title: Opportunities and burdens for nurse-midwives working in primary health care. An example from population-based cervical cancer screening in urban Sweden.
abstract: In Sweden, nurse-midwives in primary health care are responsible for taking Papanicolaou smears in population-based cervical cancer screening programs. This article discusses the manner in which a group of nurse-midwives, working with the cervical cancer screening program, view both opportunities and burdens inherent in their work. Semistructured interviews were conducted with 21 nurse-midwives engaged in screening at seven antenatal health care centers in demographically different parts of Stockholm, using a team approach to collect and inductively analyze the interviews. Results indicate discrepancies between ideals guiding the midwives and their practice. Positive aspects described by the midwives appear to be related to an ideology of care, whereas perceived burdens include the midwives' sense of powerlessness, lack of congruence between midwives' ideology and screening organization, and lack of professional familiarity with cancer. Several of these features can be related to issues that are challenges for many health care practitioners today, even in other settings. Our conclusion is that the screening program has latent potential for further development of the role of the nurse-midwife as an advocate for women throughout the lifespan and in a variety of situations.
authors.affiliation: Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden.
authors.forename: C
authors.initials: C
authors.lastname: Widmark
authors.forename: C
authors.initials: C
authors.lastname: Tishelman
authors.forename: E L
authors.initials: EL
authors.lastname: Lundgren
authors.forename: A
authors.initials: A
authors.lastname: Forss
authors.forename: L
authors.initials: L
authors.lastname: Sachs
authors.forename: S
authors.initials: S
authors.lastname: Törnberg
mesh_terms: D005260:Female; D006801:Humans; D007588:Job Satisfaction; D008403:Mass Screening / Q000379:methods; D009721:Nurse Midwives; D065006:Papanicolaou Test; D011159:Population Surveillance; D011321:Primary Nursing; D011795:Surveys and Questionnaires; D013548:Sweden; D014504:Urban Health; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control*; D014626:Vaginal Smears