång och tillhandahållande men kunde också komplicera den professionella rollen och prestationen, vilket innebar att de upplevde ett imperativ för en förändrad roll som BVC-sjuksköterskor. I studie II framkom att föräldrar i mycket hög grad sökte på Internet efter hälsorelaterade ämnen, och resultaten belyser också frågan om svårigheterna att bedöma källornas pålitlighet. Studien visade också att Internet kunde stärka föräldrarna med ny kunskap och stödja deras förmåga till egenvård, men att denna kunskap å andra sidan också oroade dem och gjorde dem osäkra i sin föräldraroll. Studie III, som rapporterade om föräldrars behov av och förväntningar på digitalt stöd, visade att de ville bli mer självständiga i sitt föräldraskap men fortfarande behövde stöd och meningsfulla relationer. Viktiga aspekter, förutom förbättrad tillgänglighet som efterfrågades var ökad tillit långsiktiga relationer och stärkt oberoende. Studie IV visade att den digitalasupport-intervention inte gav de effekter på föräldrastress och e-hälsolitteracitet som förväntades, även om tendenser kunde identifieras. Detta ansågs främst bero på en alltför kort genomförandeperiod med alltför få deltagare, då det visades att endast en femtedel av familjerna i interventionsgruppen använde supporten, resten tycktes intebehöva den eller hade kanske ännu inte upptäckt nyttan av den.

Slutsats: Den digitala eran utmanar både föräldrar och BVC-sjuksköterskor. Digitalt stöd som utvecklas tillsammans, dvs där BVC-sjuksköterskor och föräldrar i samarbete kommer överens om hur, när och om vilka ämnen denna typ av stöd och kommunikation ska omfatta, kan dock upplevas som meningsfullt. Ett genomförande i större omfattningskulle öka tillgängligheten, samtidigt stärka föräldrarnas egenmakt och leda till mer långsiktiga relationer med andra föräldrar. Implementerat klokt bland fler deltagare och över längre perioder är det möjligt att den digitala supporten också kan ha mer positiva effekter på tillfredsställelse med BHV samt på minskad föräldrastress och ökad eHälsolitteracitet.

Abstract [en]

Background: Swedish child health care is voluntary and cost-free, and 99% of Swedish families follow the program. However, it is not equally distributed across the country and therefore needs to be developed to include more digital elements and become more family focused. Many, particularly women, need much support during the transition to parenthood and appreciate professional help to manage emotional and psychosocial stress. Family-focused care is the assumption underlying nursing practice within child health care, which means to co-create care with the family, making the most of all competencies. Involving parents in child health care development is therefore of utmost importance.

Aim: The general aim was to examine how parents and child health nurses apprehend and use the Internet as a source for improved health competence, further, to evaluate the effects of a digital pilot intervention developed together with parents to reduce parental stress, improve eHealth literacy and satisfaction with child health care.

Methods: Qualitative (I, III), mixed (II), and quantitative (IV) methods based on interview data, group discussions and questionnaires were used in the four studies that aimed to; I) describe child health nurses’ experiences and opinions of parent Internet use, II) describe health and child development related Internet search patterns of parents of healthy children and, how the information was used in contacts with child health care, III) describe parents’ needs and expectations of digital support in the context of child health care, and lastly IV) evaluate the effects of a digital pilot intervention directed to parents, concerning parental stress and eHealth literacy. Qualitative data were analyzedusing qualitative content analysis and quantitative data with descriptive and comparative statistical methods.

