Danish care professional´s experience working with vulnerable pregnant women, mothers and their families in relation to the FACAM project: Preliminary results of a qualitative focus group study

Abstract

Introduction: Antenatal care and social service is provided according to each family's need in Denmark. However, care interventions often lack coordination across the primary and secondary sector and across professional specialists. The randomized controlled trial of the FACAM* project examines if an early and coordinated crosssectorial intervention during pregnancy and the first year after birth can improve maternal wellbeing and support the development of children in vulnerable families. The intervention consists of 1) assignment a support person during pregnancy and until the child is 6 years old and 2) provide women to participate in an individual- or group mentalization-based attachment intervention. Aim and Methods: The aim of this qualitative study is to get insight into how care professionals experience the FACAM intervention and the interdisciplinary and cross-disciplinary collaboration. Eight focus groups were conducted during the period of July 2020-September 2021. Participants were healthcare and social-care professionals working with vulnerable pregnant women and their families in the island of Funen, Denmark; Midwives, health visitors, family therapists, social workers, professionals from the alcohol-and drug treatment center, obstetricians and general practitioners. The focus groups lasted 60-120 minutes each and were audio-recorded and transcribed verbatim. Data were analyzed using a thematic analysis. Results: The preliminary analysis revealed three main themes; Perspectives on vulnerability, Working in the field of care and control, Experience of the Inter- and cross-sectorial collaboration. Perspectives on vulnerability; a) The concept 'vulnerability' as related to a diagnosis or a classified group of people or b) 'vulnerability' as a fragile period of life when problems got too big. The care professionals focused on, if and how the parents' vulnerability influenced the mother/father-child interaction. Working in the field of care and control; Gaining the families' trust was important for a successful collaboration and to give the families relevant support. However, the families' trust could be challenged if more support was needed than first allocated. Experience of the Inter- and cross-sectorial collaboration; Because of the FACAM project, new working alliances were generated. The analysis showed how poor- and well-functioning inter-or cross-sectorial collaboration made the families respectively more or less vulnerable. Conclusion: The preliminary findings underline that to provide coherent healthcare and social service for vulnerable families a joint understanding of 'vulnerability' is necessary to offer the most relevant support for the families. The inter- and cross-sectorial collaboration has to work well so the system does not increase burden on the families. Implication for practice: The practical part of the FACAM project is developed locally in the collaboration of one Municipality and a large hospital in Funen Denmark, but we assess that the overall findings from the study can be used when planning interventions with vulnerable groups in other settings. [ABSTRACT FROM AUTHOR]