Linkage in the chain of care: a grounded theory of professional cooperation between antenatal care, postpartum care and child health care

Abstract

PurposeThe purpose of this article is to present a Swedish study exploring health care professionals’ cooperation in the chain of care for expectant and new parents between antenatal care (AC), postpartum care (PC) and child health care (CHC). Furthermore, the rationale was to conceptualise barriers and facilitators of cooperation in order to generate a comprehensive theoretical model which may explain variations in the care providers’ experiences.MethodsThirty-two midwives and CHC nurses were interviewed in five focus group – and two individual interviews in a suburb of a large Swedish city. Grounded Theory was applied as the research methodology.ResultsOne core category was discerned: linkage in the chain of care, including six categories with subcategories. Despite the fact that midwives as well as CHC nurses have common visions about linkage, cooperation is not achieved because of interacting barriers that have different influences on the three links in the chain.ConclusionsBarriers to linkage are lack of professional gain, link perspective and first or middle position in the chain, while facilitators are chain perspective, professional gain and last position in the chain. As the last link, CHC nurses promote a linkage most strongly and have the greatest gain from such linking.

Interprofessional cooperation by midwives in the field of out-of-hospital obstetrical care: an integrative review / Interprofessionelle Kooperation von Hebammen im Handlungsfeld der ambulanten geburtshilflichen Versorgung: ein integratives Review

“…Six studies focus on the collaboration between midwives and nurses at the point where care progresses between midwifery services and child or family health care (Barimani & Hylander, 2008;Barimani & Hylander, 2012;Homer et al, 2009;Psaila, Kruske, Fowler, Homer, & Schmied, 2014;Psaila et al, 2015). This shows a particular characteristic of the care systems in Sweden and Australia.…”

“…This shows a particular characteristic of the care systems in Sweden and Australia. In both countries, mothers and their neonates are looked after by midwives during pregnancy, birth, and postpartum period (Barimani & Hylander, 2008;Homer et al, 2009). Apart from this, the health care services of both countries monitor the children from birth on up to toddler age; in Australia, this is carried out by child and family health nurses, in Sweden by child health care nurses (Barimani & Hylander, 2008;Homer et al, 2009).…”

“…In both countries, mothers and their neonates are looked after by midwives during pregnancy, birth, and postpartum period (Barimani & Hylander, 2008;Homer et al, 2009). Apart from this, the health care services of both countries monitor the children from birth on up to toddler age; in Australia, this is carried out by child and family health nurses, in Sweden by child health care nurses (Barimani & Hylander, 2008;Homer et al, 2009). In six other studies, the primary interest lies in interprofessional cooperation between midwives and physicians (Ratti et al, 2014;Schölmerich et al, 2014;Shaw, 2013;Skinner & Foureur, 2010;Smith et al, 2009;Vedam et al, 2012).…”

“…Many studies underline the benefits gained by crossprofessional cooperation in health and social services (Ayerle et al, 2014;Barimani & Hylander, 2008;Barimani & Hylander, 2012;Clancy et al, 2013;Munro et al, 2013;Peterson et al, 2007;. This is particularly the case in the care of women and families with special needs (Ayerle et al, 2014;Barimani & Hylander, 2008;.…”

“…This is particularly the case in the care of women and families with special needs (Ayerle et al, 2014;Barimani & Hylander, 2008;. Meetings between members of the various professions, where problems are jointly discussed , allow the psychosocial needs of families to be considered from all angles .…”