Results: Study I showed that parents’ Internet use influenced child health nurses’ work in various ways. Internet was seen as facilitating care, access, and provision but also complicated their professional role and performance, which implied that they experienced an imperative for a changing role as child health nurses. In study II, it was shown that parents, to a very high degree, searched the Internet for health-related topics, and the results also highlighted the problem of determining the trustworthiness of sources. The study also indicated that the Internet could strengthen parents with new knowledge and support their self-care capacity. However, on the other hand, this knowledge also worried them, making them insecure in their parental role. Study III, reporting on parents' needs and expectations of digital support, showed that they wished to become empowered in parenthood but still needed support and meaningful relationships. Important aspects, besides improved accessibility that were requested were improved parental confidence, longer-term relationships and strengthened independence. Study IV, which evaluated the effects of a pilot intervention,demonstrated limited effects on parental stress and e-Health literacy, even if tendencies were identified. This was mainly seen as related to a short intervention periodwith too few participants since only a fifth of the families in the intervention group used the intervention. The others did not need it or maybe had not discovered its benefits yet.

Conclusion: The digital era challenges both parents and child health nurses. However, digital support developed together, where child health nurses and parents in collaboration agree on how, when and regarding which topics this kind of support and communication should embrace could be experienced as meaningful. It would probably increase accessibility and parental empowerment and lead to longer-term relationships with other parents. Implemented wisely in larger samples and over more extended periods will probably also in a higher degree improve satisfaction with child health care, eHealth literacy and parental stress.

Place, publisher, year, edition, pages
Umeå: Umeå Universitet , 2023. , p. 60
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 2257
Keywords [en]
Child health care, digital support, eHealth, eHealth literacy, health literacy, family-focused care, nursing, parents, parental stress, satisfaction, self-care
Keywords [sv]
Barnhälsovård, digital support, egenvård, e-Hälsa, eHälsolitteracitet, familjefokuserad omvårdnad, föräldrar, föräldrastress, hälsolitteracitet, tillfredsställelse
National Category
Nursing
Research subject
caring sciences in social sciences
Identifiers
URN: urn:nbn:se:umu:diva-215068ISBN: 978-91-8070-158-7 (print)ISBN: 978-91-8070-159-4 (electronic)OAI: oai:DiVA.org:umu-215068DiVA, id: diva2:1803321
Public defence
2023-11-03, Ankarets Aula, Hälsocentralen Ankaret, Örnsköldsvik, Örnsköldsvik, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2023-10-13 Created: 2023-10-09 Last updated: 2024-03-22Bibliographically approved
List of papers
1. Child health nurses’ experiences and opinions of parent Internet use
Open this publication in new window or tab >>Child health nurses’ experiences and opinions of parent Internet use
2018 (English)In: Early Child Development and Care, ISSN 0300-4430, E-ISSN 1476-8275, Vol. 188, no 12, p. 1736-1747Article in journal (Refereed) Published
Abstract [en]

Background: On the basis of parents’ growing use of the Internet as a resource for health-related information, and the total lack of scientific literature about how nurses in child healthcare experience how their work is affected, further information is needed.

Purpose: This study describes child health nurses’ (CHN) experiences and opinions of parent Internet use.

Design and methods: Using a qualitative descriptive approach, CHNs (n = 20) working at Health Centres in northern Sweden were interviewed.

Results: An overarching theme named ‘Parents’ use of Internet has influenced Nurses’ work’ was identified. The theme comprises three categories; ‘Internet facilitating care, access, and provision’; ‘The Internet complicating the professional role and performance’; and ‘Sensing an imperative for a new role as a CHN.

Conclusions: These findings add a fresh perspective to understanding the new and transformed professional role of CHNs.

Place, publisher, year, edition, pages
Routledge, 2018
Keywords
Child healthcare, counselling, content analysis, e-health, information, internet advice, nurses, parenting, qualitative research
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-132097 (URN)10.1080/03004430.2017.1278697 (DOI)000447301100010 ()2-s2.0-85009829462 (Scopus ID)
Available from: 2017-03-03 Created: 2017-03-03 Last updated: 2024-03-22Bibliographically approved
2. Health-related internet information both strengthens and weakens parents’ potential for self-care: a mixed-methods study on parents’ search patterns
Open this publication in new window or tab >>Health-related internet information both strengthens and weakens parents’ potential for self-care: a mixed-methods study on parents’ search patterns
2018 (English)In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 08, no 10, p. 731-745Article in journal (Refereed) Published
Abstract [en]

Background: Today’s parents belong to the digital generation and regularly use the Internet as a source of information. Parents’ quests for health-related online information comprise an effort to manage symptoms of illness or address questions about child development which may be an expression of self-management or self-care.

