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Int J Integr Care. 2008;8:e77. Epub 2008 Dec 17.

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

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  • 1Centre for Family and Community Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Alfred Nobels AllĂ© 12, SE-141 83 Huddinge, Stockholm, Sweden.



The 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.


Thirty-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.


ONE 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.


Barriers 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.


chain of care; expectant/new parents; focus group; grounded theory; professional cooperation

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