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  • 1.
    Valan, Lotha
    Umeå University, Faculty of Medicine, Department of Nursing.
    Barnhälsovårdens förändrade roller och behov av digital utveckling2023Doctoral thesis, comprehensive summary (Other academic)
    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.

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  • 2.
    Valan, Lotha
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Hörnsten, Åsa
    Umeå University, Faculty of Medicine, Department of Nursing.
    Isaksson, Ulf
    Umeå University, Faculty of Medicine, Department of Nursing.
    Nurse-led digital support in Swedish child healthcare: a pilot studyManuscript (preprint) (Other academic)
  • 3.
    Valan, Lotha
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Isaksson, Ulf
    Umeå University, Faculty of Medicine, Department of Nursing.
    Hörnsten, Åsa
    Umeå University, Faculty of Medicine, Department of Nursing.
    Needs and expectations of nurse-led digital support among parents of children in child health care2023In: Child Care Health and Development, ISSN 0305-1862, E-ISSN 1365-2214Article in journal (Refereed)
  • 4.
    Valan, Lotha
    et al.
    Department of Nursing, Mid Sweden University, Sundsvall, Sweden.
    Kristiansen, Lisbeth
    Department of Health Care, Faculty of Sciences, University of Gävle, Gävle, Sweden.
    Sundin, Karin
    Department of Nursing, Umeå University, Örnsköldsvik, Sweden.
    Jong, Mats
    Department of Nursing, Mid Sweden University, Sundsvall, Sweden.
    Health-related internet information both strengthens and weakens parents’ potential for self-care: a mixed-methods study on parents’ search patterns2018In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 08, no 10, p. 731-745Article in journal (Refereed)
    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.

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  • 5.
    Valan, Lotha
    et al.
    Department of Nursing, Mid Sweden University, Sundsvall, Sweden; Department of Research and Development, Hälsocentralen Bjästa, Västernorrland County Council, Bjästa, Sweden.
    Sundin, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Kristiansen, Lisbeth
    Department of Nursing, Mid Sweden University, Sundsvall, Sweden.
    Jong, Mats
    Department of Nursing, Mid Sweden University, Sundsvall, Sweden.
    Child health nurses’ experiences and opinions of parent Internet use2018In: Early Child Development and Care, ISSN 0300-4430, E-ISSN 1476-8275, Vol. 188, no 12, p. 1736-1747Article in journal (Refereed)
    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.

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