Purpose: This study aims to describe health and child development related Internet search patterns used by parents of children ages zero to six, and further, how the obtained information was used in contacts with Child Health Care.

Design and Methods: A two-step mixed- method approach is used in this study, comprising both a quantitative and a qualitative approach. First, a questionnaire was distributed to parents (n = 800) at 13 health centers in a medium sized county in Sweden. Second, one narrative interview with two parents total was conducted. Descriptive and non-parametric statistics were calculated, and qualitative manifest content analyses were performed.

Results: A total of 687 completed the questionnaire, which corresponds to a response rate of 86%. The results show that 97% used the Internet for health-related and developmental child issues. The results show that parents often look at basic tips and the Internet is seen as a fast and accessible forum to obtain information. Parents often initiated their Internet searches using Google search for the specific subject, but the most common and most used website (used by 95% of parents), was the Swedish health site 1177.se. 98.4% of parents evaluated the general information searches they made on the Internet as reliable despite only 31% of the parents checking to see if the websites they used were scientifically based. Parents (81.7%) stated that they wanted their Child Health Nurses (CHN) to give them recommendations for valid websites.

Conclusions: The results in this study show that, on the one hand, the Internet could strengthen parental knowledge (support self-care capacity), but, on the other hand, the found information could worry them and increase their anxiety—negatively affected self-care capacity. The parents suggested that the information should be double-checked to establish trust and develop self-care knowledge. Having a good resource to rely on, such as personal contact with a CHN, or using reliable websites seems to strengthen and reassure parents.

Place, publisher, year, edition, pages
Scientific Research Publishing, 2018
Keywords
Health Literacy, Internet Advice, Mixed-Method, Parenting, Self-Care
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-215110 (URN)10.4236/ojn.2018.810055 (DOI)
Available from: 2023-10-09 Created: 2023-10-09 Last updated: 2024-03-22Bibliographically approved
3. Needs and expectations of nurse-led digital support among parents of children in child health care
Open this publication in new window or tab >>Needs and expectations of nurse-led digital support among parents of children in child health care
2023 (English)In: Child Care Health and Development, ISSN 0305-1862, E-ISSN 1365-2214Article in journal (Refereed) Submitted
Place, publisher, year, edition, pages
John Wiley & Sons, 2023
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-215112 (URN)
Available from: 2023-10-09 Created: 2023-10-09 Last updated: 2024-03-22
4. Nurse-led digital support in Swedish child healthcare: a pilot study
Open this publication in new window or tab >>Nurse-led digital support in Swedish child healthcare: a pilot study
(English)Manuscript (preprint) (Other academic)
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-215113 (URN)
Available from: 2023-10-09 Created: 2023-10-09 Last updated: 2024-03-22

Open Access in DiVA

fulltext(1021 kB)255 downloads
File information
File name FULLTEXT04.pdfFile size 1021 kBChecksum SHA-512
f4e558490f101d0d5984b81f0cfb0b158a6682ce885efa4f77475a6af3b6e15c3216987953b31bfe86acbbb65cc49c436b642257a815bd76a7c2b0494130238e
Type fulltextMimetype application/pdf
spikblad(108 kB)34 downloads
File information
File name SPIKBLAD01.pdfFile size 108 kBChecksum SHA-512
5b4c1c6fec1ab83a24794d72ebc3a57c13bc83c6aa0420f2c8445aa7738de8a5341878ee22580f9eae7cb6705d44ed7d86eae040753bb4702b1375f91659689e
Type spikbladMimetype application/pdf

Authority records

Valan, Lotha

Search in DiVA

By author/editor
Valan, Lotha
By organisation
Department of Nursing
Nursing

Search outside of DiVA

GoogleGoogle Scholar
Total: 255 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: 2017 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • 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